GUM

Question 1

Features of syphillis infection

Answer 1

Trepanoma palladum - spirochete bacteria
(potential for TLS type reaction with endotoxin release)

chronic infection can lead to tertiary neurosyphillis

Painless chancre primary presentation - not painful

Question 2

Treatment of syphillis

Answer 2

IM penicillin
Azithromycin 2g once - effective and no comps
Ciprofloxacin - 3 days - compliance issues
Doxycyclin - 14 days - compliance

Question 3

New onset seborrheic dermatitis + travel history - what do you think of

Answer 3

HIV

80% prevelance in HIV Vs 1-3%

Question 4

How is Chlamydia treated?

Answer 4

1 Doxycyclin 7 days - covers rectal infection too
CONTRA PREG

2 Azithromycin 1g once

3 Erythromycin 14 days

4 Ofloxacin 7 days but must be >18
CONTRA PREG

5 Amoxicillin 500 mg three times a day for seven days.

Question 5

What are complication of chlamydia infection?

Answer 5

Disseminated infection

1. PID
2. Lymphogranuloma venerum
   - Chlamydia trachomonis infects macrophages instead of epithelium resulting in trafficking to LN causing lymphadenopathy and disseminated infection

This will require 21 days treatment minimum with doxycylin

Question 6

How is recurrent herpes managed?

Answer 6

E.G >6 outbreaks of genital herpes in a year

Qualifies for suppressive therapy
12 months 400mcg aciclovir 400mg BD
- can reactivate post
>2 qualifies again for ongoing management

Question 7

How is ghonorrhoea treated?

Answer 7

pregnance Ceftriaxone IM and azithromycin

Penicillin