Gonorrhoea

Question 1

What is the definition of gonorhoea?

Answer 1

Curable sexually transmitted infection caused by neisseria gonorrhoea.

Question 2

What type of bacterium is neisseria gonorrhoea?

Answer 2

Gram negative intracellular diplococcus

Question 3

How is gonorrhoea transmitted?

Answer 3

Unprotected vaginal/oral/anal sex
Vertically from mother to child

Question 4

What age group has the highest incidence of gonorrhoea?

Answer 4

<25 years

Question 5

What are the primary sites of infection in gonorrhea?

Answer 5

Mucous membranes of:
Urethra
Endocervix
Rectum
Pharynx

Question 6

What is the clinical presentation of gonorrhoea in men?

Answer 6

Often asymptomatic
Discharge (green or yellow usually)
Dysuria
Tender inguinal nodes

Question 7

What is the clinical presentation of gonorrhoea in women?

Answer 7

Discharge (green or yellow usually)
Dysuria
Abnormal bleeding

Question 8

What are some investigations for gonorrhoea?

Answer 8

NAATS (screening test): self taken vulvovaginal swab in women or first pass urine in men, self taken rectal swab, clinician observed endocervical or penile swab
Microscopy (if symptomatic)
Culture (if microscopy positive or contact of someone)

Question 9

What is the management of gonorrhoea?

Answer 9

Cextriaxone 1G IM (first line)
Cefixime 400mg oral plus azithromycin 2G (second line)
Test of cure in all patients

Question 10

What are some lower genital tract complications of gonorrhoea?

Answer 10

Bartholinitis
Tysonitis
Periurethral abscess
Rectal abscess
Epididymitis
Urethral stricture

Question 11

What are some upper genital tract complications of gonorrhoea?

Answer 11

Endometritis
PID
Hydrosalpinx
Infertility
Ectopic pregnancy
Prostatitis