sexually transmitted infections

Question 1

which types of HPV are associated with cervical cancer

Answer 1

16 + 18

Question 2

what types of HPV are associated with genital warts

Answer 2

6 + 11

Question 3

clinical sign of HPV infection

Answer 3

koilocytosis on cervical smear

Question 4

self-applied treatments of genital warts

Answer 4

podophyllotoxin, imiquimod creams

Question 5

what are some alternate treatments for genital warts

Answer 5

cryotherapy and electrocautery

Question 6

what is genital herpes

Answer 6

sexually transmitted infection caused by the herpes simplex virus

Question 7

what is the most common type of herpes

Answer 7

HSV-1

Question 8

which type of herpes virus is associated with oral herpes

Answer 8

HSV-1

Question 9

what are the 3 main stages of a herpes infection and what happens in each

Answer 9

transmission
latency - virus travels along sensory nerves to the dorsal root ganglion and remains inactive
reactivation - causes symptoms in distribution of the nerve root

Question 10

what is the incubation period for herpes

Answer 10

3-9 days

Question 11

which type of herpes is most likely to cause recurrent anogenital symptoms

Answer 11

HSV-2

Question 12

clinical presentation of genital herpes

Answer 12

multiple painful ulcers
dysuria
vaginal discharge
tender inguinal lymphadenopathy

Question 13

most common prodromal symptom of herpes recurrence

Answer 13

tingling

Question 14

investigation for genital herpes

Answer 14

NAATs - swabbing from an open ulcer

Question 15

mainstay of treatment for genital herpes

Answer 15

aciclovir

Question 16

what is gonorrhoea

Answer 16

STI caused by neisseria gonorrhoeae

Question 17

microbiology of gonorrhoea

Answer 17

gram negative intracellular diplococcus

Question 18

when is the highest incidence of gonorrhoea

Answer 18

<25 years

Question 19

primary sites of infection for gonorrhoea (4)

Answer 19

mucous membranes of the urethra, endocervix, rectum and pharynx

Question 20

extragenital complications of gonorrhoea

Answer 20

conjunctivitis, septic arthritis, pharyngitis, rectal pain and discharge

Question 21

most common presentation of gonorrhoea

Answer 21

green/yellow discharge

Question 22

investigation for suspected gonorrhoea

Answer 22

NAATs
vagina, throat, rectal or first void urine in males

Question 23

what kind of agar is required to grow gonorrhoea

Answer 23

chocolate agar

Question 24

first line management of gonorrhoea

Answer 24

ceftriaxone IM or ciprofloxacin orally

Question 25

clinical presentation of disseminated gonorrhoea

Answer 25

fever, malaise, joint pain and swelling, rash

Question 26

what is chlamydia

Answer 26

STI caused by chlamydia trachomatis

Question 27

pathophysiology of chlamydia

Answer 27

bacteria infects columnar epithelium at mucosal sites

Question 28

most common presentation of chlamydia in women

Answer 28

ASYMPTOMATIC

Question 29

symptoms of chlamydia in women

Answer 29

abnormal vaginal discharge - milky postcoital bleeding deep dyspareunia

Question 30

what is dyspareunia

Answer 30

painful intercourse

Question 31

signs of chlamydia in women

Answer 31

cervicitis +/- contact tracing endocervical discharge pelvic tenderness cervical excitation

Question 32

symptoms of chlamydia in men

Answer 32

dysuria urethral discharge testicular pain

Question 33

first choice investigation for men and women with suspected chlamydia

Answer 33

NAATs vulvo-vaginal swab for women first catch urine sample for men

Question 34

first line management for chlamydia

Answer 34

doxycycline

Question 35

complications of chlamydia

Answer 35

PID, ectopic pregnancy, reactive arthritis, epididymitis

Question 36

what symptom is most commonly associated with mycoplasma genitalium

Answer 36

urethritis

Question 37

investigation for mycoplasma genitalium

Answer 37

NAAT

Question 38

management of mycoplasma genitalium

Answer 38

doxycycline BD for 7 days

Question 39

what causes syphilis

Answer 39

treponema pallidum

Question 40

what kind of bacteria is treponema pallidum

Answer 40

spirochaete

Question 41

how can syphilis be spread (3)

