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Maddy DipGUM > Basic GU > Flashcards

Basic GU Flashcards

1
Q

What’s the chlamydia concordance rates between partners?

A

75%

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2
Q

What’s the spontaneous clearance rate of chlamydia?

A

50% by 12 months

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3
Q

How many a) men and b) women are symptomatic for chlamydia?

A

Men 60%

Women 20%

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4
Q

In MSM what are Chlamydia rates a) rectally b) pharyngeal?

A

A) rectal 3-10.5%

B) pharyngeal 0.5-2.3%

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5
Q

What % of LGV is asymptomatic?

A

26%

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6
Q

Chlamydia treatment: what to give if azithro and doxy contraindicated.

A

Erythromycin 500mg BD for 14 days
Or
Ofloxacin 200mg BD for 7 days

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7
Q

Chlamydia treatment in pregnancy

A 
Azithromycin
Or 
Erythromycin 50pmg qds for 7 days 
Or
Amoxicillin 500mg tds for 7 days
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8
Q

Time frame for a) opthalmia neonatorum b) pneumonia?

A

A) 5-12 days

B) 1-3 months

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9
Q

What’s the cause of LGV?

A

Ct serovarse L1 L2 L3

L2 most common

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10
Q

Lgv incubation period?

A

3-30 days

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11
Q

Lgv lymphadenopathy follows the primary lesion by how many days?

A

10-30

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12
Q

Lgv treatment

A 
Doxycycline 100mg bd 3 weeks
Or
Erythromycin 500mg qds 3 weeks
Or 
Azithromycin 1g once a week for 3 weeks
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13
Q

What % of gonorrhoea–> PID or epididymo-orchitis

A

14%

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14
Q

When is a confirmatory test reccomended for positive gonorrhoea?

A

If the positive predictive value of a population on <90%

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15
Q

What % of patients with gonorrhoea will also have chlamydia?

A

19%

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16
Q

Gonorrhoea transmission risk after 1 episode of sex for man to woman. And reduction with condom use?

A

Man to woman 60-80%

Reduced by 40% with a condoms

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17
Q

Gonorrhoea transmission risk after 1 episode of sex for woman to man. And reduction with condom use?

A

Woman to man 20%

Reduced by 75% by condom use

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18
Q

What’s can be used for treatment for gonorrhoea (other than ceftriaxone) if sensitivity is known? And what’s the UK resistance rate to this?

A

500mg ciprofloxacin only if known susceptible. UK resistance is 36.4%

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19
Q

What are alternative gonorrhoea treatments?

A

Cefixime 400mg po
Gebtanicin 240mg im
Spectinomycin 2g im (+ azithromycin if pregnant)

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20
Q

Treatment for disseminated gonorrhoea infection? 4 options.

Then oral switch options

A 
Ceftriaxone 1g im or iv every 24 hours
Or
Cefotaxime 1g iv every 8 hours
Or
Ciprofloxacin 500mg iv every 12 hours
Or
Spectinomycin 2g im every 12 hours

24-48 hours after symptoms improve can switch to oral:
Cefixime 400mg bd
Ciprpfloxacon 500mg bd
Ofloxacin 400mg bd

Total 7 day treatment

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21
Q

Whats the estimated prevalence of M Gen in the general population?

A

1-2%

22
Q

M gen is seen in what % of a) NGU b) PID

A

Ngu: 15-25%
Pid: 10-13%

23
Q

What % of m gen carriers are symptomatic? A men b) women

A

Men <10%

Women <5%

24
Q

Whats the abstinence advice for M Gen?

A

14 days from starting treatment (and until symptoms resolve)

25
Q

What’s the UK rate of microcode resistance in M Gen?

A

40%

26
Q

Whats the eradication rate of M Gen with doxycycline monotherapy?

A

30-40%

27
Q

What’s the reccomended treatment for ‘simple’ M Gen?

A

Doxycycline 100mg bd for 7 days then azithromycine 1g then 500mg od for 2 days (max 2 weeks between the 2)

28
Q

What’s the treatment for m gen PID and epididymo orchids?

A

Moxifloxaxin 400mg is for 14 days

29
Q

What are the risks of moxifloxacin?

A

As a fluoroquinolone: tendinitis and tendon rupture, prolonged QT, peripheral neuropathy

30
Q

Whats the treatment of m gen in pregnancy?

A

3 day course of Azithromycin

31
Q

Other than chlamydia and m gen what are causes of NGU?

A

Ureaplasmas
TV
Adenovirus
HSV

32
Q

What’s the diagnostic criteria for NGU?

A

> 5 PMNLs per high power field (x1000)

33
Q

SARA occurs in what % of lower genital tract infections?

A

0.8-4%

34
Q

What factors increase susceptibility to SARA?

A

Male gender

HLA b27 gene

35
Q

Whats the time from sex to onset of arthritis?

A

Within 30 days (mean is 14 days)

36
Q

Describe the point involvement pattern in SARA

A

Asymmetrical
1-5 joints
Usually lower limb (upper limb involvement is rare in the absence of psoriasis)

37
Q

Whats the mean duration of 1st SARA episode?

A

4-6 months

38
Q

What % have recurrent SARA symptoms?

A

50%

39
Q

What % have chronic SARA symptoms >1 year?

A

17%

40
Q

What skin lesions can be found in SARA?

A

Keratoderma blennorrhagica

Circinate balanitis

41
Q

How long can it take pain and swelling to resolve following treatment for epididymo orchitis?

A

Swelling and tenderness can persist after treatment but should be significantly better. Will have completely resolved in 80% by 3 months

42
Q

Whats the sensitivity of a wet slide diagnosis in TV?

A

45-60%

43
Q

Whats the spontaneous cure rate of TV?

A

20-25%

44
Q

Whats the intravaginal therapy cure rate for TV?

A

50%

45
Q

What do to in the case of tv treatment failure

A

1) repeat 7 day course
2) higher dose metro eg 2g od or 800mg tds for 7 days (70% will respond)
3) resistance testing
4) high dose Tinidazole (92% will respond)

46
Q

What % of women will have recurrent thrush?

A

6%

47
Q

In recurrent thrush cases what would make you test for mannose binding lectin deficiency?

A

History of URTIs, otitis media, autoimmune conditions

48
Q

Whata thrush treatment in pregnancy?

A

Clotrimazole pessary ON for 7 nights

49
Q

Treatment for:
Candida glabrata
Candida krusei

A

Glabrata: mostly susceptible to azoles but may need higher dose eg fluconazole 200-300mg OD every 48 hours for a week

Krusei: resistant to fluconazole so non azole therapy for 14 days

50
Q

What are the intra vaginal treatment options for BV?

A

0.75% metronidazole gel

2% clindamycin cream

51
Q

Bilateral epididymo orchitis- what’s the rate on infertility?

A

13%

52
Q

Infertility rate with PID
1 episode
2 episodes
3 episodes

A

8%
20%
40%

Maddy DipGUM (6 decks)

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