STIs

Question 1

Candida vaginal infection:
Symtpoms
Investigation
Drugs

Answer 1

Clinical diagnosis: itchy +white discharge
Ix: high vaginal swab
Dx: clotrimazole (pessary or cream), fluconazole

Question 2

Bacterial vaginosis:
Symptoms
Ix
Rx

Answer 2

Symp: watery, fishy-smelling discharge
Clinical diagnosis, raised pH
Ix: CLUE CELLS
Dx: metronidazole orally

Question 3

Bacterial prostitis
Symptoms
Organisms
Ix
Rx

Answer 3

symptoms of UTI + back pain/penile/prostate; complication of UTI
Same org as in UTI (e. coli & other coliforms, enterococcus, check for STI)
Ix: clinical + MSSU for C&S
Rx: ciprofloxacin (trimethroprin if C diff risk)

Question 4

Chlamydia trachomatis
sites, reproduce outside host?, stain
Rx
serological grouping
life cycle

Answer 4

urethra, rectum, throat, eyes, endocervix
NOT reproduce outside
no gram stain
Rx: azithromycin oral
Serology: A-C (trachoma in eye, not STI), D-K (genital), L1-3 (Lymphoganuloma venereum)
Energy parasite, biphasic life cycle

Question 5

Neisseria gonorrhoea

sites, organism look, discharge, Rx

Answer 5

urethra, rectum, throat, eyes, endocervix
Gram -ve diplococcus (two kidneys)
white pus
Rx - IM ceftriaxone + oral azithromycin (super resistant)

Question 6

Tests for chlamydia and gonorrhoea

Answer 6

NAAT (nucleic acid amplification) & PCR
males: first pass urine,
female: HVS / vulvo-vaginal (self-taken)
rectal/throat/eye swabs
will detect dead too (so 5 weeks for test of cure)

Question 7

syphilis (treponema pallidum)
stain, Rx
4 stages

Answer 7

no stain, Rx: penicillin

1 - chancre lesion (will heal itself)
2- different site manifestation (rash on palms+ soles, ulcers, patchy alopecia)
Latent - no symptoms, present in blood
Late stage - cardio or neuro complications years later

Question 8

Syphilis tests

Answer 8

PCR or serology (blood) as doesn’t culture;
VDRL, RPR (non-specific, to monitor progress)
TPPA, TPHA - specific but +ve for life
IgG&IgM ELISA - screening

Question 9

genital warts
organisms
diagnosis
Rx

Answer 9

HPV (6, 11 - genital; 16, 18 - cervical cancer);
Also Herpes simplex type 1 (also cold sores), type 2 (more viral shedding!)
clinical
Rx: cryotherapy, podophyllotoxin cream

Question 10

Trichomonas vaginalis
organism
clinical presentation
test
Rx

Answer 10

protozoal parasite,
vaginal discharge and urethritis in males
high vaginal swab (potentially PCR for males)
metronidazole oral

Question 11

Pubic lice
organism
Rx

Answer 11

phthirus pubis, parasite, lay eggs there

malathion lotion