GC

Question 1

Incubation for penile urethral GC

Answer 1

2-5/7

Question 2

Complicated GC infection - sites

Answer 2

Epididymorchitis 
Prostatitis
PID
Skin lesions
Arthralgia
Arthritis
Tenosynovitis

Question 3

Microscopy sensitivity for
Penile urethra
Female urethra and endocervix
Rectum and pharynx

Answer 3

1) 90% if Sx. 50% if nil - therefore don’t
2) 20% - not routinely recommended
3) if anal Sx then do. Don’t for pharynx or asymp anal

Question 4

Sensitivity of NAAT for GC and sample

Answer 4

>95% regardless of Sx or not
Penile urethra - first pass urine
Endocervix and female urethra - VVS
Hysterectomy - urine and VVS
Oropharynx - harder to Rx

Question 5

Pharyngeal GC harder to RX therefore who swab?

Answer 5

Susceptibility not available and infection from Asia- pacific
Or
Genital infection with confirmed cef resistance

Question 6

GC how long to abstain from sex

Answer 6

7/7 post Rx

Question 7

1st line GC Rx

Answer 7

Ceftriaxone 1g IM

If susceptibility known - ciprofloxacin 500mg single dose (quinolone caution)

Question 8

Who to avoid using quinolones on

Answer 8

> 60
On corticosteroids
Renal disease
Post transplant

Question 9

GC alternative regimes

Answer 9

Cefixime 400mg orally plus 2g azith (if IM contraindicated or refused)
Gentamicin 240mg IM plus azith 2g
Spectinomycin 2g IM plus azith 2g (not for pharynx)
Azith 2g stat - high resistance

Question 10

Complicated GC RX disseminated infection

Answer 10

Cef IM or IV daily or
Cefotaxime 1g IV TDS or
Cipro 500mg BD IV (if resistance known) or
Spectinomycin 2g IM BD

Continue for 7/7 total but switch to oral after 24-48 hours improvement to:
Cefixime 400mg BD or
Ciprofloxacin 500mg BD or
Ofloxacin 400mg BD

Question 11

Abx to Rx GC in pregnancy

Answer 11

No quinolones or tetracyclines
Cef 1g IM
Spectinomycin 2g IM (not in BF)
Azith 2g single dose - if no other option

Question 12

Pn for GC

Answer 12

Partners in past 2/52 of Sx male urethra
Past 3/12 for all others

Rx if pre 2/52 otherwise wait for NAAt

Question 13

When to particularly emphasis GC TOC

Answer 13

Pharyngeal
Not 1st line Rx
Asia pacific acquired and no sensitivities known
Sx persist

Question 14

Still Sx of GC post Rx what to do?

Answer 14

Culture at least 72 hours after completing abx

Question 15

Toc for GC when asymp post Rx

Answer 15

NAAT
If rna NAAT - 7/7 post finishing Rx
If dna NAAT - 14/7 post finishing Rx