STIs

Question 1

What Sx are associated with urethritis?

Answer 1

Discharge
Frequency/dysuria
Dyspareunia (women)
Meatitis

Question 2

Which of gonorrhoea and chlamydia is usually asymptomatic and which is often symptomatic?

Answer 2

Gonorrhoea usually Sx

Chlamydia usually no Sx

Question 3

Is gonorrhoea usually symptomatic?

Answer 3

Yes

Question 4

Is chlamydia usually symptomatic?

Answer 4

No

Question 5

What investigations are appropriate for urethritis?

Answer 5

Gram stain discharge swabs looking for WBCs

Question 6

Presence of what on gram stain indicates gonorrhoea? Absence = what?

Answer 6

Presence of gram negative intracellular diplococci

Absence = non-gonococcal urethritis

Question 7

What is the next step after identifying presence of gonorrhoea infection?

Answer 7

Culture and sensitivity for neisseria gonorrhoea

Question 8

What investigation is used for identifying both chlamydia and gonorrhoea?

Answer 8

PCR

Question 9

What is urethritis if not caused by gonorrhoea or chlamydia?

Answer 9

Non-specific urethritis

Often mycoplasma or ureaplasma

Question 10

Treatment for gonorrhoea?

Answer 10

Ceftriaxone 500mg OD (/cefexime 400mg PO)
And azithromycin 1g single dose
Alternatively ciprofloxacin/ofloxacin BD for 7 days

Question 11

Treatment for chlamydia?

Answer 11

Doxycycline 100mg BD for 7 days

Or azithromycin 1g PO stat

Question 12

What are the 2 most common causes of urethritis?

Answer 12

Gonorrhoea

Chlamydia

Question 13

3 common infectious causes of vaginal discharge?

Answer 13

BV
Trichomonas
Candida

Question 14

What is the pathophysiology behind BV?

Answer 14

Anaerobic gardnerella vaginalis replace lactobacilli in vagina

Question 15

Describe the discharge associated with BV?

Answer 15

Malodorous, grey, ‘dirty’

Question 16

What is Fitz-Hugh-Curtis syndrome?

Answer 16

Perihepatitis with violin string adhesions, caused by gonorrhoea spread via paracolic gutters

Question 17

Complications of gonorrhoea or chlamydia infection?

Answer 17

Local abscess/Bartholinitis in women
Epididymo-orchitis or prostatitis in men
PID
Disseminated gonococcal infection (FHC syndrome)
Neonatal ophthalmia/conjunctivitis

Question 18

In what 2 groups is BV more common in?

Answer 18

WSW and IVDU

Question 19

Ix to identify BV?

Answer 19

Often clinical - KOH ‘sniff test’

Clue cells on smear

Question 20

Rx for BV if required?

Answer 20

Metronidazole

Question 21

Describe the Sx associated with vaginal candidiasis?

Answer 21

Vulvovaginitis - itch worse at night, non-malodorous white discharge, painful fissuring

Question 22

RFs for candidiasis?

Answer 22

Poor hygiene

Immunosuppression - DM, pregnancy, HIV

Question 23

What can a film show when sample is positive for candidiasis?

Answer 23

Spores and pseduohyphae

Question 24

Rx for candidiasis?

Answer 24

Pessary - clotrimazole

Single dose fluconazole

Question 25

What is Trichomonas infection?

Answer 25

Causes very offensive vaginal discharge and itching

Question 26

Is trichomonas symptomatic in men? Under what circumstances?

Answer 26

Often no unless Afro-Caribbean

Question 27

Results on film positive for trichomonas?

Answer 27

Motile flagellated protozoa on wet slide

Question 28

Rx for trichomonas?

Answer 28

Metronidazole

Question 29

2 common causes of genital ulcers?

Answer 29

HSV infection | Syphillis - treponema pallidum

Question 30

Bacterial cause of chlamydia?

Answer 30

Chlamydia trachomatis

Question 31

2 types of HSV causing ulcers? Which is which?

Answer 31

Oral = HSV1 Genital = HSV2 Although the 2 are interchangeable

Question 32

What diagnostic method is used for coding HSV infection?

Answer 32

PCR

Question 33

Rx (if necessary) for HSV?

Answer 33

Aciclovir topical

Question 34

Causative microorganism of Syphillis?

Answer 34

Treponema pallidum

Question 35

What is the first sore that presents in a Syphillis infection called?

Answer 35

Primary chankre

Question 36

What rash is commonly associated with Syphillis?

Answer 36

Palmarplantar

Question 37

Someone presents with a sore, rash, painless lymphadenopathy. What 2 things should be considered?

Answer 37

HIV | Syphillis

Question 38

Possible manifestations for early (infectious) period of Syphillis (

Answer 38

Primary, secondary or early latent

Question 39

Manifestations of late (non-infectious) period of Syphillis (>2 years)?

Answer 39

Late latent CV infection Neurosyphillis Gummatous liver

Question 40

What organism may be visible on microscopy in a Syphillis infection?

Answer 40

Spirochete

Question 41

3 tests for Syphillis in the lab?

Answer 41

PCR | Serology - VDRL (nonspecific) and treponemal IgG EIA

Question 42

2 serological tests for Syphillis?

Answer 42

VDRL | Treponemal IgG EIA

Question 43

Rx for Syphillis?

Answer 43

Benzathine penicillin injection | Or doxycycline

Question 44

Tropical infections causing genital warts?

Answer 44

Chancroid | Lymphogranuloma (tropical chlamydia with HIV association)

Question 45

What are the common causative agents of genital warts?

Answer 45

HPV 6 and 11

Question 46

What is Gardasil protective against?

Answer 46

HPV 6, 11, 16 and 18

Question 47

Rx approaches for genital warts?

Answer 47

Freezing (cryotherapy) Cautery Podophyllotoxin Imiquimod

Question 48

What is molloscum contagiosum?

Answer 48

Can cause genital warts but also commonly spread around schoolyards eg on arms