Urethritis Flashcards

1
Q

What is urethritis?

A
  • Inflammation of urethra
  • Gonococcal urethritis or non-gonococcal
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2
Q

Causative organisms for each urethritis type

A
  • Gonococcal - neisseria gonorrhoeae
  • Non-gonococcal - Chlamydia trachomatis, mycoplasma genitalium, trichomonas vaginalis
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3
Q

RF for urethritis

A
  • Age <25
  • Men who have sex with men
  • Previous STI
  • Recent/new sexual partner
  • One or more partner in last year
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4
Q

Symptoms of urethritis

A
  • Dysuria
  • Penile irritation
  • Discharge from urethral meatus
  • Complications - eg reactive arthiritis, epididymitis
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5
Q

Sexual history importance urethritis

A
  • Narrow down likely pathogens
  • Risk stratify burden of disease
  • Inform necessary additonal sexual health screens
  • Partner notification
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6
Q

What is reactive arthiritis? Common causative organisms

A
  • Sterile inflammatory arthritis
  • Caused by distant infection producing autoimmune response in certain joints
  • Commonly caused by chlamydia trachomatis, chlamydia pneumoniae, camplylobacter, shigella or salmonella
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7
Q

Presentation of reactive arthiritis

A
  • Lower limb joints
  • Oligoarthiritis

Other extra-articular:
* Conjunctivitis/uveitis
* Urethritis/cervicitis/prostatitis
* Keratoderma blenorrhagicum
* Painless oral ulcers
* Malaise/fatigue

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8
Q

Management reactive arthiritis

A
  • Usually resolves within 6 months
  • Rest
  • Treat affected joint with NSAIDs or local steroid injections
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9
Q

Bedside tests for urethritis

A
  • Urethral swab - gram stain
  • First void urine NAAT - gonorrhoea, chlamydia, m.genitalium
  • Urine dip - send MSU for MC&S if suggests infection
  • Consider further STI testing eg HIV and syphilus serology
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10
Q

What is triple site testing?

A
  • Swab genitals, pharynx and rectum
  • Do this if suspect gonococcal infection
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11
Q

Management urethritis

A

Abx - BASHH guidelines

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12
Q

Abx for gonococcal vs non-gonococcal urethritis

A
  • Gonococcal - Ceftriaxone IM + Azithromycin PO
  • Non-gonococcal - Doxycycline oral OR Azithromycin PO
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13
Q

Long term management urethritis

A
  • Abstain from sexual activity until abx course finished, symptoms have resolved and sexual partners treated
  • If gonorrhoea - test of cure is needed
  • Counsel on condom use
  • Advise to notify sexual partners and to attend sexual health clinic for testing and treatment
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14
Q

Contact tracing guidelines urethritis

A
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15
Q
A
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