GI and STIs

Question 1

Modes of sexual transmission of disease?

Answer 1

• genital secretions
• direct inoculation (HSV)
• trauma (HCV)
• ingestion (shigella)
• fomites (gonorrhoea)
• IVDU (HIV, HCV)

Question 2

Microscopy of gonorrhoea?

Answer 2

gram -ve (pink) diplococci (kindey shaped, paired cocci)

Question 3

Rectal gonorrhoea?

Answer 3

Neisseria gonorrhoea

• Via direct contact of mucosal surfaces.
• low abdo pain, diarrhoea, rectal bleeding, anal discharge, tenesmus
• inflamed mucosae with purulent exudate

Treat with: Ceftriaxone; Doxycycline

Question 4

Rectal chlamydia?

Answer 4

Chlamydia trachomatis
-70% asymptomatic
-anal discharge tends to be less purulent
anal discomfort/itch

treat with: Azithromycin, Doycycline

Question 5

Syphilis?

Answer 5

• solitary painless ulcer (hard to touch)
• mucosal patches and ulcers in the mouth, anogenital, rectal
• systemic inflammation
• hepatitis

Question 6

Herpes simplex virus?

Answer 6

• ano-genital or oro-genital contact

- symptoms: pain, ulcers, pain on defaecation, bleeding mucus

Question 7

Human papillomavirus?

Answer 7

• ano-genital, oro-genital transmission
• causes anal warts, which can extend to the rectum
• increase anal cancer incidence

Question 8

LGV (lymphogranuloma venereum)?

Answer 8

Associated with chlamydia in HIV +ve patients

Treat with: Doxycycline