Sexually Transmitted Infections

Question 1

Which type of genital herpes simplex has higher viral shedding?

Answer 1

type 2

Question 2

What STI is known as the great imitator?

Answer 2

syphilis

Question 3

What % of patients with chlamydia are asymptomatic?

Answer 3

70 women and 50% men

Question 4

What is the gram stain appearance of chlamydia?

Answer 4

gram negative

Question 5

What is the risk of PID with chlamydia?

Answer 5

9%

Question 6

What are the risks associated with an episode of PID?

Answer 6

ectopic pregnanyc and tubal factor infertility

Question 7

What are the common female presentations for chlamydia?

Answer 7

post-coital or intermenstrual bleeding; lower abdo pain; dyspareunia and mucopurulent cervicitis

Question 8

What ar ethe common male presentations for chlamydia?

Answer 8

urethral discharge; dysuria; urethritis; epididymo-orchitis; proctitis

Question 9

What are the symptoms with lymphogranuloma venereum?

Answer 9

rectal pain; discharge and bleeding

Question 10

What is the risk of other STIs associated with lymphgranuloma venerum?

Answer 10

high risk- 67% HIV

Question 11

When can chlamydia be tested for after exposure?

Answer 11

14 days

Question 12

What is the test for females for chlamydia?

Answer 12

vulvovaginal swab NAAT

Question 13

what is the test for males for chlamydia?

Answer 13

first void urine NAAT

Question 14

When should a rectal swab for chlamydia be added with MSM?

Answer 14

if has receptive anal intercourse

Question 15

What is the incubation period of urethral infection in men for gonorrhoea?

Answer 15

2-5 days

Question 16

What is the risk of transmission of gonorrhoea from an infected woman to male?

Answer 16

20%

Question 17

Waht is the risk of transmission of gonorrhoea from infected man to female?

Answer 17

50-90%

Question 18

What is the presentation of gonorrhoea in males?

Answer 18

urethral discharge; dysuria; asymptomatic (<10%)- pharyngeal/rectal

Question 19

What is the presentation of gonorrhoea in females?

Answer 19

asymptomatic (upto 50%); altered/increased vaginal discharge; dysuria; pelvic pain

Question 20

What is the first line treatment for gonorrhoea?

Answer 20

ceftriaxone 500mg IM and azithromycin 1G

Question 21

What is the second line treatment for gonorrhoea?

Answer 21

cefixim 400mg oral

Question 22

What should be done in all patients after treatment of gonorrhoea?

Answer 22

test of cure

Question 23

What is the incubation time for genital herpes?

Answer 23

3-6 days

Question 24

How long does the primary infection of genital herpes last?

Answer 24

14-21 days

Question 25

What are the symtpoms of a primary genital herpes infection?

Answer 25

blistering and ulceration of the external genitalia; pain; external dysuria; vaginal or urethral discharge; local lymphdenopathy; fever and myalgia

Question 26

What type of HSV is recurrent episodes more common with?

Answer 26

HSV-2

Question 27

What are the symptoms in recurrent episodes?

Answer 27

localised anogenital tinglin, burning or soreness, unilateral, small blisters and ulcers

Question 28

How long does it take a recurrent episode of genital herpes to resolve?

Answer 28

5-7 days

Question 29

What is the treatment for genital herpes?

Answer 29

oral aciclovir; topical lidocaine if very painful

Question 30

What is the investigation fro genital herpes?

Answer 30

swab base of ulcer for HSV PCR

Question 31

When is viral shedding higher?

Answer 31

more frequent in first year of infection; more in individuals with frequent recurrences; reduced by suppressive therapy

Question 32

What is the lifetime risk of acquiring HPV infection?

Answer 32

80%

Question 33

What types of HPV cause anogenital warts?

Answer 33

6 and 11

Question 34

What are the treatment option for HPV?

Answer 34

podophyllotoxin; imiquimod; cryotherapy; electrocautery

Question 35

What is the MOA of podophyllotoxin (Warticon)?

Answer 35

cytotoxic

Question 36

What is the MOA of imiquimod?

Answer 36

immune modifier

Question 37

What bacterium causes syphilis?

Answer 37

treponema pallidum

Question 38

How can syphilis be transmitted?

Answer 38

sexual contact; trans-placental/during birth; blood transfusions; non-sexual contact-healthcare workers

Question 39

What stages of syphilis are infective?

Answer 39

primary; secondary and early latent

Question 40

What is the mean incubation period for syphilis?

Answer 40

21 days

Question 41

Aside from a chancre what other signs are seen with priamry syphilis?

Answer 41

non-tender local lymphadenopathy

Question 42

What are the symptosm of secondary syphilis?

Answer 42

skin- macular; follicular or pustular rash on palms and soles; lesions of mucous membranes; generalised lymphadenopathy; patchy alopecia; condylomata lata

Question 43

What is condylomata lata?

Answer 43

highly infectious lesion which exudes a serum teeming with treponemes

Question 44

What is the screening serological test for syphilis?

Answer 44

ELISA/EIA (enzyme immunoassay)

Question 45

What is the treatment for early syphilis?

Answer 45

benzathine penicillin x1

Question 46

What is the treatment for late syphilis?

Answer 46

benzathine penicillin x3

Question 47

How much should titres decrease by 3-6 months in early syphilis?

Answer 47

four-fold