23. STDs

Question 1

What pathogen causes syphilis?

Answer 1

Treponema pallidum

Question 2

How long is the incubation period of syphilis?

Answer 2

3-90 days

Question 3

What are symptoms of primary syphilis?

Answer 3

single painless chancre at sight of innoculation

Question 4

How long after the primary infection is the secondary syphilis infection?

Answer 4

2-12 weeks

Question 5

What are the signs and symptoms of a secondary syphilis infection?

Answer 5

Rash on palms and soles
Fever, sore throat, malaise
CNS
Condyloma lata

Question 6

What are the symptoms of tertiary syphilis?

Answer 6

Aortitis
Neurosyphilis: meningitis, spinal cord lesions
Gummas (granulomatous)

Question 7

What are the symptoms of early congenital syphilis?

Answer 7

Baby under 2
Hepatomegaly, lymphadenopathy
Rhinitis, rash
Skeletal abnormalities

Question 8

What are the symptoms of late congenital syphilis?

Answer 8

Baby older than 2
Facial features, Hutchinson teeth
Intellectual disability

Question 9

How is syphilis diagnosed?

Answer 9

Dark field microscopy of chancre
Serology: specific and qualitative vs non-specific quantitative
CSF serology if neurosyphilis

Question 10

What is the treatment for syphilis?

Answer 10

Penicillin G

Question 11

What is the treatment for syphilis if the patient has a penicillin allergy?

Answer 11

Doxycycline

Question 12

How long is the treatment for early, late and neurosyphilis?

Answer 12

Early: 1 dose IM
Late: 3 weeks 1 dose IM
Neuro: 10-14 IV

Question 13

What adverse reaction occurs when treating syphilis?

Answer 13

Jarisch Herxheimer reaction

Release of spirochaete antigens once the treatment begins causes an immune response

Question 14

What agar is used to culture neisseria gonorrhoea?

Answer 14

NYC

Question 15

What are the clinical features of gonorrhoea?

Answer 15

Majority asymptomatic
Men: urethritis and epididymitis
Women: cervicitis, PID

Question 16

What can gonorrhoea cause in infants?

Answer 16

Ophthalmia neonatorum

Question 17

How is gonorrhoea diagnosed?

Answer 17

Microscopy and culture: urethral swab, conjunctival swab

NAAT: first void urine, endocervical/vulvovaginal swab

Question 18

What is the treatment for neisseria gonorrhoea?

Answer 18

IM ceftriaxone

Question 19

What are the symptoms of chlamydia D-K in women?

Answer 19

Cervicitis
Urethritis
PID and pregnancy complications

Question 20

What are the symptoms of chlamydia D-K in men?

Answer 20

Urethritis
Acute epididymitis
Proctitis

Question 21

How is chlamydia diagnosed?

Answer 21

NAAT on swabs

aspirate buboes in L serovars

Question 22

What is the treatment for chlamydia D-K?

Answer 22

Macrolide or doxycylcine

Question 23

What are the stages of a lymphogranulomatous venerum infection?

Answer 23

Primary: ulcer
Secondary: inguinal lymphadenopathy, proctitis
Late: fibrosis

Question 24

What is the treatment for lymphogranuloma venerum?

Answer 24

Doxycycline for 3 weeks

Question 25

What kind of pathogen is trichomonas vaginalis?

Answer 25

Protozoa

Question 26

What is the clinical significance of trichomonas vaginalis?

Answer 26

Women: vaginal discharge, itchy vulva, dysuria, prem rupture of membranes and low birth weight Men mostly asymptomatic

Question 27

What is the treatment for trichomonas vaginalis?

Answer 27

Metronidazole

Question 28

What pathogen causes chancroid?

Answer 28

Haemophilus ducrej

Question 29

What are the features of chancroid?

Answer 29

Ulcer and tender inguinal lymphadenopathy

Question 30

What is the management of chancroid?

Answer 30

Aspirate | Azithro, ceft and cipro

Question 31

Where does latent herpes reside?

Answer 31

Sacral nerve ganglia

Question 32

What management can reduce the incidence of neonatal herpes simplex?

Answer 32

Suppressive therapy in third trimester | C-section

Question 33

Which HPV viruses cause genital warts?

Answer 33

6 and 11

Question 34

What treatments can be used to remove genital warts?

Answer 34

Chemical/physical destruction with trichloroacetic acid Immunological therapy with imiquimod Surgical excision/cryotherapy

Question 35

What links are there between HIV and other STDs?

Answer 35

Disrupted mucosa allows HIV to enter easily | Increased HIV secretion in co-infection