Urethritis Flashcards
1
Q
What is urethritis?
A
- Inflammation of urethra
- Gonococcal urethritis or non-gonococcal
2
Q
Causative organisms for each urethritis type
A
- Gonococcal - neisseria gonorrhoeae
- Non-gonococcal - Chlamydia trachomatis, mycoplasma genitalium, trichomonas vaginalis
3
Q
RF for urethritis
A
- Age <25
- Men who have sex with men
- Previous STI
- Recent/new sexual partner
- One or more partner in last year
4
Q
Symptoms of urethritis
A
- Dysuria
- Penile irritation
- Discharge from urethral meatus
- Complications - eg reactive arthiritis, epididymitis
5
Q
Sexual history importance urethritis
A
- Narrow down likely pathogens
- Risk stratify burden of disease
- Inform necessary additonal sexual health screens
- Partner notification
6
Q
What is reactive arthiritis? Common causative organisms
A
- Sterile inflammatory arthritis
- Caused by distant infection producing autoimmune response in certain joints
- Commonly caused by chlamydia trachomatis, chlamydia pneumoniae, camplylobacter, shigella or salmonella
7
Q
Presentation of reactive arthiritis
A
- Lower limb joints
- Oligoarthiritis
Other extra-articular:
* Conjunctivitis/uveitis
* Urethritis/cervicitis/prostatitis
* Keratoderma blenorrhagicum
* Painless oral ulcers
* Malaise/fatigue
8
Q
Management reactive arthiritis
A
- Usually resolves within 6 months
- Rest
- Treat affected joint with NSAIDs or local steroid injections
9
Q
Bedside tests for urethritis
A
- Urethral swab - gram stain
- First void urine NAAT - gonorrhoea, chlamydia, m.genitalium
- Urine dip - send MSU for MC&S if suggests infection
- Consider further STI testing eg HIV and syphilus serology
10
Q
What is triple site testing?
A
- Swab genitals, pharynx and rectum
- Do this if suspect gonococcal infection
11
Q
Management urethritis
A
Abx - BASHH guidelines
12
Q
Abx for gonococcal vs non-gonococcal urethritis
A
- Gonococcal - Ceftriaxone IM + Azithromycin PO
- Non-gonococcal - Doxycycline oral OR Azithromycin PO
13
Q
Long term management urethritis
A
- Abstain from sexual activity until abx course finished, symptoms have resolved and sexual partners treated
- If gonorrhoea - test of cure is needed
- Counsel on condom use
- Advise to notify sexual partners and to attend sexual health clinic for testing and treatment
14
Q
Contact tracing guidelines urethritis
A
15
Q
A
