STI's

Question 1

what bacterium causes chlamydia?

Answer 1

• chlamydia trachomatis

Question 2

how is chlamydia transmitted and what does it infect?

Answer 2

• unprotected vaginal, anal or oral sex
• highest incidence 20-24 years
• infects columnar epithelium at mucosal sites

Question 3

symptoms of chlamydia in women?

Answer 3

• dysuria
• abnormal vaginal discharge
• intermenstrual or postcoital bleeding
• deep dyspareunia
• lower abdominal pain

-> 70-80% of women are asymptomatic

Question 4

signs of chlamydia in women?

Answer 4

• cervicitis +/- contact bleeding
• mucopurulent endocervical discharge
• pelvic tenderness
• cervical excitation

Question 5

symptoms of chlamydia in men?

Answer 5

• urethritis
  dysuria
  urethral discharge
• epididymo-orchitis
  testicular pain

Question 6

signs of chlamydia in men?

Answer 6

• epididymal tenderness
• mucopurulent discharge

Question 7

investigations of chlamydia in women?

Answer 7

NAAT
- vulvo-vaginal swab 1st choice, endocervical swab or first catch urine sample

Question 8

investigations of chlamydia in men?

Answer 8

NAAT
- first catch urine sample 1st choice
- or urethral swab

Question 9

what is the 1st line mx for chlamydia?

Answer 9

• doxycycline 100mg BD x 1 week

Question 10

what is 2nd line mx for chlamydia?

Answer 10

• azithromycin 1G stat, followed by 500mg daily for 2 days
• also covered by ofloxacin

Question 11

is contact tracing involved for management of chlamydia yes or no?

Answer 11

• yes

Question 12

complications of chlamydia?

Answer 12

• PID
• ectopic pregnancy
• tubal damage
• reactive arthritis
• conjunctivitis
• Fitz Hugh-Curtis (perihepatitis - inflammation of liver capsule w adhesion formation accompanied by RUQ pain)

Question 13

what is lymphogranuloma venereum?

Answer 13

• caused by serovar L2 (L1/3) - strain of chlamydia trachomitis
• presents as outbreaks
• painless ulcers and/or haemorrhagic proctitis, pharnygitis, lymphadenopathy often unilateral