Microbiology

Question 1

What is the main bacteria found in the healthy vaginal flora?

Answer 1

Lactobacillus

Question 2

Can women be colonised with candida and be asymptomatic?

Answer 2

Yes

Question 3

How does vaginal candida present?

Answer 3

Intensely itchy white vaginal discharge

Question 4

What is the treatment for a candida infection?

Answer 4

Topical clotrimazole

Oral fluconazole

Question 5

What occurs in bacterial vaginosis?

Answer 5

Normal flora replacement with gardnerella vaginalis

Question 6

How does bacterial vaginosis present?

Answer 6

Bubbly white discharge

Fishy odor

Question 7

What effect does bacterial vaginosis have on upper tract infection risk?

Answer 7

It increases it

Question 8

How is bacterial vaginosis treated?

Answer 8

7 day course of metronidazole

Question 9

Give some examples of bacterial STIs

Answer 9

Chlamydia
Gonorrhoea
Syphilis

Question 10

What is the commonest bacterial STI in the UK?

Answer 10

Chlamydia trachomatis

Question 11

Which serovars group of chlamydia trachomatis cause genital infection?

Answer 11

Serovars D-K

Question 12

What is the treatment of chlamydia?

Answer 12

Doxycycline 100mg bd x 7 days

Question 13

What are the main tests done for diagnosis of chlamydia and gonorrohea?

Answer 13

Combined nucleic acid amplification tests (NAATs)

PCR

Question 14

How is a NAAT/PCR test taken in a male patient?

Answer 14

First pass urine sample

Question 15

How is a NAAT/PCR test taken in a female patient?

Answer 15

Vulvo-vaginal swab

Question 16

What type of bacteria is neisseria gonorrhoea?

Answer 16

Gram negative diplococcus

Question 17

How does neisseria gonorrhoea appear on gram stain?

Answer 17

2 kidney beans facing each other

Question 18

Give some advantages of PCR/NAATs over culture

Answer 18

Much less invasive
More sensitive
Positive even if organisms have died
Takes hours

Question 19

Pharyngeal gonococcal infection is more efficiently acquired by fellatio/cunnilingus

Answer 19

Fellatio

Question 20

Neisseria gonorrhoea is easily treated by most antibiotics. True/false?

Answer 20

False - huge amount of antibiotic resistance

Question 21

How is neisseria gonorrhoea treated?

Answer 21

IM ceftriaxone

Question 22

What is the treatment for acute bacterial prostatitis?

Answer 22

Ciprofloxacin

Trimethoprim (high C diff risk)

Question 23

Which organism causes syphilis?

Answer 23

Treponema pallidum

Question 24

What is the diagnostic test for syphilis?

Answer 24

PCR

Question 25

What are the four stages of syphilis?

Answer 25

``` Primary lesion (chancre) Secondary stage (large nos. bacteria circulating in blood) Latent stage (no symptoms) Late stage (CV/NV complications) ```

Question 26

What are the specific serological tests for syphilis?

Answer 26

TPPA (T. pallidum particle agglutination assay) | TPHA (T. pallidum haemagglutination assay)

Question 27

What are the non-specific serological tests for syphilis?

Answer 27

VDRL | RPR (rapid plasma reagin)

Question 28

What are the non-specific serological tests useful for?

Answer 28

Monitoring response to therapy

Question 29

What treatment is used for syphilis?

Answer 29

Injectable long-acting penicillin

Question 30

Which viruses cause genital herpes?

Answer 30

HSV types 1 and 2

Question 31

How is genital herpes tested for?

Answer 31

PCR

Question 32

What is the treatment for genital herpes?

Answer 32

Acyclovir | Pain relief

Question 33

What is the treatment of trichomonas vaginalis?

Answer 33

Oral metronidazole

Question 34

What is the treatment of public lice?

Answer 34

Malathion lotion