STI's

Question 1

What is Fitz-Hugh-Curtis Syndrome?

Answer 1

Peri-hepatitis due to an ascending gonorrhoea infection that causes inflammation in the hepatic capsule

Characterised by violin-string adhesions in the capsule

Question 1

What is used to diagnose Trichomonas vaginalis?

Answer 1

Wet prep of vaginal swab

PCR on urine if available

Question 1

What is the most common method of diagnosis for syphilis?

Answer 1

Serology

Question 2

How does the discharge in Gonorrhoea appear?

Answer 2

Thick, creamy

Can clog the urethra

Question 3

What is the most common SIT?

Answer 3

Chlamydia

Question 3

What is the trichomonas treated with?

Answer 3

Metronidazole 2g orally, single use

Tinidazole 2g orally, single use if metronidazole isn’t well tolerated

Question 4

How do chlamydia bacteria appear histologically?

Answer 4

They are obligate intracellular pathogens

Characteristic elementary bodies form

Question 6

What is the incubation period for gonorrhoea?

Answer 6

2-7 days

Question 7

Why is it important to distinguish neonatal gonococcal ophthalmia from other causes of conjunctivitis?

Answer 7

Because it requires IV antibiotics as apposed to topical antibiotics

• Cefotaxime 50mg/kg IV, 8 hours, 7 days

Question 7

Which cells does chlamydia infect?

Answer 7

Columnar epithelium

Question 9

Are asymptomatic gonorrhoea infections more common in males or females?

Answer 9

Females (80% of infections are asymptomatic)

Question 10

What samples are taken for gonorrhoea diagnosis?

Answer 10

Urine

Urethral swabs

Cervical swabs

Of samples from other areas the gonorrhoea can infect

Question 10

How is Mycoplasma genitalium treated?

Answer 10

Azithromycin 1g

Question 11

What is the causative agent of syphilis?

Answer 11

Treponema pallidum

Question 12

What are common presenting signs of STI’s?

Answer 12

Vaginal or urethral discharge

Genital lesions

Warts - anus and genitals

Generalised dermatological signs

Pelvic involvement

Question 13

What are some clinical signs of Trichomonas vaginalis?

Answer 13

Stawberry cervix (cervical erythema)

Frothy green-yellow vaginal discharge

Dysuria

Abdominal pain

Pruritis

Question 14

How is chlamydia treated?

Answer 14

Azithromycin 1g oral, 2 doses 1 week apart

or

Doxycycline, 100mg oral, BD

Question 16

What are the current, preferred treatment options for gonorrhoea?

Answer 16

Ceftriaxone 500mg IV/IM

Azithromycin 1g Oral

Question 17

What are the symptoms of chlamydia in males?

Answer 17

Dysuria

Meatal erythema (redness around the tip)

Clear urethral discharge

Testicular pain

Prostatitis

Question 18

Which stage of the chlamydia life cycle is infectious?

Answer 18

The elementary bodies

Question 19

What is the transmission rate of chlamydia to newborns?

Answer 19

50%

Question 21

For which infection is it common to test to see whether treatment has cured the disease?

Answer 21

Chlamydia

Question 22

Which STI’s can cause Pelvic Inflammatory Disease (PID)?

Answer 22

Gonorrhoea

Chlamydia

Question 23

What is clinical presentation of lymphogranuloma venereum?

Answer 23

It is a complication of chlamydia

Starts with a ulcerative genital lesion > Suppurative inguinal lymphadenopathy and procto-colitis (inflammation around rectum and colon)

Question 24

When do you test for cure with chlamydia infection?

Answer 24

4-6 weeks and also after 3 months is advised

Question 26

What is the causative agent of chlamydia?

Answer 26

*Chlamydia trachomatis*

Question 27

What is the most common presentation of chlamydia in newborns?

Answer 27

Conjunctivitis

Question 27

What are some risk factors for Trichomonas vaginalis?

Answer 27

Risky sexual behaviour Non steady partner Marijuana use

Question 29

What disease does Mycoplasma genitalium cause?

Answer 29

Urethritis in males Cervicitis, acute endometritis, PID in females May persist for 3-6 months

Question 30

What is the clinical course of syphilis infection?

Answer 30

Primary infection: ulcer on genitals, 2-3 week post infection Secondary infection: Generalised rash that will clear if left untreated Early and late latent syphilis: Asymptomatic Tertiary: 10-20 years later, can appear in any organ