STIs

Question 1

What microorganism causes syphilis?

Answer 1

Treponema pallidum - gram negative spirochaete

Question 2

Painless penile ulcer which healed and now rash on palms and soles. Dx? Mx?

Answer 2

Syphilis
IM Benpen one dose

Question 3

Ix for syphilis?

Answer 3

Treponemes are seen in primary lesions by dark-ground microscopy (detected by PCR)
Antibody tests

Question 4

Painful penile ulcer. Cultured on chocolate agar

Answer 4

Chancroid (gram -ve coccobaccili)
Tropical ulcer disease in Africa

Question 5

Vaginal/penile mucopurulent discharge. Dx? Mx?

Answer 5

Neisseria gonorrhoeae (gram -ve diplococcus)
IM ceftriaxone - 250mg single dose

Question 6

Ix & Cx of gonorrhoea?

Answer 6

Ix: Swab & culture gold standard
Cx: Disseminated infection in pts with complement deficiencies -> sepsis, rash, septic arthritis

Question 7

Frothy green mouldy-smelling vaginal discharge & strawberry cervix. Dx? Ix? Mx?

Answer 7

Trichomoniasis (trichomonas vaginalis)
PCR
Mx: Metronidazole

Question 8

Often asymptomatic infection. Dysuria and discharge. Dx? Ix? (most common STI in UK)

Answer 8

Chlamydia trachomatis (gram -ve, cannot be cultured)
Diagnosis - NAAT from genital swabs

Question 9

Management of chlamydia?

Answer 9

Doxycycline 100mg BD 7 days OR azithromycin 1g stat in pregnant women

Question 10

What infection is the cause of neonatal conjunctivitis (opthalmia neonatorum) that appears:
a) a few days after birth
b) a few weeks after

Answer 10

a - Neisseria Gonorrohoea
b - chlamydia trachomatis

Question 11

Beefy red genital ulcers with donovan bodies in tissue sample

Answer 11

Donovanosis/ Granuloma inguinale
- Klebsiella granulomatis

Question 12

Fishy vaginal discharge, clue cells in vaginal smear (stippled epithelial cells)

Answer 12

Bacterial vaginosis - sexually associated
Lifestyle - no soaps for washing
Metronidazole topical

Question 13

Thick white vaginal discharge, itchiness, soreness, redness. Dx? Mx?

Answer 13

Candida albicans
Associated with immunodeficiency and hygiene practices

Oral fluconazole or topical clotrimazole

Question 14

Genital warts. Dx?

Answer 14

HPV 6 or 11

Question 15

Painless penile ulceration

Answer 15

HSV