STI

Question 1

gonorrhoea clinical presentation male

Answer 1

purulent urethral discharge

Question 2

gonorrhoea clinical presentation female

Answer 2

mucopurulent vaginal discharge

Question 3

gonorrhoea clinical presentation both

Answer 3

dysuria, urinary frequency

Question 4

gonorrhoea management for uncomplicated

Answer 4

• X fluoroquinolones
• gonoccocal + anti-chlamydia unless chlamydia excluded
• first line ceftriaxone
  ** < 150kg: 500mg IM single dose
  ** > 150kg: 1g IM single dose
  ** if chlamydia not excluded then doxycycline oral BD 7 days
• alternative
  ** gentamycin 240mg IM single dose + azithro 2g oral single dose

Question 5

chlamydia clinical presentation

Answer 5

milder than gonorrhoea, similar complications to gonorrhoea

Question 6

chlamydia treatment

Answer 6

1) first line doxycycline 100mg PO BD 7 days

2) alternative
- azithro 1g oral OD 7 days
- levoflox 500mg PO OD 7 days

Question 7

syphilis management primary, secondary, early latent (<1 yr)

Answer 7

• IM benzathine penicillin G
  ** 2.4 million units x 1 dose
• penicillin allergic: PO doxycycline 100mg BD 14 days
  ** take with food
  ** take with water + upright for 30 mins
  ** X milk, divalent cation 2 hrs
  ** SE: GI, photosensitivity

Question 8

syphilis management late latent (>1 yr), unknown duration, teratiary

Answer 8

• IM benzathine penicillin G
  ** 2.4 million units once a week for 3 dose
• penicillin allergy
  ** PO doxycycline 100mg BD 28 days

Question 9

genital herpes clinical presentation

Answer 9

• multiple painful vesicles -> rbeak to form ulcerative lesions
• local itching, pain, tender inguinal lymphadenopathy
• flu like symptoms first few days after lesion appear
• prodromal: mild burning, itching, tingling prior to appearance of recurrent lesion

Question 10

genital herpes antiviral

Answer 10

• oral acyclovir, valacyclovir

Question 11

genital herpes antiviral - acyclovir

Answer 11

• PO 400mg TDS 7-10 days
• IV 5-10mg/kg q8h 2-7 days complete with PO 10 days
• take after food if GI upset
• AE: malaise, headache, N/V/D
• adequate hydration to prevent crystallisation

Question 12

genital herpes antiviral - valacyclovir

Answer 12

• PO 1g BD for 7-10 days
• headache maine SE
• treatment extend if healing incomplete after 10 days

Question 13

recurrent genital herpes chronic suppressive

Answer 13

acyclovir 400mg oral BD

valacyclovir 500mg oral OD

valacyclovir 1g oral OD

famicyclovir 240mg oral BD

Question 14

recurrent genital herpes episodic

Answer 14

acyclovir 800mg oral BD 5 days

acyclovir 800mg TID 2 days

valacyclovir 500mg oral BD 3 days

valacyclovir 1g oral OD 5 days

• need initiation therapy wihtin 1 day of lesion onset or during prodrome