GUM

Question 1

what are the symptoms of trichomonas?

Answer 1

green frothy discharge
vulvovaginitis
strawberry cervix 
high pH>4.5
in men, urethritis

Question 2

how is trichomonas investigated?

Answer 2

direct microscopy and culture

Question 3

how is trichomonas treated?

Answer 3

metronidazole oral stat 2g or 5-7 days

Question 4

what pathogen causes trichomonas?

Answer 4

flagellated protozoan

Question 5

what bacteria causes gonorrhoea?

Answer 5

neisseria gonorrhoeae

Question 6

where can gonorrhoea infect?

Answer 6

GU
pharynx
rectum

Question 7

what are the symptoms of gonorrhoea?

Answer 7

in women, discharge
in men, discharge and dysuria and scrotal pain
if pharynx, rectum, asymptomatic

Question 8

how long is gonorrhoea incubation period?

Answer 8

2-5 days

Question 9

why is it possible to be reinfected with gonorrhoea?

Answer 9

variability in type 4 pili and Opa proteins

Question 10

what are the complications of gonorrhoea?

Answer 10

urethral stricture
epididymitis and salpingitis
reactive arthritis

Question 11

what is the triad of disseminated gonorrhoea

Answer 11

• arthritis
• dermatitis
• tenosynovitis

Question 12

how is gonorrhoea treated?

Answer 12

ceftriaxone IM

if not, oral cefixime and azithromycin

Question 13

what sti can cause endocarditis?

Answer 13

gonorrhoea

Question 14

when should genital herpes be treated?

Answer 14

within 5 days of symptom onset acyclovir

Question 15

how should pregnant women with genital herpes be treated?

Answer 15

elective c section at term if herpes after 28 weeks

women with recurrent herpes: transmission is low, suppressive therapy

Question 16

how long is syphilis incubation period

Answer 16

9-90 days

Question 17

what are the features of primary syphilis?

Answer 17

chancre

non-painful lymphadenopathy

Question 18

when is secondary syphilis?

Answer 18

6-10 weeks

Question 19

what are the symptoms of secondary syphilis?

Answer 19

fever
lymphadenopathy
macpap rash on trunks, palms, soles 
buccal snail track ulcers
condylomata lata

Question 20

what are the tertiary features of syphilis?

Answer 20

ascending aortic aneurysms
gummas
tabes dorsalis
general paralysis of the insane 
argyl-robinson pupil

Question 21

what are the features of congenital syphilis?

Answer 21

blunted teeth, mulberry molars
keratitis
rhagades (lines on mouth)
deafness
saber shins
saddle nose

Question 22

what organism causes syphilis?

Answer 22

treponema pallidum `

Question 23

what tests can be used for syphilis

Answer 23

cardiolipin

treponemal specific antibody tests

Question 24

what are the cardiolipin syphilis tests?

Answer 24

VDRL

RPR - 1 in 2 is better than 1 in 8 (only needs diluting 2x)

Question 25

What are the treponemal specific antibody tests?

Answer 25

TPHA

Question 26

following treatment with syphilis, which tests are positive and which are negative

Answer 26

VDRL becomes negative | TPHA remains positive

Question 27

how is syphilis treated?

Answer 27

IM benpen stat

Question 28

what does eia look for in syphilis?

Answer 28

IgM

Question 29

when would eia be negative?

Answer 29

no infection or reinfection

Question 30

which viruses cause genital warts

Answer 30

HPV 6 and 11

Question 31

how are genital warts managed?

Answer 31

if keratinised and solitary, cryotherapy | if not, podophyllotoxin or imiquimod cream?

Question 32

how is hiv assessed/

Answer 32

HIV antibody and HIV antigen test | p24 antigen

Question 33

how is hiv treated?

Answer 33

cART

Question 34

what type of birth in hiv?

Answer 34

if >50 - c-section | if <50 - vaginal

Question 35

what treatment for baby in hiv?

Answer 35

zidovudine if mum has low viral load cART if mum has high avoid breastfeeding

Question 36

how is jarisch herxeimer treated>

Answer 36

admit and treat | following treatment of syphilis - rigors etx

Question 37

how do you manage absent cremasteric reflex/

Answer 37

surgery (could be torsion?)

Question 38

what causes lymphogranuloma venereum?

Answer 38

chlamydia - diagnose with pcr of ulcers painful lymph nodes treated with azithromycin

Question 39

what are the upssi guidelines?

Answer 39

``` understands professional advice persuade to tell parents sexual intercourse anyway suffer mental health interests (best) ```

Question 40

is bv vaginal or endocervical?

Answer 40

vaginal | infective, but not STI

Question 41

how is bv managed in preg?

Answer 41

metronidazole for 5-7 days same treatment in pregnancy

Question 42

what increases risk of thrush?

Answer 42

glycosuria (dm and preg) high oestrogen (COCP) too much cleaning abx?

Question 43

what is oral treatment of thrush

Answer 43

fluconazole po | contraindicated in pregnancy

Question 44

how does thrush look on microscopy?

Answer 44

pseudohyphae on KOH prep

Question 45

which sti is flagellated protozoa?

Answer 45

trichomonas

Question 46

how is trichomonas investigaed?

Answer 46

vulvovaginal NAAT Swab posterior fornix shows mo0tile trophozites pH >4.5

Question 47

how is trichomonas treated

Answer 47

po metronidazole for 5-7 days or po metronidazole 2g stat treat sexual partners

Question 48

when is stat dose of metronidazole contraindicated in?

Answer 48

men | 1st trimester preg

Question 49

how is chlamydia tested for?

Answer 49

vulvovaginal NAAT

Question 50

chlamydia treatment

Answer 50

doxycycline 7 days azithromycin 1g stat abstain for 7 days

Question 51

how does PID present?

Answer 51

``` lower bilateral abdo pain abnormal purulent discharge deep dyspareunia IMB/PCB dysuria cervical motion tenderness fever ```

Question 52

what causes pid?

Answer 52

chlamydia gonorrhoea pelvic surgery ifection and inflammaton of uterus ovaries peritoneum tubes

Question 53

how is PID investigated

Answer 53

vvs NAAT: chlamydia, gonorrhoea, and trichomonas endocervical swab for gonorrhoea culture bloods for hiv and syphilis high vaginal swab - bv, tv, candida

Question 54

how is PID treated?

Answer 54

ceftriaxone - gonorrhoea doxycycline - chlamydia metronidazole - trichomonas

Question 55

what is tabes dorsalis?

Answer 55

loss of vibration and proprioception

Question 56

what is tertiary syphilis?

Answer 56

aortic aneurysm tabes dorsalis severe ulceration of skin (gummas)

Question 57

what is secondary syphilis?

Answer 57

rash on trunks palms soles influenza systemic vasculitis

Question 58

when to test post hiv exposure and post-exposure prophylaxis?

Answer 58

test at 12 weeks

Question 59

how to test for HIV?

Answer 59

HIV antibody test - positive 4-6 weeks | p24 antigen test - from 1-4 weeks

Question 60

what is involved in the antibody test?

Answer 60

elisa and western blot to confirm

Question 61

if negative hiv antibody test at 4 weeks, when to offer a second test?

Answer 61

12 weeks

Question 62

person with meningitis | encapsulated organisms visible by India ink.

Answer 62

Cryptococcus neoformans

Question 63

most common cause of diarrhoea in patients with HIV

Answer 63

Cryptosporidium

Question 64

how is cerebral toxoplasmosis treated?

Answer 64

sulfadiazine and pyrimethamine

Question 65

what are the side effects of zidovudine?

Answer 65

peripheral neuropathy