STIs

Question 1

Amsel’s criteria for bacterial vaginosis

Answer 1

Vaginal ‘fishy’ odor.
pH >4.5.
Thin, grey discharge

Question 2

Management of bacterial vaginosis

Answer 2

No need if asymptomatic.

Otherwise, metronidazole.

Question 3

Clinical features of chlamydia (GN cocci)

Answer 3

Dysuria, discharge, pelvic pain, post-coital bleeding, entropion, reactive arthritis

Question 4

Treatment of chlamydia

Answer 4

Azithromycin

Question 5

Clinical features of gonorrhea (GN diplococci)

Answer 5

80% asymp in women. 15% asymp in men. More common in MSM + ASTI.
discharge, dysuria, dyspareunia, conjunctivitis

Question 6

Management of gonorrhea

Answer 6

Ceftriaxone IM + azithromycin

Question 7

Clinical features of syphilis (treponema pallidum)

Answer 7

Primary (10-90d): painless genital ulcer, enlarged inguinal LNs
Secondary (6-8w): constitutional symptoms, non-itchy rash, condylomata
Latent (not infectious): neurosyphilis, aortic regurg, gumma

Question 8

Treatment of syphilis

Answer 8

Penicillin

Question 9

HSV-1 (Genital herpes) features

Answer 9

anogenital vesicles –> painful ulcers

Question 10

Trichomoniasis features

Answer 10

Usually asymptomatic in males.

In women - Frothy, yellow-green discharge, “strawberry cervix”

Question 11

Mx Trichomoniasis

Answer 11

Metronidazole

Question 12

Genital warts - HPV-6/11 management

Answer 12

80% self resolving. Mx cosmetic, not curative.

Podophyllotoxin or Imiquimod topical.

Question 13

Fitz-Hugh-Curtis syndrome

Answer 13

complication of gonorrhea, chlamydia, PID. Adhesions of liver capsule. RUQ pain.