Gonorrhoea

Question 1

What is gonorrhoea?

Answer 1

An infection of mucuous membranes and columnar epithelium caused by Neisseria gonorrhoeae, a gram negative diplocpccus

Question 2

Where can gonorrhoea cause infection?

Answer 2

Endocervix, urethra, rectum, conjunctiva, pharynx

Question 3

Risk factors for gonorrhoea and chlamydia?

Answer 3

Having other STIs, HIV, young, sexually active, multiple partners

Question 4

Signs and symptoms of gonorrhoea?

Answer 4

More likely symptomatic than chlamydia

Odolourless, YELLOE/GREEN purulent discharge

Dysuria

Pelvic pain

Conjunctivitis w/ purulent discharge

Rectal discomfort/discharge

Male specific symptoms:
epidiymo-orchitis, prostatitis

Question 5

Investigations for gonorrhoea?

Answer 5

NAAT for diagnosis of gonorrhoea

Charcoal endocervical swab for MC&S to determine antibiotic treatment

Question 6

What antibiotics is Neisseria gonorrhoeae mostly resistant to?

Answer 6

Ciprofloxacin
Azithromycin

Question 7

Management of gonorrhoea?

Answer 7

IM ceftriazone 1g if sensitivies NOT known

Oral ciprofloxacin 500mg if sensitivities ARE known

Abstain from sex for 7 days after treatment started

Test + treat for other STI

Advise patient on preventing future STI

Safeguarding if patient is child

Question 8

When should the test of cure follow up be initiated after commencing treatment for gonorrhoea?

Answer 8

If symptomatic -> 72h after, if cultures used for treatment

If asymptomatic -> 7 days after if diagnosed with RNA NAAT OR 14 days after if diagnosed with DNA NAAT

Question 9

What is a complication of gonorrhoea in a pregnant mother for her child?

Answer 9

Neonatal gonococcal conjunctivitis
aka opthalmia neonatorum.

Medical emergency -> perforation of eye, sepsis

Question 10

What is the condition when gonorrhoea spreads to the skin and joints?

Answer 10

Disseminated gonococcal infection?

Symptoms:
various skin lesions
polyarthralgia
Migratory polyarthritis
Tenosynovitis
Fever
Fatigue