STIs

Question 1

What is the causative organism of gonorrhoea?

Answer 1

Neisseria gonorrhoeae

Question 2

What is the incubation period of gonorrhoea?

Answer 2

Average 5-6 days

Range of 2 days t 2 weeks

Question 3

What are the signs and symptoms of gonorrhoea in men?

Answer 3

10% asymptomatic
Thick, profuse yellow discharge
Dysuria

Question 4

What are the signs and symptoms of gonorrhoea in girls?

Answer 4

> 50% asymptomatic
Vaginal discharge
Dysuria
Intermenstrual/post-coital bleeding

Question 5

What investigations are done for gonorrhoea?

Answer 5

Nucleic acid amplification test (NAAT) of urine or swab
Gram stained smear from urethra, cervix or rectum
Culture swab for antibiotic sensitivity

Question 6

What is the treatment of gonorrhoea?

Answer 6

Ceftriaxone 500mg IM once
Azythromycin 1g oral once
Test for cure at 2 weeks and reinfection at 3 months

Question 7

What are the complications of gonorrhoea?

Answer 7

Men- epididymitis
Female- PID, Bartholin’s abscess
Acute monoarthritix
Disseminated infection- pustular skin lesions with white halo

Question 8

What is the causative organism of chlamydia?

Answer 8

Chlamydia trachomatis

Question 9

What are the signs and symptoms of chlamydia in men?

Answer 9

> 70% asymptomatic
Slight watery discharge
Dysuria

Question 10

What are the signs and symptoms of chlamydia in women?

Answer 10

> 80% asymptomatic
Vaginal discharge
Dysuria
Intermenstrual/post coital bleed

Question 11

What are the signs and symptoms of chlamydia in both sexes?

Answer 11

Dysuria

Conjunctivitis

Question 12

What investigations are done for chlamydia?

Answer 12

NAAT of first void urine in men or swab from cervix, urethra or rectum

Question 13

What is the treatment of chlamydia?

Answer 13

Azythromycin orally once
Doxycycline 100mg twice daily for 1 week if rectal infection
Test for reinfection at 3-12 months

Question 14

What ar the complications for chlamydia?

Answer 14

Male- epididymitis
Female- PID and infertility
Reactive arthritis
Reiter's syndrome
Urethritis
Cervicitis
Conjunctivitis

Question 15

What is the causative organism of herpes?

Answer 15

Herpes simplex viruses 1 and 2

Question 16

What is the incubation period of herpes?

Answer 16

5 days to several months

Question 17

What are the signs and symtoms of herpes?

Answer 17

80% asymptomatic
Burning/itching
Blistering
Tender ulceration
Tender inguinal lymphadenopathy
Flu like symptoms
Dysuria
Neuralgic pain in back, pelvis and legs

Question 18

How is herpes diagnosed?

Answer 18

Clinical impression

Swb fro lesion testing using PCR

Question 19

What is the treatment of a primary outbreak of herpes?

Answer 19

Aciclovir

Lidocaine ointment

Question 20

What is the treatment of infrequent recurrences of herpes?

Answer 20

Lidocaine ointment

Aciclovir once daily until symptoms gone

Question 21

What is the treatment of frequent recurrences of herpes?

Answer 21

Long term aciclovir

Question 22

What are the complications of herpes?

Answer 22

Autonomic neuropathy
Neonatal infection
Secondary infection

Question 23

What is the causative organism of trichomoniasis?

Answer 23

Trichomonas vaginalis

Question 24

What are the sign and symptoms of trichomoniasis?

Answer 24

Men- usually asymptomatic

Women- 10-30% asymptomatic, profuse, thin green and frothy vaginal discharge w foul smell, vulvitis

Question 25

What is the investigation of trichomoniasis?

Answer 25

PCR of vaginal swab

Question 26

What is the treatment of trichomoniasis?

Answer 26

Metronidazole 400mg 2x daily for 5 days or 2g once

Question 27

What are the complications of trichomoniasis?

Answer 27

Miscarriage | Preterm labour

Question 28

What are the causative organisms of anogenital warts?

Answer 28

HPV types 6 and 11

Question 29

What is the epidemiology of anogenital warts?

Answer 29

>90% of UK population have genital HPV at some point, 20% get symptoms

Question 30

What are the signs and symptoms of anogenital warts?

Answer 30

Lumps with surface texture of cauliflower Itching Bleeding

Question 31

How are anogenital warts diagnosed?

Answer 31

Appearance | Biopsy if unusual

Question 32

What is the treatment of anogenital warts?

Answer 32

Podophyllotoxin cream Cryotherapy Diathermy/scissor removal

Question 33

What is the causative organism of syphilis?

Answer 33

Treponema pallidum

Question 34

What % of those wth syphilis are MSM?

Answer 34

>90

Question 35

What is the incubation period of syphilis?

Answer 35

Normally 9-90 days

Question 36

What are the signs and symptoms of syphilis?

Answer 36

Asymptomatic Primary- local ulcer Secondary- rash, mucosal ulceration, neuro symptoms, patchy alopecia Tertiary- neuro, CV or gummatous symptoms

Question 37

What is early latent syphilis?

Answer 37

No symptoms but <2 years since acquired

Question 38

What is late latent syphilis?

Answer 38

No symptoms but >2 years since acquired

Question 39

How is syphilis diagnosed?

Answer 39

Clinical signs Serology for TP IgGEIA, TPPA and RPR PCR from ulcer

Question 40

What is the treatment of syphilis?

Answer 40

Early and no neuropathy involvement- benzathine penicillin IM once OR doxycycline 100mg 2x daily for 2 weeks Late and no neuroinvolvement- benzathine penicillin IM 3x OR doxycycline 100mg 2x daily for 28 days

Question 41

What are the complications of syphilis?

Answer 41

Neurosyphilis Cardiac or aortic involvement Congenital syphilis

Question 42

What is the most common manifestation of neurosyphilis?

Answer 42

Cranial nerve palsies