Genital Tract Infections

Question 1

What can cause a genital tract infection?

Answer 1

STI

Trauma

Question 2

How do you test for STIs in men?

Answer 2

Urinalysis

• first catch
• midstream

Urethral sampling
Rectal sampling
Ulcer swab
Bloods

Question 3

How do you test for STIs in women?

Answer 3

Vulvovaginal swabs
High vaginal swab 
Endocervical swab 
Urinalysis 
Rectal sampling 
Ulcer swab 
Bloods

Question 4

How do you manage STIs?

Answer 4

Treat cause
Contact tracing
STI prevention - discuss contraception

Question 5

What are the common STIs?

Answer 5

Chlamydia
Gonorrhoea
Syphilis
Herpes

Question 6

What is the causative organism of chlamydia?

Answer 6

Chlamydia trachomatis

Question 7

What is type of organism is chlamydia trachomatis?

Answer 7

Gram negative obligate intracellular bacterium

Question 8

What are the symptoms of chlamydia in males?

Answer 8

Urethritis
Dysuria
Proctitis
Epididymitis

Question 9

What are the symptoms of chlamydia in females?

Answer 9

Often asymptomatic

Increased discharge
Post coital bleeding
Dyspareunia

Question 10

What is dyspareunia?

Answer 10

Painful intercourse

Question 11

Where else can chlamydia trachomatis infect?

Answer 11

Eye - conjunctivitis

Pharynx

Question 12

How is chlamydia diagnosed in males?

Answer 12

First catch urine

Question 13

How is chlamydia diagnosed in females?

Answer 13

Vulvovaginal swab

First catch urine

Question 14

How is chlamydia managed?

Answer 14

Doxycycline or azithromycin

Question 15

What organism causes gonorrhoea?

Answer 15

Neisseria gonorrhoeae

Question 16

What type of organism is Neisseria gonorrhoeae?

Answer 16

Gram negative diplococcus

Question 17

What are the primary sites of gonorrhoea infection?

Answer 17

Urethra 
Endocervix 
Rectum 
Pharynx
Conjunctiva

Question 18

What are the symptoms of gonorrhoea in men?

Answer 18

Urethral discharge
Dysuria
Anal discharge

Question 19

What are the symptoms of gonorrhoea in women?

Answer 19

Often asymptomatic

Altered discharge
Lower abdo pain

Question 20

What are potential complications of gonorrhoea?

Answer 20

Epididymo-orchitis
Prostatitis
PID
Disseinated gonococcal infection

Question 21

How is gonorrhoea diagnosed?

Answer 21

NAATs

Cultures

Question 22

What is NAAT?

Answer 22

Nucleic acid amplification test

Question 23

How is gonorrhoea managed?

Answer 23

IM ceftriaxone + oral azithromycin

Question 24

What organism causes syphilis?

Answer 24

Treponema pallidum

Question 25

What type of organism in treponema pallidum?

Answer 25

Gram negative spirochete bacterium

Question 26

What are the stages of syphilis?

Answer 26

Primary = painless ulcer Secondary = (4-10 weeks later) rash + multisystem involvement Latent Tertiary = (up to 40 years later) neurosyphilis, parenchymous, gummatous

Question 27

How is syphilis diagnosed?

Answer 27

History + examination | Dark ground microscopy

Question 28

How is syphilis managed?

Answer 28

Early = benzathine penicillin G IM single dose Latent = benzathine penicillin G *3 Neurosyphilis = IM procaine penicillin

Question 29

What types of herpes virus are there?

Answer 29

2 HSV 1 = usual cause of oro-labial herpes HSV 2 = more likely to cause recurrent symptoms

Question 30

What type of organism is herpes simplex?

Answer 30

Double stranded enveloped DNA virus

Question 31

What are the symptoms of herpes?

Answer 31

Shallow ulcers | Fever

Question 32

How is herpes diagnosed?

Answer 32

History + examination Virus detection in ulcer swab Type specific serology

Question 33

How is herpes managed?

Answer 33

Aciclovir

Question 34

What is trichomonas vaginalis?

Answer 34

Flagellated protozoa

Question 35

What are the symptoms of trichomonas in men?

Answer 35

Can be asymptomatic Urethral discharge Dysuria

Question 36

What are the symptoms of trichomonas in women?

Answer 36

Vaginal discharge Vulvitis Vaginitis

Question 37

How is trichomonas diagnosed?

Answer 37

Vaginal wet preparation | NAATs

Question 38

How is trichomonas managed?

Answer 38

Metronidazole

Question 39

How is scabies managed?

Answer 39

Permethrin

Question 40

How is pubic lice managed?

Answer 40

Malathion

Question 41

What causes anogenital warts?

Answer 41

HPV

Question 42

Which types of HPV are oncogenic?

Answer 42

HPV 16 | HPV 18

Question 43

What is bacterial vaginosis?

Answer 43

Most common cause of abnormal discharge in women Bacterial infection of vagina

Question 44

What are risk factors for bacterial vaginosis?

Answer 44

Vaginal douching Recent sexual partner change Smoking STI

Question 45

What are the symptoms of bacterial vaginosis?

Answer 45

Offensive fishy discharge | No itching

Question 46

How is bacterial vaginosis diagnosed?

Answer 46

High vagina gram stained smear

Question 47

How is bacterial vaginosis managed?

Answer 47

Metronidazole

Question 48

What causes vulvovaginal candidiasis?

Answer 48

Candida albicans

Question 49

What are the risk factors for candidiasis?

Answer 49

``` Pregnancy Antibiotics Oestrogen oral contraceptives Diabetes Immunosuppression ```

Question 50

What are the symptoms of candidiasis?

Answer 50

Vaginal discharge - curdy Vulval itch Soreness Dyspareunia

Question 51

How is candidiasis diagnosed?

Answer 51

High vaginal smear

Question 52

How is candidiasis managed?

Answer 52

Topical/oral azoles

Question 53

What are complications of STIs?

Answer 53

PID Epididymo-orchitis SARA - sexually acquired reactive arthritis Prostatitis

Question 54

What is epididymo-orchitis?

Answer 54

Clinical syndrome of pain, swelling + inflammation of epididymis and testes

Question 55

What is Reiter's syndrome?

Answer 55

Triad of urethritis, conjunctivitis and arthritis