Sexual Health

Question 1

Candidiasis more common in?

Answer 1

Diabetes

Immunosuppressed patients

Question 2

Presentation of candidiasis?

Answer 2

Itchy
Thick, white discharge
Vulval and vaginal irritation

Question 3

Management of candidiasis?

Answer 3

Clotrimazole cream
One off clotrimazole pessary
One off fluconazole dose (150mg)

Question 4

Presentation of bacterial vaginosis (BV)?

Answer 4

Fishy smelling, watery, grey discharge
Dysuria
High vaginal pH
“clue cells” on microscopy

Question 5

Management of BV?

Answer 5

Metronidazole (1st line)
Vaginal swabs to rule out chlamydia/ gonorrhoea
Avoid vaginal irrigation that might disrupt natural flora

Question 6

Cause of gonorrhoea?

Answer 6

Neisseria gonorrhoeae, gram negative diplococcus

Question 7

Presentation of gonorrhoea?

Answer 7

More often symptomatic
Odourless green, purulent discharge
Dysuria
Pelvic pain
Testicular pain

Question 8

Diagnosis of gonorrhoea?

Answer 8

Nucleic acid amplification testing of endocervical swabs or urine
Endocervical swab for culture and sensitivity prior to antibiotics

Question 9

Management of gonorrhoea?

Answer 9

Single dose of ceftriaxone 500mg IM and azithromycin 1g oral
Contact tracing for partners
Education to prevent further infection

Question 10

Cause of chlamydia?

Answer 10

Chlamydia trachomatis, gram negative bacteria

Question 11

Chlamydia presentation?

Answer 11

Often asymptomatic
PV discharge
Pelvic pain
Abnormal bleeding
Dyspareunia

Question 12

Examination findings in chlamydia?

Answer 12

Cervical excitation
Fever
Purulent discharge
Pelvic/abdominal tenderness

Question 13

Diagnosis of chlamydia?

Answer 13

Vulvovaginal swab in females
First void urine in males
PCR

Question 14

Treatment of chlamydia?

Answer 14

Doxycycline for 7 days
Single dose of 1g azithromycin
Contact tracing for partners
Education to prevent future infection

Question 15

Cause of genital herpes?

Answer 15

HSV-2 (can be HSV-1)

Question 16

Presentation of genital herpes?

Answer 16

Labial ulceration/ vesicular lesions
Pain
No discharge
(ask about sexual contacts)

Question 17

Diagnosis or genital herpes?

Answer 17

Clinical diagnosis

Swab can be taken for viral PCR

Question 18

Management of genital herpes?

Answer 18

Oral acyclovir

Topical for cold sores

Question 19

Cause of syphilis?

Answer 19

Treponema pallidum

Question 20

Primary syphilis?

Answer 20

Local ulcer (canker)
No pain

Question 21

Secondary syphilis?

Answer 21

Symmetrical rash, mucosal ulceration, neuro symptoms

Question 22

Diagnosis of syphilis?

Answer 22

Serology for TP IgGEIA

Ulcer sample PCR

Question 23

Treatment for syphilis?

Answer 23

Benzathine penicillin IM or doxycycline 100mg 2 weeks (28 days if late latent)

Question 24

Complications of gonorrhoea?

Answer 24

Male - epididymitis
Female - pelvic inflammatory disease
Both - monoarthritis, disseminated gonococcal infection

Question 25

Complications of chlamydia?

Answer 25

Male - epididymitis
Female - pelvic inflammatory disease
Both - reactive arthritis

Question 26

Complications of herpes?

Answer 26

Autonomic neuropathy, neonatal infection