Sexually Transmitted Infections

Question 1

Why is gonorrhoea more common in men than women?

Answer 1

Gonorrhoea is an infection that is associated with frequent changing of partners

This is a behaviour seen in MSM population

Question 2

What is the name of the pathogen that causes Chlamydia?

What type of pathogen is it?

Answer 2

Chlamydia trachomatis

Question 3

What is the name of the pathogen that causes Gonorrhoea?

Answer 3

Neisseria gonorrhoea

Question 4

In adults, where do C. trachomatis and N. gonorrhoea infect?

Answer 4

Urethra
Endocervical canal
Rectum
Pharynx
Conjuctiva

Question 5

In neonates, where do C. trachomatis and N. gonorrhoea infect?

Answer 5

Conjuctiva

Pneumonia with C. trachomatis is sometimes seen too

Question 6

Symptoms of C. trachomatis and N. gonorrhoea infections in men?

Answer 6

Asymptomatic

Dysuria
Urethral discharge

Question 7

What are some complications that men infected with C. trachomatis get?

Answer 7

Epididymo-orchitis

Reactive arthritis

Question 8

Symptoms of C. trachomatis and N. gonorrhoea infections in women?

Answer 8

Asymptomatic

Discharge
Menstrual irregularity
Dysuria

Question 9

What are some complications that women with C. trachomatis and N. gonorrhoea infections get?

Answer 9

Pelvic inflammatory disease

Neonatal transmission

Fitz-Hugh-Curtis Syndrome

Question 10

What is Pelvic inflammatory disease?

Answer 10

Infection of the female upper genital tract, uterus, fallopian tube, ovaries

Caused by Chlamydia and Gonorrhea

Question 11

What problems does pelvic inflammatory disease cause for women?

Answer 11

Infertility
Ectopic pregnancies
Chronic pelvic pain

Question 12

What is Fitz-High-Curtis syndrome?

Answer 12

Inflammation of the liver capsule resulting from Pelvic inflammatory disease

Causes adhesions

Caused by Chlamydia and Gonorrhoea

Question 13

How can you tell by looking at the discharge, whether n infection is caused by C. trachomatis or N. gonorrhoea?

Answer 13

In gonorrhoea the discharge is more prominent, it is white and their is more of it

In Chlamydia it is less offensive

Question 14

C. trachomatis is an extra-cellular bacteria. True or false?

Answer 14

False

It is intracellular

Question 15

How can you test for chlamydia?

Answer 15

Female:

• endocervical swab
• self-collected vaginal swab
• first void urine

Male:
- first void urine

Question 16

Once you have received a sample from a patient suspected of having Chlamydia or Gonorrhoea, what do you do to it to check if it is either one of these?

Answer 16

Nucleic acid amplification tests

Create many copies of the bacterial DNA so you can analyse them and confirm the pathogen

Question 17

What is NAAT?

Answer 17

Nucleic acid amplification test

Used to diagnose C. trachomatis and N. gonorrhoea infections

Question 18

Management of Chlamydia?

Answer 18

Trace contacts
Test for other STIs

Azithromycin
Doxycycline

Erythromycin in pregnancy

Question 19

Which infection, Chlamydia or Gonorrhoea, are we more concerned about antibiotic resistance?

Answer 19

Gonorrhoea
It is very good at acquiring resistance from other organisms

Chlamydia is intracellular so there are no concerns there

Question 20

How can you test for Gonorrhoea?

What is it important to remember when dealing with samples with potential gonorrhoea infections?

Answer 20

Swab from male urethra or female endocervix

Use NAAT

You need to keep the samples warm or the bacteria will die

Question 21

Management of Gonorrhoea?

Answer 21

Contact tracing
Test for other STIs

Single dose: ceftriaxone injection PLUS azithromycin

Question 22

What is the name for the condition which neonates get affecting their eyes, caused by C. trachomatis and N. gonorrhoea?

Answer 22

Chlamydial or Gonococcal

Ophthalmia

Question 23

Which infection, Chlamydia or Gonorrhoea is more associated with multiple sexual partners?

Answer 23

Gonorrhoea

Question 24

Which pathogen causes Syphilis?

What type of pathogen is it?

Answer 24

Treponema pallidum

Bacteria

Question 25

There are 2 stages of Syphilis infection, name them?

Answer 25

Early: within 2 years of infection Late: over 2 years

Question 26

Syphilis is only transmissible via vaginal and anal sex. | True or false?

Answer 26

False, oral sex too

Question 27

What phases are seen within early Syphilis infection?

Answer 27

Primary Secondary Early latent

Question 28

What would you see in primary Syphilis?

Answer 28

A chancre (a painless ulcer) seen on genitals, mouth Gets better on its own

Question 29

What would you see in secondary Syphilis?

Answer 29

Multi-system disease - skin rash - mucous membrane lesions - bone pain - alopecia

Question 30

What is a chancre?

Answer 30

A painless ulcer seen in cases of Syphilis

Question 31

What is the difference in the way that these diseases are passed onto a neonate: - Chlamydia - Gonorrhoea - Syphilis?

Answer 31

C & G = passed during birth, as baby goes through the birth canal bacteria colonise the baby S = can be passed across the placenta

Question 32

What complications can arise from Syphilis infections?

Answer 32

Gummatous growths Neurosyphilis - strokes - dementia CVS: - aneurysms of a. aorta

Question 33

What are gummatous growths?

Answer 33

Soft, non-cancerous growth that can occur in liver, brain, skin etc. They have necrotic cores surrounded by inflammatory tissue They can cause deformities to the face if found on the skin

Question 34

Diagnosis of syphilis?

Answer 34

Serology | - take a sample from a genital ulcer or from a rash

Question 35

Management of Syphilis?

Answer 35

Contact tracing Test for other STIs Penicillin injection