Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCOG Part 2 > BASHH guidelines - STIs > Flashcards

BASHH guidelines - STIs Flashcards

1
Q

What is the recommendation for gonorrhoea testing in women?

A

Endocervical/vaginal specimens for NAAT
Culture - from endocervical/urethral - urine suboptimal
Rectal/pharyngeal if indicated by hx/contacts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long should women be abstinent following diagnosis of gonorrhoea?

A

Until they/partners have completed treatment

7/7 after treatment if azithromycin given

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the treatment for uncomplicated anogenital gonococcal infection?

A

Ceftriaxone 500 mg i.m. as a single dose with azithromycin 1 g oral as a single dose
(latter irrespective of chlamydial testing - for delay of ceph resistance onset)

Alternatives: Cefixime 400mg PO stat if refuses IM or Spectinomycin 2g IM - both with azithromycin

(Can be used in pregnancy/breastfeeding)
Avoid quinolones in P/BF - but also high resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the treatment of gonococcal PID?

A

Ceftriaxone 500mg i.m. immediately followed by oral doxycycline 100mg twice daily plus metronidazole 400mg twice daily for 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the treatment of disseminated gonococcal infection?

A

Ceftriaxone 1 g i.m. or i.v. every 24 hours or cefotaxime 1 g i.v. every eight hours or ciprofloxacin 500 mg i.v. every 12 hours (if the infection is known to be sensitive) or spectinomycin 2g i.m. every 12 hours

For 7/7 but if symptoms improve 24-48 hrs can be switched to oral therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the recommendation for chlamydia testing in women?

A

Vulvovaginal swab for NAAT
(Endocervical less sensitive)
Variable sensitivity for first catch urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the treatment for uncomplicated anogenital chlamydial infection?

A

Doxycycline 100mg bd for seven days (contraindicated in pregnancy)

Or

Azithromycin 1g orally in a single dose

Alternatives:
Erythromycin 500mg bd for 10–14 days
Ofloxacin 200mg bd or 400mg od for seven days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment for chlamydia in pregnancy/breastfeeding?

A

Azithromycin 1g as a single dose or
Erythromycin 500mg four times daily for seven days or
Erythromycin 500mg twice daily for 14 days or
Amoxicillin 500mg three times a day for seven days

NB Test of cure recommended in pregnancy (not generally - residual DNA can be detected 3-5/52)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When should test of cure for gonorrhoea be done?

A

Persisting symptoms or signs – test with culture, performed at least 72 hours after completion of therapy

If asymptomatic – test with NAATs where available, followed by culture if NAAT-positive. Test two weeks after
completion of antibiotic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the complications of Trichomonas vaginalis in pregnancy?

A

There is evidence that TV is associated with preterm delivery and low birth weight in pregnancy

TV infection at delivery may predispose to maternal postpartum sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the recommendation for Trichomonas testing in women?

A

Swab from posterior fornix
Self-swab - equivalent results
NAAT if available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the treatment for Trichomonas vaginalis?

A

Metronidazole 2g orally in a single dose or
Metronidazole 400-500mg twice daily for 5-7 days
In pregnancy/breastfeeding – better to avoid high dose regimen

Alternative: Tinidazole - not in T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the recommendation for failed treatment of TV?

A
  • Repeat 7 day course of metronidazole
  • If that fails -
    Metronidazole or tinidazole 2g daily for 5-7 days or
    Metronidazole 800mg three times daily for 7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the names of the criteria for diagnosis of BV?

A

Hay/Ison criteria (recommended by Bacterial Special Interest group of BASHH)
Nugent criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In which circumstances should women be treated for BV?

A
  • Symptomatic women
  • Women undergoing some surgical procedures
  • Women who do not volunteer symptoms may elect to take treatment if offered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment regimen for BV?

A
  • Metronidazole 400mg twice daily for 5-7 days or
  • Metronidazole 2 g single dose or
  • Intravaginal metronidazole gel (0.75%) once daily for 5 days
  • Intravaginal clindamycin cream (2%) once daily for 7 days

Alternatives:
Tinidazole 2g single dose
Clindamycin 300 mg twice daily for 7 days

17
Q

What is the recommendation for BV treatment in pregnancy?

A
  • Symptomatic pregnant women should be treated in the usual way
  • There is insufficient evidence to recommend routine treatment of asymptomatic pregnant women who attend a GU clinic and are found to have BV.
  • Women with additional risk factors for preterm birth may benefit from treatment before 20 week gestation
18
Q

What is the recommendation for treatment of candidiasis in pregnancy?

A
  • Colonization not assoc. with LBW or PTL
  • Topical imidazoles if symptomatic
  • Consider longer course - 50% cure for 4/7, 90% for 7/7
19
Q

What constitues recurrent vulvovaginal candidiasis?

A

At least 4 documented episodes per year
With at least partial resolution between episodes
And positive microscopy or a moderate/heavy growth of C. albicans on at least two occasions when symptomatic

Will occur in 5%

20
Q

What is the treatment for recurrent vulvovaginal candidiasis?

A

INDUCTION: Fluconazole* Capsule150mg every 72 hours x 3 doses

MAINTENANCE: Fluconazole* Capsule 150mg once a week for 6 months

(Not in pregnancy/breastfeeding)

21
Q

What proportion of sexual contacts of those with syphilis will contract the disease?

A

2/3

22
Q

How is syphilis contracted?

A

By direct contact with an infectious lesion or by vertical transmission during pregnancy

23
Q

What is the timescale of early congenital syphilis (within 2 years of birth)?

A

2/3 will be asymptomatic at birth but will develop signs within 5 weeks

24
Q

What can cause non-venereal T.pallidum infection?

A

yaws, pinta, bejel

25
Q

Which lab tests are used for T.pallidum diagnosis from lesions or infected lymph nodes?

A

Dark ground microscopy

PCR

26
Q

What are the primary serological screening tests for syphilis?

A

Treponemal EIA/CLIA (preferably that detects both IgG and IgM) or TPPA, which is preferred to TPHA

Request anti-treponemal IgM test if primary syphilis is suspected

27
Q

Which serological tests are used to assess the serological activity of syphilis?

A

Quantitative RPR/VDRL

Also used to monitor response to treatment

28
Q

What is the first line treatment of early syphilis?

A

Benzathine penicillin G 2.4 MU IM single dose

Can be used in pregnancy; if diagnosed in T3 repeat dose on day 8

29
Q

What proportion of PID is attributable to chlamydia/gonorrhoea, and what are the other commonly implicated organisms?

A

1/4

Gardnerella vaginalis, anaerobes (Prevotella, Atopobium and Leptotrichia) and other organisms commonly found in the vagina likely play a role

Mycoplasma genitalium has also been associated with PID

MRCOG Part 2 (97 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions