Gonorrhoea

Question 1

What is Neisseria gonorrhoea?

Answer 1

It is a gram-negative diplococcus (cocci) bacterium

Question 2

What type of epithelium does gonorrhoea infect?

Answer 2

Columnar

Question 3

How are the two transmission mechanisms of gonorrhoea?

Answer 3

Sex

Vertical

Question 4

What are the four risk factors for gonorrhoea?

Answer 4

Young

Sexually active

Multiple sexual partners

Other STIs

Question 5

Which virulence factor is most associated with Neisseria gonorrhoeae?

Answer 5

IgA protease

Question 6

What is more likely to be symptomatic - gonorrhoea or chlamydia?

Answer 6

Gonorrhoea

Question 7

Which gender is most likely to be symptomatic with gonorrhoea infection?

Answer 7

Males

Question 8

What are the four clinical features of gonorrhoea in females?

Answer 8

Vaginal Discharge

Dysuria

Vaginal Bleeding

Pelvic Pain

Question 9

What are the two features of vaginal discharge associated with gonorrhoea?

Answer 9

Odourless

Green/yellow

Question 10

What are the two types of vaginal bleeding that occur with gonorrhoea?

Answer 10

Intermenstrual

Postcoital

Question 11

What are the three clinical features of gonorrhoea in males?

Answer 11

Urethral Discharge

Dysuria

Epididymo-Orchitis

Question 12

What is epididymo-orchitis?

Answer 12

It is defined as pain or swelling in one testicle

Question 13

In what other three locations does gonorrhoea affect - other than the genitals?

Answer 13

Rectum

Conjunctivae

Pharynx

Question 14

What investigation is used to diagnose gonorrhoea?

Answer 14

Nucleic Acid Amplification Tests (NAATs)

Question 15

What is a NAAT?

Answer 15

It checks directly for the DNA or RNA of the organism

Question 16

What four types of NAAT swabs are used to look for gonorrhoea infections?

Answer 16

Endocervical

Vulvovaginal

Urethral

First catch urine sample

Question 17

What culture agar is used to identify gonorrhoea?

Answer 17

Thayer-Martin agar

Question 18

How do we treat gonorrhoea conservatively?

Answer 18

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

Question 19

What two antibiotics are used to treat gonorrhoea?

Answer 19

Ceftriaxone

Ciprofloxacin

Question 20

How do we administer ceftriaxone? When?

Answer 20

IM

When the sensitive are not known

Question 21

How do we administer ciprofloxacin? When?

Answer 21

Oral

When the sensitivities are known

Question 22

What do we conduct after treatment?

Answer 22

A test of cure

Question 23

How long after treatment do we conduct a culture test of cure?

Answer 23

72 hours

Question 24

How long after treatment do we conduct a RNA NAAT test of cure?

Answer 24

7 days

Question 25

How long after treatment do we conduct a DNA NAAT test of cure?

Answer 25

14 days

Question 26

What are the six complications of gonorrhoea?

Answer 26

Pelvic Inflammatory Disease

Infertility

Epididymo-Orchitis

Urethral Strictures

Disseminated Gonococcal Infection

Septic Arthritis

Question 27

What can urethral strictures lead to?

Answer 27

Urinary incontinence

Question 28

What is disseminated gonococcal infection?

Answer 28

It is a complication of untreated gonorrhoea, where the bacteria spreads to the skin and joints

Question 29

What are the four clinical features of disseminated gonococcal infection?

Answer 29

Dermatitis

Migratory Polyarthritis

Tenosynovitis

Systemic Symptoms