Sexually Transmitted Infection

Question 1

How do you treat gonnorrhoea?

Answer 1

Ceftraxone 500mg IM

Azithryomycin is also given 1g oral irrespective of chlamydia result (also acts synergistically)

Question 2

What is the incubation period of gonorrhoea?

Answer 2

2 - 5 days

Question 3

What is fitz hugh curtis syndrome?

Answer 3

A complication of PID where there is liver capsule involvement. Presents with RUQ pain

Question 4

What is lymphogranuloma venerum?

Answer 4

An STI causes by invasive serotypes of chlamydia. It is most common in MSM and presents with rectal pain, discharge and bleeding and a painless genital ulcer. Patients can also get erythema nodosum

Question 5

How is chlamydia diagnosed?

Answer 5

Tests 14 days followign exposure using a vulvovaginal swab (females) or a first void urine (males) 
NAAT test (96% sensitivity)

Question 6

What is the treatment for chlamydia?

Answer 6

Azithromycin 1g STAT

or doxycycline 100mg BD for one week

Question 7

How do you diagnose genital herpes?

Answer 7

Swab the base of the ulcer for HSV PCR

Question 8

What are the low risk types of HPV?

Answer 8

6. 11.

Question 9

What are the high risk types of HPV?

Answer 9

16, 18, 31, 33, 35, 45, 52. 58

Question 10

What is the treatment for genital warts?

Answer 10

Imiquimob
Podophyllotoxin
Cryotherapy

Question 11

When is syphillis infectious?

Answer 11

Primary, secondary and early latent phases

Question 12

When is syphillis not infectious?

Answer 12

Late latent and tertiary phases

Question 13

How does primary syphillis present?

Answer 13

Primary painless chancre

Non tender local lymphadenopathy

Question 14

How does secondary syphillis present?

Answer 14

Pustular rash on hands/soles 
Mucous membrane lesions 
Lymphadenopathy 
Alopecia 
Condylomata lata (very infectious lesion!)

Question 15

What investigations do you do for syphillis?

Answer 15

1. Dark field microscopy from lesion
2. serum treponemal enzyme immune assay
   - Positive lifelong
   - may be negative in early syphillis
3. Serum TPPA
   - Positive lifelong
4. Serum VDRl test
   - titres correlate to disease activity and as a marker or treatment efficacy
5. Serum cadiolipin test
   - Antibodies increased and decreased depending on load of T pallidum
6. Point of care test
   - looks for antibodies
   - can’t distinguish between current or treated infections
7. T pallidum PCR

Question 16

What is the treatment for syphillis?

Answer 16

Benzylpenicllin IM