STIs

Question 1

STI

Answer 1

infection predominanty sexually transmitted

other infections can be sexually transmissable but aren’t classed as STI

Question 2

STD

Answer 2

the disease the infection causes

Question 3

gonorrhoea: caused by

Answer 3

neisseria gonorrhoeae

Question 4

gonorrhoea: symptoms in men

Answer 4

10% no symptoms

thick profuse yellow discharge, dysuria

Question 5

gonorrhoea: symptoms in women

Answer 5

> 50% no symptoms

vaginal discharge, dysuria or intermenstrual/post-coital bleeding

Question 6

gonorrhoea: complications

Answer 6

M: epididymitis
F: PID, bortholin’s abscesses

both: acute monoarthritis, disemminated gonococcal infection

Question 7

gonorrhoea: incubation period

Answer 7

avg 5-6 days

range 2 days - 2wks (if get symptoms at all)

Question 8

gonorrhoea: diagnosis

Answer 8

nucleic acid amplification test (NAAT) on urine or swab from exposed site - vagina, rectum, throat

gram stained smear from urethra/cervix/rectum in symptomatic people

culture of swab-obtained specimen from exposed site using highly selective lysed blood agar in a 5% CO2 environment

Question 9

gonorrhoea: treatment

Answer 9

blind treatment with ceftriaxone 1mg

can also treat according to antibiotic sensitivities

Question 10

gonorrhoea: follow up

Answer 10

test of cure at 2wks

test of reinfection at 3mo

Question 11

chlamydia: caused by

Answer 11

chlamydia trachomatis serovars D to K

Question 12

chlamydia: symptoms men

Answer 12

> 70% asymptomatic

slight watery discharge, dysuria

Question 13

chlamydia: symptoms women

Answer 13

> 80% asymptomatic

vaginal discharge, dysuria, intermenstrual/post-coital bleeding

Question 14

chlamydia: symptoms in both sexes

Answer 14

conjunctivitis

Question 15

chlamydia: complications

Answer 15

M: epididymitis

F: PID, ectopic pregnancy, pelvic pain, infertility

both: reactive arthtitis, urethritis, conjunctivitis, arthritis

Question 16

chlamydia: diagnosis

Answer 16

first void urine in men

self taken or clinical taken swab from cervix, urethra, rectum as appropriate

all specimens tested using NAAT

Question 17

chlamydia: treatment

Answer 17

doxycycline 100mg bd 1wk

azithromycin 1g po once if pregnant

Question 18

chlamydia: follow up

Answer 18

test for reinfection at 3-12mo

earlier test of cure not needed unless symptoms persist

Question 19

herpes: caused by

Answer 19

herpes simplex virus types 1 and 2

Question 20

herpes: symptoms

Answer 20

80% no symptoms
rest have recurring symptoms - monthly, annually

burning/itching then blistering then tender ulceration
tender inguinal lymphadenopathy
dysuria, neuralgic pain back, pelvis, legs

Question 21

herpes: complications

Answer 21

autonomic neuropathy (urinary retention)
neonatal infection
secondary infection

Question 22

herpes: incubation period

Answer 22

about 5 days to months

some people never report symptoms

Question 23

herpes: diagnosis

Answer 23

clinical impression

swab from lesion tested using PCR

Question 24

herpes: treatment primary outbreak

Answer 24

aciclovir - various regimens e.g. 400mg tds 5 days

lidocaine ointment

Question 25

herpes: treatment infrequent recurrences

Answer 25

lidocaine ointment

aciclovir 1.2mg once daily until symptoms gone (1-3 days)

Question 26

herpes: treatment frequent recurrences

Answer 26

aciclovir 400bd long-term as suppression

Question 27

trichomoniasis: caused by

Answer 27

trichomonas vaginalis

Question 28

trichomoniasis: symptoms men

Answer 28

usually asymptomatic

Question 29

trichomoniasis: symptoms women

Answer 29

10-30% asymptomatic
profuse thin vaginal discharge - greenish, frothy and foul smelling
vulvitis

Question 30

trichomoniasis: complications

Answer 30

miscarriage and preterm labour

Question 31

trichomoniasis: diagnosis

Answer 31

PCR on vaginal swab

not validated on urine yet so no test for men

Question 32

trichomoniasis: treatment

Answer 32

metronidazole 400mg op bd for 5 days or 2g single dose

Question 33

anogenital warts: caused by

Answer 33

human papilloma virus types 6 and 11 (occasionally 1)

Question 34

anogenital warts: symptoms

Answer 34

lumps with surface texture of small cauliflower

occasionally itching or bleeding esp if perianal or intraurethral

Question 35

anogenital warts: complications

Answer 35

none common

neonatal laryngeal papillomatosis

Question 36

anogenital warts: diagnosis

Answer 36

appearance

biopsy if unusual to exclude intraepithelial neoplasia

Question 37

anogenital warts: treatment

Answer 37

podophyllotoxin, imiquimod

Question 38

syphilis: caused by

Answer 38

treponema pallidum sub species pallidum

Question 39

syphilis: symptoms/staged

Answer 39

primary: local ulcer
secondary: rash, mucosal ulceration, neuro symptoms, patchy alopecia

early latent: no symptom but <2yrs since caught

late latent: no symptoms but 2+ years since caught

tertiary: neurological, cardiovascular or gummatous

Question 40

syphilis: complications

Answer 40

neurosyphilis - cranial nerve palsies commonest, cardiac or aortal invovlement

congenital syphylis

Question 41

syphilis: incubation period

Answer 41

9-90 days

but can be asymptomatic

Question 42

syphilis: diagnosis

Answer 42

clinical signs

serology for TP IgGEIA, TPPA and RPR

PCR on sample rom an ulcer

Question 43

syphilis: treatment early

Answer 43

<2yrs and no neurological involvement

benzathine penicillin 2.4MU im once
or doxycycline 100mg bd po 2wks

Question 44

syphilis: treatment late

Answer 44

2+ yrs and no neurological involvement

benzathine penicillin 2.4MU im weekly for 3 doses

doxycycline 100mg bd po 28days