Sexually Transmitted Diseases

Question 1

Urethritis signs and symptoms

Answer 1

Urethral discharge +/- dysuria

WITHOUT frequency of urination

Question 2

30-40% cause of NON-gonococcal urethritis (NGU) esp in heterosexual men

Answer 2

Chlamydia trachomatis

Question 3

98% sensitive diagnosis of Gonococcal urethral infection

Answer 3

Typical gram-negative diplococci on Gram’s-stained smear of urethral exudate containing inflammatory cells

Question 4

Treatment for Urethritis

Answer 4

Non-Gonococcal: Azithromycin or Doxycycline PO

Gonococcal: IV cephalosporin + Azithromycin PO

If with recurrence or reexposure (with compliance to previous regimen): Metronidazole or Tinidazole 2gm PO + Azithromycin 1gm PO both as single dose

Question 5

Acute Epididymitis signs and symptoms

Answer 5

UNILATERAL epididymis pain + swelling + tenderness +/- SSx of urethritis

Question 6

Causes of Acute Epididymitis in sexually active men <35

Answer 6

C.trachomatis

N.gonorrheae

Question 7

Treatment of Acute Epididymitis

Answer 7

Ceftriaxone 250mg IM as single dose + Doxcycline 100mg PO x 10 days

if Enterobacteriaceae suspected: Levofloxacin 500mg PO x 10 days

Question 8

Urethral syndrome in women

Answer 8

Internal dysuria (without urgency or frquency) + pyuria + absence of E.coli or uropathogens

Question 9

Bacterial cystitis signs and symptoms

Answer 9

Acute onset of urinary urgency or frequency + hematuria + suprapubic bladder tenderness

Question 10

Treatment of Vulvovaginal Candidiasis

Answer 10

Miconazole 100mg vaginal supp x 7d
or
Clotrimazole 100mg vaginal tab x 7d
or
Fluconazole 150mg PO as single dose

Question 11

Treatment of Trichomonal Vaginitis

Answer 11

Metronidazole or Tinidazole 2g PO as SD
or
Metronidazole 500mg PO BID x 7d

Question 12

Treatment of Bacterial Vaginosis

Answer 12

Metronidazole 500mg PO BID x 7d
or
Metronidazole gel 5gm intravaginal OD x 5d
or
Clindamycin 2%cream vaginally at night x 7d

Question 13

So-called “Strawberry Cervix” by colposcopy

Answer 13

Vaginal Trichomoniasis

Question 14

Criteria to clinically diagnose Bacterial Vaginosis

Answer 14

Amsel Criteria (3 out of 4)

1. Objective signs of inc white homogenous discharge
2. Vag pH >4.5
3. Fishy odor after KOH soln
4. “clue cells” in microscopy

Question 15

Diagnosis of Vulvovaginal Candidiasis

Answer 15

Demonstration of pseudohyphae or hyphae by microscopy of vaginal fluid mixed with 10% KOH or Gram’s stain

Question 16

Harbinger or sign of PID

Answer 16

Mucopurulent Cervicitis

Question 17

Cardinal signs of Mucopurulent Cervicitis (MPC)

Answer 17

Yellow mucopurulent discharge from the cervical os + endocervical bleeding upon gentle swabbing + edematous cervical ectopy

Question 18

Specific and sensitive test for N.gonorrhea and C.trachomatis

Answer 18

Nucleic Acid Amplification Test (NAAT)

Question 19

Factor which accelerates squamous metaplasia in cervical ectopy

Answer 19

Smoking

Question 20

Infection ascending from cervix or vagina to endometrium and/or fallopian tubes

Answer 20

Pelvic Inflammatory Disease (PID)

Question 21

OPD regimen for PID

Answer 21

Ceftriaxone 250mg IM + Doxycycline 100mg PO BID x 14d + Metronidazole 500mg PO BID x 14d

Question 22

Inpatient regimen for PID

Answer 22

Cefotetan 2gm IV q 12 or Cefoxitin 2gm IV q 6 + Doxycycline 100mg IV or PO q 12

or

Clindamycin 900mg IV q 8 + Gentamicin