sexual health

Question 1

what type of bacteria is gonorrhoeae

Answer 1

gram negative diplococci

Question 2

how is gonnorrhoea screened

Answer 2

PCR
- requires chocolate agar to grow
NAAT

Question 3

management of chlamydia (uncomplicated)

Answer 3

Doxycycline 100mg bd (7 days).
If intolerant: azithromycin 1g od day 1 then 500mg od for 2 days

Question 4

testing for chlamydia

Answer 4

male: first pass urine
NAAT

Question 5

presentation of chlamydia

Answer 5

mostly asymptomatic
male: urethritis, urethral discharge, dysuria, orchiditis/proctitis
female: mucopurulent cervicitis, dyspareunia, PCB/IMB

Question 6

complication of chlamydia

Answer 6

PID
neonatal conjunctivitis
reactive arthritis
fitz-hugh-curtis syndrome

Question 7

what is fitz-hugh-curtis syndrome

Answer 7

adhesions and inflammation of liver capsule

Question 8

presentation of gonorrhoea

Answer 8

mostly asymptomatic
male: purulent urethral discharge, dysuria
female: discharge, dyuria

Question 9

investigation for gonorrhoea

Answer 9

Male (1st pass urine), female (ECS) > Combined NAATs/PCR

Question 10

treatment of gonorrhoea

Answer 10

First-line: Ceftriaxone 1G IM or Ciprofloxacin500mg orally as a single dose

Second-line: Cefixime 400 mg oral plus Azithromycin 2G (only if IM injection is contra-indicated or refused by patient)

test for cure in all patients 2-3 weeks later

Question 11

what is mycoplasma genitalium

Answer 11

emerging sexually transmitted pathogen
associated with non-gonococcal urethritis and PID
asymptomatic carriage
NAAT test at same sights as GC/CT

Question 12

what is lymphogranuloma venereum

Answer 12

rare complication of chlamydia
caused by serovar L2
presents as outbreaks
presentation: painless ulcers and/or haemorrhagic proctitis, pharyngitis, lymphadenopathy

Question 13

management of BV

Answer 13

reassure
metronidazole 400mg bd 5/7
worsening/recurring advice
(topical clindamycin 2% cream or metronidazole 0.75% gel)

Question 14

management of candidiasis

Answer 14

reasure
clotrimazole 500mg pessary OR fluconazole 150mg stat

clortimazole 1% cream for external symptoms
worsening/recurring advice

Question 15

presentation of candidiasis in females

Answer 15

thick, curdy
white
associated with vulval itch
pain with sex

Question 16

presentation of trichomonas

Answer 16

copoius, watery
associated with smell
vulvovaginal itch
dysuria
strawberry cervix

Question 17

management of trichomonas

Answer 17

treat with metronidazole 400mg BD x 5-7/7
partner notification

Question 18

obligate anaerobe bacteria

Answer 18

gardnerella vaginalis
prevoltells sp.
mobiluncus sp.
atopobium sp.

Question 19

management of mycoplasma genitalium

Answer 19

doxycycline or moxifloxacin

Question 20

bacteria responsible for syphilis

Answer 20

treponema pallidum

Question 21

presentation of stage 1 syphilis

Answer 21

chancre
local lymphadenopathy

Question 22

presentation of stage 2 syphilis

Answer 22

copper palmar plantar rash
snail trail mouth ulcers
patchy alopecia
flu like illness
generalised lymphadenopathy

Question 23

stage 3 syphilis presentation

Answer 23

latent stage= no symptoms

Question 24

stage 4 syphilis presentation

Answer 24

neurosphylis- argyll robertson pupil (miotic pupil), CVS effects

Question 25

dark ground microscpy/PCR

Answer 25

investigation seen for syphilis

Question 26

treatment of syphilis

Answer 26

benzathine penicillin

Question 27

presentation mostly for HSV-1

Answer 27

cold sores oral-oral contact

Question 28

presentation mostly for HSV-2

Answer 28

genital herpes with lesions

Question 29

severe diseases found in immunocompromised patients with HSV-1

Answer 29

keratitis encephalitis

Question 30

severe disease found in immunocompromised patients with HSV-2

Answer 30

meningoencephalitis

Question 31

treatment of herpes simplex

Answer 31

aciclovir and valaciclovir

Question 32

what versions of HPV cause cervical cancers

Answer 32

16 and 18 commonly

Question 33

investigation for primary genital herpes simplex

Answer 33

swab lesion for HSV-1 and 2 PCT recommend full STI screen

Question 34

what strain is genital warts

Answer 34

HPV 6+11

Question 35

presentation of genital warts

Answer 35

white, rough, raised, not painful

Question 36

management of genital warts

Answer 36

cryotherapy podophyllotoxin cream imiquimod cream

Question 37

what is the look back period for male with chlamydia

Answer 37

4 weeks

Question 38

what is the look back period for a female with chlamydia or anal and oral chlamydia

Answer 38

6 weeks

Question 39

what is the look back period for male gonorrhoea

Answer 39

2 weeks

Question 40

first line investigation for heterosexual men for asymptomatic chlamydia

Answer 40

first catch urine or urethral swab

Question 41

first line investigation for heterosexual men with symptomatic chlamydia

Answer 41

microscopy of urethral swab first catch urine