Sexually Transmitted Infection

Question 1

Chlamydia Trachomatis

Answer 1

Gram -ve intracellular
L1, L2 L3 cause lymphogranuloma venereum (LGV)
A, B, C cause trachoma (eye)
D-K - genital and opthalmia neonatorum
Mostly asymptomatic, can lead to PID
Diagnosis: Nucleic Acid Amplification Test
Mx: azithromycin + doxycycline 100mg BD 1 week

Question 2

Treponema Pallidum

Answer 2

Syphilis 
Painless chancre -> gumma later
Diagnosis: non-treponemal tests VDRL
Treponemal antigens (TPHA, TP-PA)
Mx: single dose IM benzylpenicillin (doxycycline if allergic)

Question 3

Haemophilus Ducreyi

Answer 3

Gram -ve coccobacillus
Tropical ulcer disease (chancroid)
Unilateral inguinal lymph node swelling
Chocolate agar

Question 4

Neisseria Gonorrhoea

Answer 4

IC gram -ve diplococci
Urethritis and PID/epididymitis
Gram stain
Thayer Martin VCN medium 
Most common cause of septic arthritis in young, sexually active 
Mx: ceftriazone 250 mg single dose IM
Cefixime PO 400mg
Spectinomycin 2g IM (resistant)
For septic arthritis: IV cefotaxime 4-6 weeks

Question 5

BV

Answer 5

Fishy, white-cream discharge
Litmus test: loss of acidity,, pH > 4.5
Whiff test
Clue cells

Question 6

Klebsiella Granulomatis

Answer 6

Gram +ve rod
Donovanosis - large, expanding ulcers
Beefy red appearance
Giemsa stain 
Donovan bodies 
Mx: azithromycin

Question 7

Trichomonas Vaginalis

Answer 7

Flagellate protozoan
Vaginal discharge and urethritis
Wet prep microscopy
Mx: metronidazole

Question 8

Candida Albicans

Answer 8

Candidiasis
Itchy, cottage cheese discharge
Mx: topical clotrimazole, PO fluconazole

Question 9

HSV 1/2

Answer 9

Fluid filled blisters over genital area

Mx: aciclovir