Answer 41

sex, blood transfusion, during pregnancy

Question 42

what is the range of incubation period for primary syphilis infection

Answer 42

9-90 days

Question 43

what are the main stages of a syphilis infection

Answer 43

primary, secondary and tertiary

Question 44

what is early latent syphilis

Answer 44

asymptomatic syphilis of less than 2 years duration

Question 45

what is late latent syphilis

Answer 45

asymptomatic syphilis of 2 years duration or longer

Question 46

clinical presentation of primary syphilis

Answer 46

chancre

Question 47

what is a chancre

Answer 47

painless, firm open sore at the site of infection

Question 48

clinical presentation of secondary syphilis

Answer 48

non-itchy rash all over the body - particularly soles and palms fever, lymphadenopathy, malaise

Question 49

what is condylomata lata

Answer 49

grey/white, moist lesions present in secondary syphilis

Question 50

what are the 3 main presentations of tertiary syphilis

Answer 50

gummatous, cardiovascular and neurosyphilis

Question 51

investigations for suspected syphilis

Answer 51

PCR serology: treponemal IgG and IgM

Question 52

management of syphilis

Answer 52

benzathine penicillin

Question 53

what is trichomoniasis

Answer 53

type of parasite spread through sexual intercourse

Question 54

microbiology of trichomoniasis

Answer 54

flagellated protozoan parasite trichomonas vaginalis

Question 55

clinical presentation of trichomoniasis

Answer 55

discharge: frothy, yellow dysuria, dyspareunia balanitis (in men)

Question 56

clinical sign of trichomoniasis on examination

Answer 56

strawberry cervix

Question 57

management of trichomoniasis

Answer 57

metronidazole

Question 58

what is lymphogranuloma venereum

Answer 58

STI caused by the L1,2 or 3 serovars of chlamydia

Question 59

clinical presentation of lymphogranuloma venereum

Answer 59

painless genital ulcers, inguinal lymphadenopathy

Question 60

investigation for suspected lymphogranuloma venereum

Answer 60

PCR

Question 61

management of lymphogranuloma venereum

Answer 61

oral doxycycline for 21 days

Question 62

what kind of virus is HIV

Answer 62

RNA retrovirus

Question 63

what type of HIV is responsible for the global epidemic

Answer 63

HIV-1 group M

Question 64

what is the target site for HIV

Answer 64

CD4+ receptors

Question 65

where are CD4+ receptors found

Answer 65

surface of: T helper lymphocytes, dendritic cells, macrophages and microglial cells

Question 66

pathophysiology of a HIV infection (4)

Answer 66

infection of CD4 cells transport to regional lymph nodes infection is established dissemination of virus

Question 67

what is the main effect of HIV on immune response

Answer 67

reduced CD4 cells

Question 68

clinical presentation of a primary HIV infection

Answer 68

fever, rash, myalgia, headache

Question 69

what is an opportunistic infection

Answer 69

infection by an individual that does not normally produce disease in a health individual

Question 70

most common respiratory AIDS-defining condition

Answer 70

pneumocystis pneumonia

Question 71

microbiology of pneumocystis pneumonia

Answer 71

pneumocystis jiroveci

Question 72

when are HIV patients at risk of pneumocystis pneumonia

Answer 72

CD4 < 200

Question 73

clinical presentation of pneumocystis pneumonia

Answer 73

insidious onset SOB and dry cough, exercise oxygen desaturation

Question 74

management of pneumocystis pneumonia

Answer 74

high dose co-trimoxazole +/- steroid

Question 75

why do HIV patients with CD4 count < 50 need ophthalmic screening

Answer 75

for cytomegalovirus retinitis

Question 76

clinical presentation of CMV retinitis

Answer 76

reduced acuity, floaters pizza pie appearance on fundoscopy

Question 77

what causes progressive multifocal leukoencephalopathy

Answer 77

reactivation of JC virus

Question 78

clinical presentation of progressive multifocal leukoencephalopathy

Answer 78

rapidly progressing, confusion, personality change

Question 79

name 3 skin infections associated with HIV

Answer 79

herpes zoster, herpes simplex, HPV

Question 80

name 3 AIDS-related cancers

Answer 80

kaposi's sarcoma non-hodgkin lymphoma cervical cancer

Question 81

what causes kaposi's sarcoma

Answer 81

human herpes virus 8

Question 82

clinical presentation of non-hodgkins lymphoma

Answer 82

painless lymphadenopathy, B symptoms ? hepatosplenomegaly

Question 83

blood marker that might indicated NHL

Answer 83

LDH

Question 84

investigation for HIV

Answer 84

antibody testing

Question 85

management of HIV

Answer 85

HAART

Question 86

what is the most common cause of genital ulceration in sexually active young people and adults

Answer 86

herpes