Management

Question 1

Treatment for chlamydia - uncomplicated genital or pharyngeal infection

Answer 1

doxycycline 100 mg BD for 7 days
alternative: azithromycin 1g PO stat

Question 2

Treatment for chlamydia - anorectal infection

Answer 2

Doxycycline 100 mg PO, BD for 7 days if asymptomatic, but 21 days if symptomatic
alternative: Azithromycin 1 g PO and repeat in 12-24 hours

Question 3

Treatment of chlamydia - pregnancy

Answer 3

Azithromycin 1 g PO, stat.

Question 4

Treatment of gonorrhoea

Answer 4

Ceftriaxone 500 mg IMI, stat. in 2 mL 1% lignocaine
PLUS
Azithromycin 1 g PO, stat.

Question 5

Treatment Genital herpes simplex

Answer 5

Valaciclovir 500mg PO, BD for 5 -10 days.
1g BD for 10 days in pregnancy, followed by 500 mg BD
Alternative: Aciclovir 400mg PO, TDS for 5 -10 days

Question 6

Treatment Early syphilis (primary, secondary, early latent)*

Answer 6

Benzathine benzylpenicillin 2.4 MU (1.8 g) IMI, Stat, given as 2 injections containing 1.2 MU (0.9 g)

Question 7

Treatment trichomoniasis
Treatment bacterial vaginosis

Answer 7

Metronidazole 400 mg PO with food, BD for 7 days

Question 8

Pelvic inflammatory disease treatment
(Chlamydia, gonorrhoea, mycoplasma genitalium)

Answer 8

Ceftriaxone 500 mg in 2 mL of 1% lignocaine IMI, or 500 mg IV, stat
PLUS
Metronidazole 400 mg PO, BD for 14 days
PLUS
Doxycycline 100 mg PO, BD for 14 days

Question 9

Epididymo-orchitis

Answer 9

Ceftriaxone 500mg in 2 mL of 1% lignocaine IMI, stat
PLUS EITHER
Doxycycline 100mg PO, BD for 14 days
OR
Azithromycin 1g PO, stat and repeated 1 week later.

Question 10

Infections implicated in chorioamnionitis

Answer 10

STI: chlamydia, gonorrhoea, mycoplasma genitalium, trichomonas vaginalis
Non STI: Mycoplasma hominis, ureaplasma urealyticum, E.coli, bacterial vaginosis

Question 11

Neonatal HSV symptoms

Answer 11

vesicular skin lesions / atypical pustular or bullous lesions
seizures
low platelets
elevated LFTs
DIC
respiratory distress
corneal ulcer/ keratitis

Question 12

Neonatal HSV surveillance

Answer 12

HSV PCR from eyes, mouth, nasopharynx, umbilicus, urine, rectum

Question 13

Neonatal HSV - high risk

Answer 13

LP
LFT
FBC
surface swabs
Commence IV acyclovir

Question 14

Primary syphilis

Answer 14

Painless genital ulcer / chancre
Enlarged, non painful inguinal nodes

Question 15

Secondary syphilis

Answer 15

Constitutional symptoms
Rash (trunk, but can be just palms and soles of feet)
alopecia and condylomata lata
neurological signs