GUM

Question 0

What is an endocervial swab used for?

Answer 0

Gonorrhoea (and chlamydia)

Question 1

Name two infections that commonly present to GUM that are not strictly STIs ..

Answer 1

Bacterial vaginosis

Thrush

Question 2

What is a high vaginal swab used for?

Answer 2

TV BV Thrush

Question 3

What is the treatment for BV?

Answer 3

Metronidazole 2g PO one off dose
Or
500mg for 5-7 days - this is a better dose if breast feeding to avoid large dose
Advice against soap or douching

Question 4

If a woman has assymptomatic BV would you treat it?

Answer 4

Only if preganant or undergoing a TOP

Question 5

What might cause you to have a strawberry cervix?

Answer 5

Trichomniasis - due to small petichie haemorrhages

Question 6

What are the risk factors for candidiasis?

Answer 6

Pregnancy
Diabetes
Antibiotics

Question 7

What is the treatment for candidiasis?

Answer 7

Fluconazole 150mg single dose

Question 8

If there is a white discharge but the vagina is not red and irritated do you think thrush or BV?

Answer 8

BV

Question 9

What causes the fishy odour in BV

Answer 9

Amines from bacterial proteolysis

Question 10

What causes BV?

Answer 10

An overgrowth of anaerobic bacteria in the vagina

Question 11

Name some bacteria that cause BV?

Answer 11

Gardnerella
Prevotella
Mycoplasma hominis

Question 12

How common is BV?

Answer 12

5-12% although many assymptomatic

Question 13

BV is ‘sexually associated’ what does this mean?

Answer 13

More common in those who are sexually active but not sexually transmitted

Question 14

What might you see on microscopy in a lady with BV?

Answer 14

Clue cells

Question 15

In BV what is the vaginal pH?

Answer 15

Over 4.5

Question 15

What substance is added to elicit a fishy odour from vaginal secretions with BV?

Answer 15

Potassium hydroxide

Question 16

What bacteria normally predominate in the vagina?

Answer 16

Lactobacilli

Question 17

What can BV cause in pregnancy?

Answer 17

Pre term labour

Question 18

Why symptoms might a woman get with chlamydia?

Answer 18

Pain when passing urine

Vaginal discharge

Question 19

What are the complications of chlamydia?

Answer 19

PID
Tubal factor infertility
Chronic pelvic pain

(Reiters syndrome)

Question 20

What is te treatment for chlamydia?

Answer 20

Azirhromycin 1g stat

Question 21

What is the treatment for gonorrhoea?

Answer 21

Azithromycin 1g stat

Ceftriaxone 500mg IM

Question 22

What is NAAT?

Answer 22

Neucleic acid amplification test

Question 23

What is the first choice of test for gonorrhoea and chlamydia?

Answer 23

NAAT

Question 24

What is the flagellated protozoan that causes an STI?

Answer 24

Trichomniasis vaginalis

Question 25

What STI is causes by a gram negative diplococci?

Answer 25

Neisseria gonnhorrea

Question 26

How soon after getting gonnhorrea to men get symptoms?

Answer 26

3-5 days

Question 27

What signs do you get in disseminated gonnhorrea?

Answer 27

Pyrexia Vasculitis rash Polyarthritis

Question 28

What might a cobble stone cervix indicate?

Answer 28

Chlamydia

Question 29

If a woman with chlamydia gets RUQ pain and tenderness what might have happened?

Answer 29

Infection has ascended and causes a peri hepatitis

Question 30

Name 2 anaerobic flora?

Answer 30

Gardnerella vaginalis | Mycoplasma hominis

Question 31

What is pelvic inflammatory disease?

Answer 31

Infection of uterus, Fallopian tubes, and ovaries

Question 32

If PID goes untreated what are the complications?

Answer 32

Infertility Ectopic preganacy Absess formation Chronic pelvic pain

Question 33

How many weeks after IUCD insertion is there a risk of PID?

Answer 33

3 weeks

Question 34

What are the risk factors of PID?

Answer 34

STI TOP IUD instertion

Question 35

What symptoms suggest PD?

Answer 35

Lower abdo pain Deep dysparunia Abnormal vaginal bleeding Purilent discharge

Question 36

What are the signs of PID?

Answer 36

Lowe abdo tenderness Mycopurulent discharge Cervical motion/ adnexal tenderness Fever above 38 Positive swabs

Question 37

What antibiotics would you use to treat PID?

Answer 37

Ceftriaxone IM Doxycycline PO Metronidazole PO Take them for 14 days (except ceftriaxone which is a one off)

Question 38

In PID in pregnancy what you you replace the doxycycline with?

Answer 38

Erythromycin

Question 39

What are the causes of post coital bleeding?

Answer 39

``` Chlamydia/ gonorrhoea Polyp CIN Malignancy Ectropian ```

Question 40

What is a NGU in men?

Answer 40

Non gonococcal urethritis

Question 41

What are the causes of NGU?

Answer 41

``` Chlamydia Trichomniasis UTI Herpes Adenovirus ```