Gonorrhoea Flashcards
What is Neisseria gonorrhoea?
It is a gram-negative diplococcus (cocci) bacterium
What type of epithelium does gonorrhoea infect?
Columnar
How are the two transmission mechanisms of gonorrhoea?
Sex
Vertical
What are the four risk factors for gonorrhoea?
Young
Sexually active
Multiple sexual partners
Other STIs
Which virulence factor is most associated with Neisseria gonorrhoeae?
IgA protease
What is more likely to be symptomatic - gonorrhoea or chlamydia?
Gonorrhoea
Which gender is most likely to be symptomatic with gonorrhoea infection?
Males
What are the four clinical features of gonorrhoea in females?
Vaginal Discharge
Dysuria
Vaginal Bleeding
Pelvic Pain
What are the two features of vaginal discharge associated with gonorrhoea?
Odourless
Green/yellow
What are the two types of vaginal bleeding that occur with gonorrhoea?
Intermenstrual
Postcoital
What are the three clinical features of gonorrhoea in males?
Urethral Discharge
Dysuria
Epididymo-Orchitis
What is epididymo-orchitis?
It is defined as pain or swelling in one testicle
In what other three locations does gonorrhoea affect - other than the genitals?
Rectum
Conjunctivae
Pharynx
What investigation is used to diagnose gonorrhoea?
Nucleic Acid Amplification Tests (NAATs)
What is a NAAT?
It checks directly for the DNA or RNA of the organism
What four types of NAAT swabs are used to look for gonorrhoea infections?
Endocervical
Vulvovaginal
Urethral
First catch urine sample
What culture agar is used to identify gonorrhoea?
Thayer-Martin agar
How do we treat gonorrhoea conservatively?
We advise patients to on how to prevent further infection
We refer them to contact tracing of sexual partners
We advise patients to abstain from sexual intercourse for seven days of treatment to reduce the risk of re-infection
What two antibiotics are used to treat gonorrhoea?
Ceftriaxone
Ciprofloxacin
How do we administer ceftriaxone? When?
IM
When the sensitive are not known
How do we administer ciprofloxacin? When?
Oral
When the sensitivities are known
What do we conduct after treatment?
A test of cure
How long after treatment do we conduct a culture test of cure?
72 hours
How long after treatment do we conduct a RNA NAAT test of cure?
7 days
How long after treatment do we conduct a DNA NAAT test of cure?
14 days
What are the six complications of gonorrhoea?
Pelvic Inflammatory Disease
Infertility
Epididymo-Orchitis
Urethral Strictures
Disseminated Gonococcal Infection
Septic Arthritis
What can urethral strictures lead to?
Urinary incontinence
What is disseminated gonococcal infection?
It is a complication of untreated gonorrhoea, where the bacteria spreads to the skin and joints
What are the four clinical features of disseminated gonococcal infection?
Dermatitis
Migratory Polyarthritis
Tenosynovitis
Systemic Symptoms
