Gonorrhea and Chlamydia

Question 1

gonorrhoea diagnosis

Answer 1

gram stain of genital discharge, culture, NAAT

Question 2

gonorrhoea/chlamydia symptoms in males

Answer 2

purulent urethral discharge
dysuria
urinary frequency
milder in chlamydia

Question 3

gonorrhoea/chlamydia symptoms in women

Answer 3

mucopurulent vaginal discharge
dysuria
urinary frequency
milder in chlamydia

Question 4

complications from gonorrhea/chlamydia

Answer 4

males: epididymitis, prostatitis, urethral stricture, disseminated disease
females: pelvic inflammatory disease, ectopic pregnancy, infertility, disseminated disease
disseminated disease: skin lesions, tenosynovitis, monoarticular arthritis

Question 5

first line uncomplicated urogenital gonococcal infection treatment

Answer 5

ceftriaxone IM 500mg single dose (< 150kg)

ceftriaxone IM 1g single dose (> 150kg)

Question 6

alternative uncomplicated urogenital gonococcal infection treatment

Answer 6

gentamicin IM 240mg single dose plus azithromycin PO 2g single dose

or cefixime PO 800mg single dose

Question 7

management of sex partners

Answer 7

sex partners in last 60d should be evaluated

abstain from sexual activity for 7 days after treatment and resolution of symptoms

Question 8

chlamydia diagnosis

Answer 8

NAAT

antigen detection

Question 9

chlamydia treatment

Answer 9

doxycycline PO 100mg BD 7d

or azithromycin PO 1g single dose
or levofloxacin PO 500mg OD 7d