STIs

Question 1

What is the commonest bacterial STI in the UK?

Answer 1

Chlamydia

Question 2

Women with chlamydia are at high risk of developing PID. True/false?

Answer 2

False - 9%

Question 3

A patient with chlamydia develops PID. Give two risks of this.

Answer 3

Ectopic pregnancy

Tubal infertility

Question 4

How does chlamydia present in a female?

Answer 4

Bleeding - post-coital/intermenstrual
Lower abdo pain
Dyspareunia

Question 5

How does chlamydia present in a male?

Answer 5

Urethral discharge
Dysuria
Urethritis
Epididymo-orchitis

Question 6

Give some potential complications of chlamydia infection

Answer 6

PID
Tubal damage
Chronic pelvic pain
Conjunctivitis
Reactive arthritis

Question 7

How long after exposure should chlamydia be tested for?

Answer 7

14 days

Question 8

What test is used to diagnose chlamydia and how is it taken in males/females?

Answer 8

NAAT
Females - vulvovaginal swab
Males - first void urine

Question 9

When should a rectal swab for chlamydia be added?

Answer 9

Receptive anal intercourse

Question 10

What is the treatment for chlamydia?

Answer 10

Doxycycline 100 mg twice daily for 1 week

Question 11

How does gonorrhoea present in men?

Answer 11

Mucopurulent urethral discharge

Dysuria

Question 12

How does gonorrhoea present in women?

Answer 12

Increased vaginal discharge
Dysuria
Pelvic pain

Question 13

Give some potential complications of gonorrhoea

Answer 13

Bartholinitis
Endometritis
PID
Rectal/periurethral abscesses
Prostatitis

Question 14

What test is done to screen for gonorrhoea?

Answer 14

NAATs

Question 15

What is the first-line treatment for gonorrhoea?

Answer 15

Ceftriaxone 500mg IM

Question 16

When is test of cure carried out in patients with gonorrhoea?

Answer 16

2 weeks

Question 17

What are the incubation and duration periods of genital herpes?

Answer 17

Incubation - 3-6 days

Duration - 14-21 days

Question 18

Give some symptoms of primary genital herpes

Answer 18

Blistering/ulceration of external genitalia
Pain
Dysuria
Discharge
Lymphadenopathy

Question 19

Recurrent episodes of genital herpes are more common with which HSV? Why?

Answer 19

HSV 2

Higher rates of viral shedding

Question 20

How do recurrent episodes of HSV present?

Answer 20

Unilateral small blisters and ulcers

Question 21

Outline the management of genital herpes

Answer 21

Swab base of ulcer for PCR
Oral acyclovir
Topical lidocaine

Question 22

When should you be very concerned about an episode of genital herpes?

Answer 22

First episode in 3rd trimester

Question 23

What is the most common viral STI in the UK?

Answer 23

HPV

Question 24

Give the main low and high risk HPV serotypes

Answer 24

Low risk - 6 & 11

High risk - 16 & 18

Question 25

How may HPV infection present?

Answer 25

Anogenital warts

Question 26

What treatment is available for genital warts?

Answer 26

Podophyllotoxin Imiquimod Cryotherapy - pregnancy

Question 27

The HPV vaccine covers which serotypes?

Answer 27

6, 11, 16 and 18

Question 28

What bacterium causes syphilis?

Answer 28

Treponema pallidium

Question 29

What are the stages of acquired syphilis infection?

Answer 29

``` Primary Secondary Early latent Late latent Tertiary ```

Question 30

What is the average incubation period of primary syphilis infection?

Answer 30

21 days

Question 31

How does primary syphilis infection classically present?

Answer 31

Primary painless chancre

Question 32

Give some clinical features of secondary syphilis

Answer 32

Macular/follicular rash Mucous membranes lesions Lymphadenopathy Condylomata lata

Question 33

What test is usually done to diagnose syphilis?

Answer 33

PCR

Question 34

What can be done to test for antibodies to pathogenic treponemes?

Answer 34

Serological testing

Question 35

What is the main serological screening test for treponema?

Answer 35

ELISA

Question 36

How is syphilis treated?

Answer 36

2.4 MU benzathine penicillin

Question 37

How is syphilis followed up serologically?

Answer 37

Testing RPR titres to see if they decrease