Gonorrhoea

Question 1

How would you describe gonorrhoea organism?

Answer 1

Gram negative intracellular diplococcus

Question 2

Primary sites of gonorrhoea infection?

Answer 2

Mucous membranes of urethra
Endocervix
Rectum
Pharynx

Question 3

Incubation period of urethral gonorrhoea infection in men?

Answer 3

Short

2-5 days

Question 4

20% risk from infected women to male partenr. What is the risk vice versa?

Answer 4

50-90% infected man to female partner

Question 5

Presnetation of gonorrhoea?

Answer 5

Mucopurulent urethral discharge
Urethral GC infection (discharge >90% dysuria)
Pharyngeal/rectal GC infections: mostly asymptomatic
Endocervical GC infection: discharge, irregular bleeding and external dysuria

Question 6

Testing for Gonorrhoea?

Answer 6

Vulvovaginal sab 
Urine: first void urine 
Throat swab 
Rectal swab 
NAATs screening tests 
Microscopy (symptomatic) 
Culture (if micro +ve or contact of GC)

Question 7

Treatment for gonorrhoea?

Answer 7

1st line: Ceftriaxone 1G IM

2nd line: Cefixime 400mg oral plus azithromycin 2G (only if IM injection is contra-indicated)

Question 8

Lower genital tract potential complications?

Answer 8

Bartholonitis 
Tysonitis 
Periurethral abscess 
Rectal abscess 
Epididymitis 
Urethral stricture

Question 9

Upper genital tract complications?

Answer 9

Endometritis 
PID 
Hydrosalpinx 
Ectopic pregnancy 
Infertility 
Prostatitis

Question 10

What is Mycoplasma Genitalium?

Answer 10

Emerging sexually transmitted pathogen

assoc with non-gonococcal urethritis and PID

Question 11

What is more common chlamydia or gonorrhoea?

Answer 11

Chlamydia

Question 12

What gender is chlamydia more common in and what gender is gonorrhoea more common in?

Answer 12

Chlamydia: Women
Gonorrhoea: Men

Question 13

Presentation of men with gonorrhoea?

Answer 13

Anterior urethritis with mucopurulent or purulent urethral discharge and dysuria

Question 14

Women with GC infection presentation?

Answer 14

Increased vaginal discharge
Dysuria
Post-coital intermenstrual bleeding
Lower abdo pain

Question 15

Test of choice for gonorrhoea?

Answer 15

NAATs

Nucleic acid amplification tests

Question 16

Men test?

Answer 16

First void urine

Urethral swabs

Question 17

Women test?

Answer 17

Vulvo-vaginal swabs

Endocervical swabs

Question 18

MSM test for gonorrhoea?

Answer 18

Rectal or pharyngeal swabs

Question 19

Incubation of women with gonorrhoea infection?

Answer 19

2-14 days

Question 20

Which sex more likely to pass on GC?

Answer 20

Men to women partner

Question 21

Patients with confirmed GC must be…

Answer 21

Referred to sexual and reproductive health because antimicrobial resistance is high ad treatment should be prescribed with sensitivity testing

Question 22

Often treatment for GC is?

Answer 22

Ceftriaxone