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Outline chlamydia Trachomatis. What are the Sx (male +
female), Ix and Rx? - Answers-Chlamydia Trachomatis is
an obligate intracellular gram negative bacteria and is the
most common STI
Sx:
i) Male: Asymptomatic (50%), discharge (mucoid),
proctitis, epidydimal/testicular pain, dysuria
ii) Female: Asymptomatic (80%), vaginal discharge,
proctitis, inter-menstral/post-coital bleeding and lower
abdo pain
Ix:
i) NAAT swab
ii) FPU (males)
Rx: i) Doxycycline BD 100mg (1/52) ii) Azithromycin 1g
(STAT) iii) Protected sex
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How far back is contact testing for Chlamydia? In which
population do you 'test for cure'? - Answers-i) 6 months
ii) Pregnant women
How fare back is contact testing for Gonorrhea? -
Answers-3 months
Outline Neisseria gonorrhea. What are the Sx (male +
female), Ix and Rx? What needs to happen after
treatment? - Answers-Neisseria gonorrhea is a gram-
negative diplococcus
Sx:
i) Male: Asymptomatic, dysuria, purulent discharge,
epididymitis/testicular pain, proctitis/anal discharge,
pharyngitis/exudate on tonsils
ii) Female: Asymptomatic, dysuria, purulent discharge,
PID, proctitis/anal discharge, pharyngitis/exudate on
tonsils
Ix:
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i) Symptomatic Males: urethral swab + NAAT/Culture swab
(confirm diagnosis)
ii) Females: Double or Triple Swabs
Rx: i) 1st line: IM Ceftriaxone 1g ii) 2nd line: Cefixime
400mg (single dose) + Azithromycin 2g (single dose)
Post treatment: Test for cure (e.g. i) NAAT >2/52 post rx ii)
Culture (post 72hrs)
What is DGI (disseminated gonococcal infection)? -
Answers-DGI: Not fully understood, known as gonorrhoeal
arthritis.
Sx:i) Triad: A) Tenosynovitis B) Dermatitis (maculopapular
or vesicular) C) Polyarthritis
What are the Ix for syphilis? What are the rx? - Answers-Ix
(tend to need 2):
i) Dark Field Microscopy (chancers)
ii) Trepenemal Specific Tests:
- TPPA, TPHA, EIA and IgM
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iii) Staging Tests (non-trepenemal specific):
- VDRL (venereal disease research laboratory test)
Rx: (dependent on stage of infection)
i) Primary, Secondary or Latent:
- IM Benzathine Benzylpenicillin
ii) Late latent:
- IM Benzathine Benzylpenicillin
iii) Tertiary Syphilis:
- Procaine Penicillin IM
- Probenecid (500mg QDS)
What is syphilis? How is it transmitted? Outline the
different stages of syphilis infection - Answers-Syphilis is
caused by Treponema pallidum, obligate parasite (gram-
negative) spirochete. Transmission occurs via two main
methods:
i) Acquired Transmission: Via contact with contaminated
body fluids via broken cutaneous tissue or intact mucous
membranes
ii) Congenital Transmission: Either in utero or during birth