Sexually Transmitted Diseases

Question 1

Which bacteria causes Chlamydia? State the serotypes that give clinical presentations of Chlamydia.

Answer 1

Chlamydia Trachomatis, serotypes D - K

Question 2

What is the percentage of men and women who have asymptomatic Chlamydia?

Answer 2

50% men and 80% women

Question 3

Which type of drug is Chlamydia not susceptible to?

Answer 3

beta-lactam antibiotics

Question 4

Is the parasite causing Chlamydia enveloped or non-enveloped?

Answer 4

Enveloped

Question 5

Treatment for Chlamydia

Answer 5

single dose of 1g of Azithromycin or Doxycycline 100mg twice daily for 7 days

Question 6

Is the cell envelope of Chlamydia bacteria gram negative or gram positive?

Answer 6

Gram negative

Question 7

What bacteria causes Gonorrhoea?

Answer 7

Neisseria Gonorrhoea

Question 8

Describe the bacteria that causes Gonorrhoea.

Answer 8

Gram negative, aerobic cocci (diplococci)

Question 9

Gonorrhoea is often co-infected with which 3 other conditions?

Answer 9

HIV, Chlamydia and genital warts

Question 10

Percentage of men and women who are asymptomatic with Gonorrhoea

Answer 10

50% women

5% men

Question 11

Treatment of uncomplicated Gonorrhoea

Answer 11

Ceftriaxone and azithromycin

Question 12

What are the clinical manifestations of Gonorrhoea in males?

Answer 12

Gonococcal Urethritis (>80%) mucopurulent
Dysuria (>50%) - pain in micturation
Rectal infection (usually asymptomatic) can cause constipation, painful defecation and discharge
Pharyngeal infection (usually asymptomatic)

Question 13

What are the clinical manifestations of Gonorrhoea in females?

Answer 13

Endocervical infection (abnormal vaginal discharge)
Pelvic inflammatory disease (only if endocervical infection isn't treated)

Question 14

Which bacteria causes Syphilis?

Answer 14

Treponema Pallidum

Question 15

What is the shape of Treponema Pallidum?

Answer 15

Spirochete

Question 16

What are the clinical manifestations in secondary syphilis?

Answer 16

Maculopapular rash (raised rash) seen 6 weeks post primary lesion
Condylomata lata in anogenital area (warts that are flattened,watery and very infective)

Question 17

What are the clinical manifestations in tertiary syphilis?

Answer 17

Gummata (ulcerating lesions seen on skin and bones)
neuro-syphilis (dementia, Stroke, paralysis, blindness)
Cardiovascular syphilis (heart diseases)

Question 18

What serotypes leads to anogenital warts?

Answer 18

Serotypes of Papillomavirus 6,11,16 and 18

Question 19

What is caused by serotypes 1 and 4 of papillomavirus?

Answer 19

Plantar and facial warts

Question 20

Which serotypes causes warts on knees and fingers?

Answer 20

Serotypes of papillomavirus 2,3, and 10

Question 21

What causes Lymphogranuloma Venereum?

Answer 21

A type of Chlamydia bacteria that cause infection of mononuclear phagocytes in the lymphatic system.
(this is unlike genitourinary Chlamydia which infects squamocolumnar epithelial cells.)

Question 22

What is the most sensitive test for detecting Chlamydia or Gonococcal infections?

Answer 22

NAAT testing

Question 23

What treatment is recommended for Chlamydia?

Which is preferred if there are anorectal infections?

Answer 23

1G single dose of Azithromycin or Doxycycline 100MG BD PO for 7/7.
Doxycycline is preferred if patient has anorectal infections.

Question 24

What are the complications of Chlamydia?

Answer 24

Pelvic Inflammatory Disease (PID) –> Can lead to Fitz-Hugh-Curtis Syndrome, a complication of PID
Infertility
Ectopic Pregnancy
Neonatal conjunctivitis or Neonatal pnuemonia/RDS
Reactive arthritis

Question 25

What is the treatment for Gonorrhoea?

Answer 25

Single dose of Ceftriaxone 500MG IM + Single dose Azithromycin 1G PO If IM is contraindicated, single dose Cefixime 400MG PO + Single dose Azithromycin 1G PO If cephalosporins are contraindicated due to penicillin-allergy, Single dose Ciprofloxacin 500MG PO + Single dose Azithromycin 1G PO.

Question 26

What is the mainstay of syphilis diagnosis?

Answer 26

Serology

Question 27

What are the 2 types of serology testing for syphilis?

Answer 27

Non-treponemal serology and treponemal specific serology testings

Question 28

What is detected for in Non-Treponemal serology testing?

Answer 28

In non-treponemal serology testing, detection of antibodies to non-specific antigens such as Cardiolipin which is present in most patients with Syphilis

Question 29

What cream is prescribed for those with Genital Warts? What is the purpose served by the cream?

Answer 29

Imiquimod cream helps boost patient's immune system to fight the genital warts

Question 30

How is Lymphogranuloma Venereum different from Chlamydia infection?

Answer 30

Lymphogranuloma Venereum: Chlamydia Trachomatis Serotype L1, L2 and L3 causes infection of mononuclear phagocytes in the lymphatic system. However, in genitourinary Chlamydia, bacteria Chlamydia Trachomatis infects the squamocolumnar epithelium.

Question 31

What are buboes?

Answer 31

Buboes are grossly enlarged tender lymph nodes seen in patients with Lymphogranuloma Venereum.