REPRO 9

Question 1

candida does everyone get symp

Answer 1

30% of females are colonised with small number of candida and are asymptomatic

Question 2

what can cause candida

Answer 2

recent antibiotic therapy 
high oestrogen levels (pregnancy)
poorly controlled DM
immunocomp
decreased CD4
steroids

Question 3

symp of candida

Answer 3

intensely itchy white discharge

cottage cheese

Question 4

budding - hyphae under microsopcy

Answer 4

candida albicans

Question 5

treatment of candida

Answer 5

topical clotrimazole 500mg pessary and dotrimazole 1% cream
or
fluconazole 150mg PO stat and cream

Question 6

bacteria vagninosis is caused by what

Answer 6

gradinella vaginalis

Question 7

what are the symp in BV

Answer 7

asymp in 50%
thin water dc
fishy smell

Question 8

BV features

Answer 8

ph >4.5

clue cells

Question 9

treatment of BV

Answer 9

metronidazole 400mg BD for 7d
or
2g stat

Question 10

prostatitis symptoms

Answer 10

UTI symptoms
lower abdominal pain
pain and tender prostate on examination

Question 11

ix in prostatitis

Answer 11

G+C STI in <35s
MSU for culture and staining
FPU for STIs

Question 12

treatment of prostatitis

if high cdiff risk

Answer 12

ciprofloxacin 500mg BD for 28 days

if high CDiff infection then erimethoprim 200mg BD for 28 days

Question 13

syphilis is caused by what which does not what

Answer 13

treponema pallidum

which does not stain with gram stain

Question 14

trensmission of syphilis

Answer 14

sexual contact, transplacental/birth, parental

Question 15

primary syphilis symp

rx

Answer 15

primary chancre at site of sexual contact 90% genital. painless. non tender local LD

heals without treatment

Question 16

secondary syphilis

Answer 16

snail track ulcers buccal. fever. LD. rash including soles and palms. flu like symptoms. patchy alopecia. condylomatala.

Question 17

tertiary syphilis

Answer 17

granulomatous lesions of skin and bones. ascending aortic aneurysms. paralysis.

Question 18

late syphilis

Answer 18

CVS/neuro cx

Question 19

investigations - demonstrate of exudate from lesion

Answer 19

dark field microscopy or swab of lesion for PCR

Question 20

to see how active the disease is and to monitor it
what serology
what happens after rx

Answer 20

VDRL, RPR, IgM

should become negative after rx

Question 21

specific serology to confirm dx

Answer 21

TPPA, INNILIA, FTAAS, IgG

stays positive for life

Question 22

in tayside what

Answer 22

if positive IgG/IgM then IgM, ELISA, VDRL, TPPA

Question 23

treatment of syphilis

Answer 23

2.4 MUB penicillin IM 2 in early and 3 in late

Question 24

follow up in syphilis

Answer 24

RPR should be negative or serofast titres should decreased by fourfold in 3-6 months in early

Question 25

what is the jarich-hexheimer reaction

Answer 25

fever, rash, tachy after first dose of ABs | release of endotoxins after bacterial death

Question 26

ghonnorhea micro

Answer 26

gram neg intracellular diplococcus which is easily phagocytksed by polymorphs and can't survive outside the body

Question 27

where gonnorhoea

Answer 27

mucous membranes: genitourinary, rectum, pharynx

Question 28

symptoms of G in males

Answer 28

asymp <10% yellow/green dc dysuria

Question 29

symptoms of G in females

Answer 29

asymp in 50% increased or change in dc dysuria plevic pain

Question 30

ix for G

Answer 30

NAATS/PCR males FPU females HVS rectal/throat/eye swab for culture

Question 31

complications of gon

Answer 31

endometriosis, PID, infertility, ectopic pregnancy, prostattitis

Question 32

treatment of gon and follow up

Answer 32

ceftriaxone 500mg IM and aziathoprine 1g stat PO ceftriaxone 400mg PO test of cure in all px

Question 33

what is the commonest STI

Answer 33

chlamydia

Question 34

does chlamydia stain with gram stain and if no why

Answer 34

no | no peptidoglycan in walls

Question 35

C A-C

Answer 35

not sexually transmitted. trachoma - eye infection

Question 36

C D-K

Answer 36

genital

Question 37

C L1-L3

Answer 37

lymphogranulomatoma venerum. can mimic crohns. MSM

Question 38

PID and chlamydia link

Answer 38

PID increases the risk of chlamydia by 10

Question 39

female chlamydia symptoms

Answer 39

70% asymp post coital or inter menstrual bleeding lower abd pain dyparuria

Question 40

male chlamydia symptoms

Answer 40

``` 50% asymp urethreal dc dysuria urethritis epididmo-orchitis ```

Question 41

ix for chlamydia

Answer 41

NAATS/PCR males FPU females HVS/VVS msm - rectal swab

Question 42

complications of chlamydia

Answer 42

PID, fitz Hugh curtis Syndrome, tubal damage, chronic pelvic pan, reiters, ectopic, endometriosis

Question 43

tranmission to neonate chlamydia

Answer 43

17% conjunctivitis | 20% pneumonian

Question 44

treatment of chlmaydia | if rectal

Answer 44

azithromycin 1g stat | doxy 100mg BD for 7 days

Question 45

bad thing about NAATS/PCR

Answer 45

have to wait 5 weeks to do test of cure as will detect dead organisms