STD

Question 1

What bacteria is gonorrhoea caused by?

Answer 1

Neisseria gonorrhoeae

Question 2

How is gonorrhoea transmitted?

Answer 2

• sexual contact

- mother-to-child during childbirth

Question 3

Common presentation of gonorrhoea?

Answer 3

Can be asymptomatic.

If symptomatic, for
Males: purulent urethral discharge, dysuria, urinary frequency
Females: mucopurulent vaginal discharge, dysuria, urinary frequency

Question 4

Treatment for uncomplicated urogenital gonococcal infections?

Answer 4

Ceftriaxone 500mg IM in a single dose.
If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100mg PO BD x 7 days.

Alternative regimen:
Gentamicin 240mg IM in single dose +
Azithromycin 2g orally in a single dose

Question 5

What bacteria is chlamydia caused by?

Answer 5

Chlamydia trachomatis

Question 6

What is the presentation like for chlamydia?

Answer 6

Similar to gonorrhoea.

Question 7

How is chlamydia transmitted?

Answer 7

• Sexual contact

- mother to child during childbirth

Question 8

Treatment for chlamydia?

Answer 8

Doxycycline 100mg PO BD x 7 days

Alternative: azithromycin 1g PO in single dose or Levofloxacin 500mg PO OD x 7 days

Question 9

What bacteria is syphilis caused by?

Answer 9

Treponema pallidum

Question 10

How is syphilis transmitted?

Answer 10

• sexual contact

- mother to child * transplacental during pregnancy

Question 11

What are the different stages of syphilis?

Answer 11

• primary
• secondary
• latent
• tertiary
• neurosyphilis

Question 12

What is the treponemal test for?

Answer 12

Used for diagnosis of syphilis.

Question 13

What is nontreponemal test for?

Answer 13

Commonly used non treponemal tests are VDRL and RPR.

Used to monitor response to treatment.

Question 14

Treatment for syphilis?

Answer 14

Primary, secondary and early latent (<1year duration):
IM Benzathine penicillin G 2.4 million units x 1 dose
If penicillin allergic, PO Doxycycline 100 mg bid x 14 days

Late latent (>1year) or unknown duration or tertiary: 
IM benzathine penicillin G 2.4 million units once a week x 3 doses 
Penicillin allergy: PO Doxycycline 100mg BD x 28 days 

Neurosyphilis: IV crystalline penicillin G 3-4 million units q4h or 18-24 million units/day as continuous infusion x 10-14 days OR
IM procaine penicillin G 2.4MU daily + PO probenecid 500mg QID x 10-14 days
If penicillin allergy: IV/IM ceftriaxone 2g daily x 10-14 days

Question 15

How to monitor for therapeutic response of syphilis?

Answer 15

Treatment success is where there is decrease of VDRL or RPR titre by at fourfold.

Question 16

What type of virus is herpesvirus?

Answer 16

• double stranded DNA virus
• persists lifelong in infected hosts (latent infection)
• periodic reactivations, especially in immuonocompromised hosts

Question 17

What is HSV type 1?

Answer 17

Affects young children, transmitted through contact, commonly presented as cold sores.
Usually self limiting, can use PO acyclovir or valacylovir.

Question 18

What is herpesvirus 3?

Answer 18

Varicella zoster virus.

Question 19

Treatment for varicella or shingles?

Answer 19

Start within 24-48 hours of rash to reduce duration and severity of symptoms.

Acyclovir dose: PO 800mg 5 times daily x 7 days.
Valacyclovir dose: PO 1g 3 times a day x 7 days

Question 20

Herpes simplex virus 2?

Answer 20

Causes genital herpes, a STI.

Question 21

How is genital herpes transmitted?

Answer 21

• transfer of body fluids

- intimate skin to skin contact

Question 22

Antiviral therapy for first episode of genital herpes?

Answer 22

Acyclovir: 400mg TDS x 7-10 days
Valacyclovir: 1 g BD x 7-10 days

Question 23

Chronic suppressive therapy for genital herpes?

Answer 23

Acyclovir 400mg PO BD

Valacyclovir 500mg or 1g PO OD

Question 24

Episodic therapy for genital herpes?

Answer 24

Acyclovir 800mg PO BD x 5 days

Valacyclovir 500mg PO BD x 3 days