STIs

Question 1

What is the most common STI?

Answer 1

Chlamydia, by a long way

Question 2

What is the causative organism of chlamydia?

Answer 2

Chlamydia trachomatis

Question 3

What % of people with chlamydia are asymptomatic?

Answer 3

WOmen= 70%
Men= 30%

Question 4

What are the features of chlamydia in men?

Answer 4

Slight watery urethral discharge, esp in morning
Dysuria
Itch

Question 5

What are the features of chlamydia in women?

Answer 5

Change in bleeding pattern- IMB, PCB
Dysuria
Vaginal discharge
Pelvic pain
Dyspareunia

Question 6

How is chlamydia diagnosed?

Answer 6

NAAT at least 2 weeks after possible exposure of

• first void urine in men
• low vaginal swab in women
• rectal/pharyngeal swab

Question 7

What is the management of chlamydia?

Answer 7

Doxycycline 100mg 2x daily for 7 days

Question 8

What is the alternative management of chlamydia?

Answer 8

High dose azithromycin if intolerant to doxy

Question 9

What are the possible complications of chlamydia?

Answer 9

Reiter's syndrome
Men= epididimytis
Women
-PID
-endometriosis
-ectopic pregnancy
-infertility

Question 10

What is the 2nd most common STI?

Answer 10

Gonorrhoea

Question 11

What is the causative organism of gonorrhoea?

Answer 11

Neisseria gonorrhoeae

Question 12

How % of people with gonorrhoea are asymptomatic?

Answer 12

10% men

50% women

Question 13

What are the symptoms of gonorrhoea in men?

Answer 13

Profuse thick yellow-y discharge

Dysuria

Question 14

What are the symptoms of gonorrhoea in women?

Answer 14

Vaginal discharge
Change in bleeding pattern- IMB, PCB
Dysuria

Question 15

How is gonorrhoea diagnosed?

Answer 15

NAAT of

• first void urine in men
• low vaginal swab in women
• rectal/pharyngeal swab

Question 16

What is the management of gonorrhoea?

Answer 16

IM ceftriaxone once

Question 17

What are the complications of gonorrhoea?

Answer 17

Disseminated gonococcal infection
Men= epididimytis
Women= PID, Bartholin’s cyst

Question 18

What does disseminated gonococcal infection cause?

Answer 18

Tenosynovitis
Migratory polyarthritis
Dermatitis

Question 19

What causes genital warts?

Answer 19

HPV 6 and 11

Question 20

What is the normal presentation of HPV 6 and 11?

Answer 20

Asymptomatic

Question 21

What are the features of genital warts?

Answer 21

Lumps with surface texture of cauliflower

Itching, bleeding

Question 22

How are genital warts diagnosed?

Answer 22

Clinically on appearance

Biopsy if unusual

Question 23

What is the management of genital warts?

Answer 23

1. Topical podophyllum
2. Imiquimod cream
   Cryotherapy- good for solitary keratinised warts
   Diathermy
   Scissor removal

Question 24

When is podophyllotoxin cream avoided?

Answer 24

Pregnant, or trying women

Teratogenic

Question 25

What is the causative organism of herpes?

Answer 25

HSV 1 and 2

Question 26

What ar the features of herpes?

Answer 26

80% asymptomatic Primary= painful genital ulceration, lymphadenopathy, neuralgic pain, flu like symptoms, dysuria Recurrences

Question 27

How is herpes diagnosed?

Answer 27

Clinical impression | Occasional PCR swab of ulcer

Question 28

What is the management of herpes?

Answer 28

Oral aciclovir and lidocaine ointment

Question 29

What are the complications of herpes?

Answer 29

Autonomic neuropathy Neonatal infection Secondary infection

Question 30

Who is syphilis seen in?

Answer 30

>90%= MSM

Question 31

What is th causative organism of syphilis?

Answer 31

Treponema pallidum

Question 32

What ar th 3 stages of syphilis?

Answer 32

Primary Secondary Tertiary

Question 33

What are the features of primary syphilis?

Answer 33

Local ulcer aka chancre- firm, round and painless

Question 34

What are the features of secondary syphilis?

Answer 34

``` Triad -Rash- involves palms and soles -Mucosal ulceration -lymphadenopathy Fever ```

Question 35

What are the features of congenital syphilis?

Answer 35

``` Blunted incisors Saber shins Saddle nose Keratitis Deafness ```

Question 36

What are the types of symptoms in tertiary syphilis?

Answer 36

Neuro, CV or gummatous

Question 37

How is syphilis diagnosed?

Answer 37

Cardiolipin tests | Treponomal specific antibodies

Question 38

How is syphilis treated?

Answer 38

IM benzathine penicillin OR doxycycline

Question 39

What are the complications of syphilis?

Answer 39

Neurosyphilis- CN palsies common , Argyll Robertson pupils CV involvement Congenital syphilis

Question 40

What ar the symptoms of trichomonas vaginalis in men?

Answer 40

asymptomatic | urethritis

Question 41

What are the features of trichomonas vaginalis in women?

Answer 41

Profuse, thin vaginal discharge- greenish, frothy, foul smelling Itch Vulvitis Strawberry cervix

Question 42

How is trichomonas vaginalis diagnosed?

Answer 42

PCR and microscopy of swab

Question 43

What is the management of trichomonas vaginalis?

Answer 43

Oral metronidazole

Question 44

What are the complications of trichomonas vaginalis?

Answer 44

Miscarriage | Preterm labour

Question 45

What is lymphogranuloma venereum?

Answer 45

STI of lymphatics caused by chlamydia trachomatis

Question 46

What are the features of lymphogranuloma venereum?

Answer 46

Pustule progressing to ulcer | Painful inguinal lymphadenopathy

Question 47

What is a chancroid?

Answer 47

Painful genital ulcer with unilateral lymph node enlargement | Common in developing world but rare in UK

Question 48

What causes a chancroid?

Answer 48

H. ducreyi