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PHCY320 GULT20 STIs STUDY SET EXAM
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PHCY320 GULT20 STIs STUDYSET EXAM
Risk populations for STIs - Answer Infants infected in utero or during delivery.
Sexually active young adults & further increased with risk behaviours (alcohol, drug
use, multiple partners, not using barrier protection, other STI past/current).
Chlamydia trachomatis - Answer A non-motile, gram negative, cocci bacteria. Has two
specialised forms: intracellular or extracellular and in humans, is an obligate
intracellular pathogen. It can affect the eyes, genitals and lower gastrointestinal tract.
Chlamydia is the most commonly diagnosed - Answer STI in NZ.
Chlamydia cases are most often - Answer Young females (reflects testing).
C. trachomatis disease in women are - Answer Commonly asymptomatic, if
symptomatic: urethritis, cervicitis, purulent discharge, burning sensation.
If C. trachomatis is left untreated, - Answer It could lead to ascending infections which
could lead to PID, involvement of the uterus, Fallopian tubes, ovaries leading to chronic
pain, infertility or ectopic pregnancy.
C. trachomatis disease in neonates are - Answer Premature birth, conjunctivitis,
pneumonia.
C. trachomatis disease in men are - Answer Asymptomatic, urethritis (discharge, pain
on urination), epididymitis (swollen, painful testicles), proctitis (rectal infection; pain,
bleeding, discharge). If left untreated can lead to infertility.
Diagnosis of C. trachomatis - Answer Direct culture not possible (intracellular), PCR test
is available (self-test kit).
Treatment of C. trachomatis - Answer 1 or 7 day therapy & contacts must also be
treated.
Asymptomatic urogenital infection: Azithromycin 1g po stat
Symptomatic urethritis, rectal pharyngeal or eye infection, or if pt on QT-prolonging
medication: Doxycycline 100mg po twice daily for 7 days (NOT in pregnancy)
Prevention of C. trachomatis - Answer Education, screening programs for high risk.
Currently no vaccines available(many immune evasion mechanisms, intracellular
organism, need to stimulate mucosal immunity in the reproductive tract but animal
studies suggest stimulating protective immune responses is possible).
, Screening rates for C. trachomatis is - Answer Low(20-60%) & variable for pregnant
women.
The percentage of infected from those screened is - Answer 10%.
High risk groups for C. trachomatis includes - Answer Sexually active <30y or >2 sexual
contacts in last year or had an STI in the past 12 months or has a sexual contact with an
STI, pregnant, increased risk of complications, signs or symptoms suggestive of
chlamydia, requesting a sexual health check.
Signs or symptoms suggestive of chlamydia are - Answer Females: vaginal discharge,
dysuria, lower abdominal pain, abnormal bleeding, anal pain or discharge
Males: Urethral discharge, dysuria, testicular pain or swelling, anal pain or discharge.
Neisseria gonorrhoeae - Answer A gram negative, diplococci bacteria. Person-person
transmission. It can only affect the mucus membranes lined with columnar epithelium
(urethra, cervix, rectum, pharynx, conjunctiva).
Gonorrhoea in adults - Answer May be asymptomatic or if symptomatic: inflammation,
dysuria, discharge, pain on urination may be extreme.
If gonorrhoea is left untreated could lead to complications - Answer Ascending
infection(male - prostate, testicles, female - PID) causing infertility or systemic
spread(endocarditis, meningitis).
Gonorrhoea in neonates - Answer Ocular infection can lead to blindness.
Gonorrhoea Testing/Diagnosis - Answer Self collected sampling possible, first line test
is nucleic acid amplification tests(NAAT), culture for detection of new/unknown
antimicrobial resistance mutations, follow up test at 3 months.
Routine testing should occur for high risk individuals (2 weeks post contact).
Gonorrhoea Treatment - Answer Many strains are now AMR, should also treat for
chlamydia (vv).
Gonorrhoea Prevention - Answer Currently no vaccines.
Trichomonas vaginalis (TV) is a - Answer Protozoa, obligate human pathogen of
genitourinary
tract, twitching motility, sexually transmitted. It is common & often found with other STI
pathogens (risk factor for other STI).
TV disease in women - Answer Commonly asymptomatic, severe vaginitis, thin frothy
yellow-green discharge, foul odour, vulva red and swollen, itching, post-coital bleeding,
cervical haemorrhage, +/- abdominal pain.
TV complications in women - Answer Risk factor for other STI, pre-term delivery, very
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