Microbiology

Question 1

What is the predominant organism in a healthy vagina?

Answer 1

Lactobacillus spp.

Question 2

What does a healthy vagina produce to suppress growth of other bacteria?

Answer 2

Lactic acid +/- Hydrogen peroxide

Question 3

What factors predispose to a candida infection?

Answer 3

Recent antibiotics
High oestrogen levels
Poorly controlled diabetes
Immunocompromised

Question 4

How does a candida infection present?

Answer 4

Intensely itchy white vaginal discharge

“Cottage cheese”

Question 5

How is candida diagnosed?

Answer 5

Usually clinically (can high vaginal swab)

Question 6

What is the treatment for a candida infection?

Answer 6

Topical clotrimazole (or oral fluclonazole)

Question 7

What are clue cells indicative of?

Answer 7

Bacterial Vaginosis

Question 8

What scoring system is used for BV?

Answer 8

Hay-Ison scoring system

Question 9

What is the treatment forBV?

Answer 9

Oral metronidazole

Question 10

How does prostatitis present?

Answer 10

Symptoms of UTI _ lower back/abdo/perineal/penile pain + tender prostate

Question 11

What organisms tend to cause prostatitis?

Answer 11

Same as UTI (E. coli & othercoliforms,Enterococcus sp.)

Question 12

How is prostatitis diagnosed?

Answer 12

MSSU for C & S +/- first pass urine for chlamydia/gonorrhoea tests

Question 13

What is the commonest bacterial STI in the UK?

Answer 13

Chlamydia

Question 14

Where can chlamydia infect?

Answer 14

Urethra 
Rectum
Endocervix
Throat 
Eyes

Question 15

What are Chlaymidia Serovars A-C responsible for?

Answer 15

Trachoma (eye infection)

Question 16

What are Chlamydia Serovars D-K responsible for?

Answer 16

Genital infection

Question 17

What are Chlamydia Serovars L1-L3 responsible for?

Answer 17

Lymphoganuloma venereum

Question 18

How does Chlamydia present in females?

Answer 18

Post coital bleeding
Lower abdo pain
Dyspareunia
Mucopurulent cervicitis

Question 19

How does Chlamydia present in males?

Answer 19

Urethral discharge
Dysuria
Urethritis
Epidymo-orchitis

Question 20

How is chlamydia treated?

Answer 20

Aithromycin (1g oral) if uncomplicated

Or doxycycline 100mg bd for 7 days

Question 21

How is chlammydia diagnosed?

Answer 21

NAAT or PCR
Male = FPU + rectal + throat + eye swab
Female = HVS or VVS + rectal + throat + eye swabs

Question 22

What are the complications of chlamydia?

Answer 22

PID 
Neonate transmission 
Tube damage 
Reiter's syndrome 
Adult conjuctivitis

Question 23

What type of organism is gonorrhoea?

Answer 23

Gram negative diplococcus (“2 kidney beans facing each other”)

Question 24

What is the incubation period of gonorrhoea?

Answer 24

2-5 days

Question 25

How does gonorrhoea present in males?

Answer 25

Urethral discharge | Dysuria

Question 26

How does gonorrhoea present in females?

Answer 26

Vaginal discharge Dysuria Pelvic pain

Question 27

How is gonorrhoea diagnosed?

Answer 27

NAAT or PCR

Question 28

How is gonorrhoea treated?

Answer 28

IM ceftriaxone + oral azithromycin

Question 29

Do you test for cure in chlamydia or gonorrhoea?

Answer 29

Gonorrhoea

Question 30

What are the complications of gonorrhoea?

Answer 30

``` Endometritis Bartholinitis Abscess Hydrosalphnx Infertility ```

Question 31

What spirochaete organism causes syphillis?

Answer 31

Treponema pallidum

Question 32

Does syphillis stain with gram stain?

Answer 32

Nope

Question 33

How is syphillis diagnosed?

Answer 33

Dark ground microscopy (gold standad but not avails in Tayside) Swab fro primary or secondarylesions for PCR

Question 34

What is the primary lesion in syphillis called?

Answer 34

Chancre

Question 35

How does the secondary stage of syphillis present?

Answer 35

"Snail-track" mouth ulcers Generalised rash (palms + soles) Generalised lymphadenopathy Patchy alopecia

Question 36

What test is used to screen for syphillis?

Answer 36

IgM & IgG ELISA

Question 37

What onn-specific serological tests can be useful for monitoring syphilis response to treatment?

Answer 37

VDRL or RPR

Question 38

How is syphillis treated?

Answer 38

Penicillin

Question 39

What virus tends to cause genital warts?

Answer 39

HPV

Question 40

Which serotypes of HPV are responsible for 90% of urogential warts?

Answer 40

6 & 11

Question 41

How are genital warts treated?

Answer 41

Podophyllotoxin cream/lotion | Cryotherapy

Question 42

Which types of HPV does the vacine immunise against?

Answer 42

6. 11. 16 & 18

Question 43

What causes genital herpes?

Answer 43

HSV-1 & HSV-2

Question 44

Which HSV is responsible for cold sores?

Answer 44

HSV-1

Question 45

What is th incubation period of HSV?

Answer 45

3-6 days

Question 46

Where does HSV replicate in genital herpes?

Answer 46

Epidermis & dermis

Question 47

Where does HSV "hide" in a genital herpes infection?

Answer 47

Sacralrot ganglion

Question 48

How is genital herpes diagnosed?

Answer 48

Swab of deroofed blister for PCR

Question 49

How is genital herpes treated?

Answer 49

``` Aciclovir may be helpful if taken early enough Pain relief (topical lidocaine) ```

Question 50

What is tricomonas vaginalis

Answer 50

Single celled protooal parasite

Question 51

How does trichomonas vaginalis present?

Answer 51

Frothy yellow/green musty vaginal discharge & irritation Urethritis in males Strawberry cervix

Question 52

How is trichomonas vaginalis diagnosed?

Answer 52

HVS for microscopy

Question 53

How is trichomonas vaginalis treated?

Answer 53

Oral metronidazole

Question 54

How long do pubic lice live in males & females?

Answer 54

``` Male = 22 days Females = 17 days ```

Question 55

How are pubic lice treated?

Answer 55

Malathion lotion