Week 9 - Genital Tract Infections

Question 1

Causes of abnormal discharge?

Answer 1

Chlamydia, gonnorhea, bacterial vaginosis, candida albicans, trichomonas vaginalis

Question 2

Are STIs always transmitted via penetrative sex?

Answer 2

Nope, some via genital contact e.g. scabies

Question 3

Risk factors for genital infections?

Answer 3

Age 15-24
Younger age at virginity loss 
Condom use 
Low SES  
MSM 
Menstrual cycle stage 
Ethnicity

Question 4

Name some burdens of STIs

Answer 4

PID, cervical cancer, infertility, ectopic pregnancy, syphilis systemic issues, increasing resistance, vertical transmission

Question 5

Most common STI diagnosis?

Answer 5

Anogenital warts

Question 6

Black population is more at risk of..

Answer 6

anogenital herpes, chlamydia and gonorrhea

Question 7

When should you do rectal and pharyngeal samples?

Answer 7

For gonorrhea/chlamydia

Question 8

What should you do bloods for?

Answer 8

Syphilis and HIV

Question 9

Vulvovaginal swabs for…

Answer 9

Gonorrhea/chlamydia

Question 10

High vaginal swabs for…

Answer 10

Trichomonas, bacterial vaginosis, candida

Question 11

Endocervical swabs for…

Answer 11

gonorrhea

Question 12

Swab ulcer base for…

Answer 12

HSV, dark ground microscopy or PCR for syphilis

Question 13

Urethral sampling in males for…

Answer 13

Gonorrhea cultures

Question 14

Full name of chlamydia and type of bacterium?

Answer 14

Chlamydia trachomatis

Intra-cellular

Question 15

Symptoms of chlamydia

Answer 15

M- dysuria, urethritis, epididymitis, prostatitis, proctitis

F- asymptomatic, increased discharge, post coital and intermenstrual bleeds, dyspareunia

Question 16

Treatment of chlamydia trachomatis?

Answer 16

Doxycycline or Azithromycin

Question 17

Organism of gonorrhea?

Answer 17

Neisseria gonorrhea, a gram negative intracellular diplococcus

Question 18

Symptoms of gonorrhea?

Answer 18

M- urethral discharge, dysuria, anal discharge, pharyngeal infection but asymptomatic
F- asymptomatic, altered discharge, lower abdo pain, rectal and pharyngeal infections asymptomatic

Question 19

Complications of gonorrhea?

Answer 19

PID, prostatitis, epididymo-orchitis

Question 20

How to diagnose gonorrhea?

Answer 20

Vulvovaginal/rectal/pharyngeal samples for culture, microscopy for gram staining

Question 21

Treatment for gonorrhea?

Answer 21

IM ceftriaxone + oral azithromycin

Question 22

Causative organism of syphilis?

Answer 22

Treponema pallidum, a spirochete bacterium

Question 23

Group with highest prevalence of syphilis?

Answer 23

MSM 25-34

Question 24

Describe the multi-stage disease process of syphilis?

Answer 24

Primary: painless ulcer (chancre)
Secondary: 4-10wks later rash, mucosal lesions
Latent
Tertiary: up to 40yrs later neurosyphilis, cardiovascular syphilis, gummas (local destruction)
Congenital syphilis

Question 25

How to diagnose syphilis?

Answer 25

Dark ground microscopy & bloods

Question 26

Treatment for syphilis?

Answer 26

Early: benzathine x1 Late: benzathine x3 Neurosyphilis: IM procaine penicillin + probenecid x14

Question 27

Commonest cause of oro-labial herpes?

Answer 27

HSV-1

Question 28

Which type of herpes is most likely to cause recurrent symptoms?

Answer 28

HSV-2

Question 29

Symptoms of HSV?

Answer 29

Asymptomatic, painful ulceration, dysuria | + Systemic symptoms: fever & myalgia

Question 30

Diagnosis of herpes?

Answer 30

Sample ulcer base

Question 31

Treatment for herpes

Answer 31

Aciclovir

Question 32

Trichomonas vaginalis is..

Answer 32

a flagellated protozoa

Question 33

Vaginal discharge in trichomonas vaginalis?

Answer 33

Yellowy and frothy

Question 34

Symptoms in M of trichomonas vaginalis?

Answer 34

Urethral discharge, dysuria

Question 35

Diagnosis of trichomonas vaginalis?

Answer 35

High vaginal swab

Question 36

Treatment of trichomonas vaginalis?

Answer 36

Metronidazole

Question 37

Treatment for scabies?

Answer 37

Permethrin

Question 38

Treatment for pubic louse?

Answer 38

Malathion

Question 39

Which HPV types cause warts?

Answer 39

6 & 11

Question 40

Which HPV types cause cervical and anogenital cancer?

Answer 40

16 & 18

Question 41

Treatment for anogenital warts?

Answer 41

Spontaneous resolution 70% in 1 year | Topical treatment, cryotherapy

Question 42

Since 2012 HPV vaccination Gardasil protects against which HPV types?

Answer 42

6,11,16,18

Question 43

Commonest cause of abnormal discharge in Fs of childbearing age?

Answer 43

Bacterial vaginosis

Question 44

Risk factors for bacterial vaginosis?

Answer 44

Receptive cunnilingus, vaginal douching, black, recent partner change, smoking

Question 45

Symptoms of bacterial vaginosis

Answer 45

Fishy discharge, no itch

Question 46

Treatment for bacterial vaginosis?

Answer 46

Metronidazole

Question 47

Symptoms of vulvovaginal candidiasis?

Answer 47

Vagina discharge non-offensive, vulval itch, soreness, dyspareunia

Question 48

Risk factors for vulvovaginal candidiasis?

Answer 48

Pregnancy, antibiotics, combined oral contraceptive, diabetes

Question 49

Diagnosis of vulvovaginal candidiasis?

Answer 49

High vaginal smear

Question 50

Treatment of vulvovaginal candidiasis?

Answer 50

Topical azole (clotrimazole)

Question 51

What is SARA?

Answer 51

Sexually acquired reactive arthritis- inflammation triggered by STI

Question 52

Name an example of SARA

Answer 52

Reiter's syndrome- triad of urethritis, conjunctivitis, arthritis (can't pee, can't see, can't climb up a tree)