STIs

Question 1

Describe the symptoms and treatment of vaginal candidiasis.

Answer 1

Thick white curd like d/c, non smelly
Itchy/burning
Dysuria
pH<5

Clotrimazole

Question 2

What are the symptoms and treatment of bacterial vaginosis?

Answer 2

Increased fishy d/c
High pH
Clue cells on microscopy

Metronidazole

Question 3

What are the symptoms of trichomonas vaginalis?

Answer 3

Frothy smelly yellow d/c
Pain/itchy
Cervicitis: strawberry cervix

Question 4

How do you diagnose trichomonas vaginalis?

Answer 4

Urinary/swab NAAT
PCR
Microscopy: motile flagella
Culture

Question 5

How do you treat trichomonas?

Answer 5

Metronidazole

Question 6

What are the symptoms of gonorrhoea and how do you diagnose it?

Answer 6

Profuse yellow/green discharge
LUTs
PID
IMB

Microscopy, NAAT, culture

Question 7

How do you treat gonorrhoea?

Answer 7

Ceftriaxone and azithromycin

Question 8

What are the symptoms of chlamydia and how do you diagnose it?

Answer 8

Usually asymptomatic 
IMB
Change in discharge 
LUTs
PID

NAAT

Question 9

How do you treat chlamydia?

Answer 9

Doxycycline and azithromycin

Question 10

What are the symptoms of PID?

Answer 10

Dyspareunia

Lower abdo pain + uterine or adnexal tenderness + cervical motion tenderness

Question 11

How do you treat PID?

Answer 11

Ceftriaxone, doxy and metronidazole 14days

Question 12

What are the symptoms of an HSV infection?

Answer 12

Prodrome then painful ulcers, d/c, proctitis and LUTs

Subsequent attacks can be asymptomatic but still infectious

Question 13

How do you diagnose HSV?

Answer 13

Viral swab PCR

Serology

Question 14

How do you manage HSV?

Answer 14

Aciclovir for 1 week in first attack and 5 days for subsequent

Question 15

What are the risks of HSV in pregnancy?

Answer 15

Miscarriage
Preterm
Low birth weight
Neonatal infection

Question 16

What are the symptoms and risk of HPV infection?

Answer 16

Multiple painless irregular warts- 6+11

Need to look at cervix as risk of cancer with 16+18

Question 17

What is the treatment for HPV?

Answer 17

Clears itself within a few years
If large and obstructive can use cryotherapy, topical therapy or laser/surgical excision

HIV test

Cervical screening and vaccination!!

Question 18

What causes gonorrhoea?

Answer 18

Neisseria gonorrhoeae

Question 19

What causes chlamydia?

Answer 19

Chlamydia trachomatis

Question 20

What causes lymphogranuloma venereum?

Answer 20

Subtype of chlamydia trachomatis that infects lymph system

Question 21

What are the symptoms of LGV?

Answer 21

Primary, weeks: painless papule or shallow ulcer
Secondary, months: enlarged LNs with groove sign
Tertiary, up to 20yrs: severe proctitis (can have complications like strictures)

Question 22

How do you diagnose LGV?

Answer 22

MC&S/NAAT Fromm ulcer swab

High suspicion if anorectal chlamydia

Question 23

How do you treat LGV?

Answer 23

Doxycycline for 3 weeks

Question 24

What is chancroid caused by?

Answer 24

Haemophilus ducreyi

Question 25

What are the symptoms of chancroid?

Answer 25

Tender red papule-> pustule-> large friable ulcer
Can be multiple
Inguinal bubo
High risk of secondary bacterial infection

Question 26

How do you diagnose chancroid?

Answer 26

MC&S- G-ve rods

PCR/serology

Question 27

How do you treat chancroid?

Answer 27

Azithromycin or erythromycin or cipro for 7 days

Question 28

What causes donovanosis?

Answer 28

Klebsiella granulomatous

Question 29

What are the symptoms of donovanosis and how do you treat it?

Answer 29

Pruritic papule-> painless haemorrhagic granulomatous ulcer

Azithromycin/doxycycline