STI

Question 1

RF for STIs

Answer 1

Unprotected sex
Multiple sexual partners
Sex with people with multiple sexual partners
MSM
Prostitution (CSW)
Illict drug use

Question 2

Sx and Abx for Uncomplicated urogenital gonorrhea

Answer 2

Neisseria gonorrhoeae (intracellular gram-ve diplococci)

1w after;
Yellow mucopurulent discharge and pain when urinating, dysuria, urinary frequency

IM ceftriaxone 500mg single dose for <150kg
OR
IM Gentamycin 240mg + PO Azithromycin 2g

Question 3

Sx and Abx for Chlamdydial

Answer 3

Chlamydia trachomatis

1-3w after;
white/yellow discharge and pain when urinating

PO Doxycycline 100mg BD x7d
OR
PO Azithromycin 1g, single dose
OR
Levofloxacin 500mg OD x7d

Question 4

Sx and Abx for Syphilis

Answer 4

treponema pallidum

1w-3m;
Painless sore on genital, anus or mouth tt heals by itself but rashes appear on face, palm and soles

Primary:
IM Benzathine pen G 2.4m units x 1dose
OR
(pen-all) PO doxycycline 100mg BD x14d

Late latent(>1y):
IM Benzathine pen G 2.4m units once weekly x 3dose
OR
(pen-all) PO doxycycline 100mg BD x 28d

Neurosyphilis: IV Crystalline pen G 3-4m units q4h or 18-24MU/d x 10-14d
OR
IM Procaine pen G 2.4m units OD + PO probenecid 500mg QDS x10-14d
OR
(pen-all) IM/IV ceftriaxone 2g OD x10-14d

Question 5

Sx and Abx for gential herpes

Answer 5

Small blisters develop over 7-10d → ulcers in gential/anal region, possible swelling of groin lymph nodes;
Lasts 2-3w;
Local itching; flu-like sx during first few days of lesion appearance; prodromal sx (itching, burning, tingling)

PO Acyclovir 400mg TDS x7-10d
OR
IV 5-10mg/kg q8h x 2-7d + po for total of 10d
OR
PO Valacyclovir 1g BD x7-10d