Urethritis

Question 1

What are non-infectious causes of urethritis?

Answer 1

• Trauma
• Reiter’s
• Urethral stricture
• Urethral stone
• Urethral lesions

Question 2

What are infectious causes of urethritis?

Answer 2

Gonococcal “GNIDs”

Nongonococcal:

• Chlamydia
• Mycoplasma genitalium

Question 3

How does urethritis present?

Answer 3

• Dysuria
• Discharge
• Pruritis

Question 4

Gonorrhea vs chlamydia sx

Answer 4

Gonorrhea: profuse purulent discharge

Chlamydia: clear, purulent, or absent discharge

Question 5

What labs should be performed for urethritis?

Answer 5

First void UA: leukocyte esterase, >10 WBC

Gram stain of discharge: > 5 WBC

Question 6

How do you test for gonorrhea?

Answer 6

Culture: 1 hr after voiding (gives sensitivities)

NAAT: urethral or cervical swab, or urine (no sensitivities)

Question 7

How do you tx urethritis if gonorrhea is present?

Answer 7

Ceftriaxone 1 dose

Alternative = Cefixime

Question 8

How do you tx urethritis if chlamydia is present?

Answer 8

Azithromycin or doxy x 7days

Question 9

What is a lifestyle form of tx for urethritis?

Answer 9

Abstain from sex until 7 days after med initiated

Question 10

If the pt received the alternative tx for gonorrhea, when should he/she be tested for cure?

Answer 10

Test for cure 1 wk after tx, & again at 3 mos

Question 11

If the pt received ceftriaxone for gonorrhea, when should he/she be tested for cure?

Answer 11

At 3mos after tx

Question 12

In uncomplicated urethritis w/ chlamydia that is responsive to treatment, is f/u necessary?

Answer 12

Nope!

Question 13

If the pt is pregnant & has urethritis/chlamydia, when should you test for cure?

Answer 13

Test for cure 3-4 wks after tx

Question 14

Which sexual contacts should you treat?

Answer 14

Those that had sexual contact w/ patient within the 60 days prior to his/her sx