Gonorrhoea Flashcards Preview

B - Gynaecology > Gonorrhoea > Flashcards

Flashcards in Gonorrhoea Deck (47)
1

What is gonorrhoea?

A sexually transmitted infection caused the bacterium Neisseria gonorrhoea

2

What type of bacteria is Neisseria gonorrhoea?

A gram -ve diplococcus

3

What does Neisseria gonorrhoea infect?

The mucous membranes of the urethra, endocervix, rectum, pharynx and conjunctiva

4

What parts of the body can be affected by gonorrhoea?

- Genitals
- Mouth
- Rectum

5

How does gonorrhoea spread?

By direct inoculation of infected secretions from one mucous membrane to another

6

When can gonorrhoea be transmitted?

Usually sexually but can occur perinatally

7

What is the incubation period of gonorrhoea?

2-5 days but can be up to 10

8

How many cases of gonorrhoea were diagnosed in England in 2017?

44,000

9

Which group of people have a disproportionate increase in gonorrhoea cases?

MSM

10

What is thought to have caused the increase in cases of gonorrhoea?

- More young men coming forward for testing
- Increasing unsafe sex

11

Where is gonorrhoea more common?

URban areas

12

What are the risk factors for gonorrhoea?

- Young age
- History of previous STI
- Co-existent STI
- New or multiple sexual partners
- Recent sexual activity abroad
- Certain sexual activities
- Inconsistent condom use
- History of drug use or commercial sex work

13

What sexual activities are particularly risky for gonorrhoea transmission?

- Anal intercourse
- Frequent insertive oral sex

14

Which sex is gonorrhoea more commonly symptomatic in?

Men (90-95%)

15

What percentage of women with gonorrhoea are symptomatic?

50%

16

What do symptoms of gonorrhoea depend on?

The site of infection

17

What are the symptoms of urethral gonorrhoea infection in men?

- Discharge
- Dysuria
- Asymptomatic in <10% of cases

18

What are the symptoms of rectal gonorrhoea infection in men?

- Usually asymptomatic
- Anal discharge
- Perianal/anal pain
- Pruritis
- Bleeding

19

How does pharyngeal gonorrhoea infection usually present in men and women?

Usually asymptomatic

20

How does endocervical gonorrhoea infection present?

- Up to 50% asymptomatic
- Increased or altered vaginal discharge (up to 50% of cases)
- Lower abdominal pain
- Intermenstrual bleeding or menorrhagia

21

What are the symptoms of urethral gonorrhoea infection in women?

- Dysuria without frequency

22

How does rectal gonorrhoea infection present in women?

Usually asymptomatic

23

What are the differentials for gonorrhoea?

- Chlamydia
- Thrichomonas
- Candidiasis
- Bacterial vaginosis
- Urinary tract infection

24

How was gonorrhoea traditionally investigated?

Culture for diagnosis and sensitivity testing

25

What is overtaking culture as the main diagnostic test for gonorrhoea?

NAAT (nucleic acid amplification testing)

26

When is culture still necessary?

- In positive NAAT tests to ensure resistant strains are identified
- Signs and symptoms consistent with gonorrhoea

27

How can samples for gonorrhoea NAAT be taken?

- Urethral/endocervical swabs
- First pass urine

28

When should a patient be referred to a GUM clinic for gonorrhoea?

If they have symptoms or is at high risk or has tested positive

29

What are the management aspects in gonorrhoea?

- Give advice
- Partner notification
- Drug treatment

30

What advice should be given to patients with gonorrhoea?

- Explain condition, implications for patient and partner(s)
- Advice on safer sex
- Avoid sex until treatment completed in patient and partner(s)

31

Who should perform partner notification in gonorrhoea?

Preferably health professional

32

Which contacts of a man with symptomatic urethral gonorrhoea infection should be notified?

All that they have had sexual contact with in past 2 weeks or their last partner if more than 2 weeks

33

Which contacts of a person with asymptomatic or symptomatic non-urethral gonorrhoea infection should be notified?

All sexual partners for last 3 months

34

What should form part of partner notification for gonorrhoea?

- Full STI screen
- Empirical treatment for gonorrhoea and chlamydia in advance of test results

35

What is the recommended treatment for confirmed uncomplicated anogenital gonorrhoea?

State doses of:

- Ceftriaxone 500mg IM
- Azithromycin 1g orally

36

What is recommended after all treatments of gonorrhoea?

Test of cure

37

What can be given if there is a history of cephalosporin sensitivity (in the patient)?

Azithromycin 2g single oral dose

38

What are the potential complications of gonorrhoea in men?

- Gonococcal urethritis
- Local spread

39

What can gonococcal urethritis cause?

- Scarring
- Stricture
- Bladder-outflow obstruction

40

What gonorrhoea spread cause in men?

- Acute epididymitis
- Prostatitis
- Seminal vesiculitis
- Penile lymphangitis
- Peri-urethral abscess

41

What are the potential complications of gonorrhoea in women?

- PID
- Bartholin’s abscess
- Peri-hepatitis

42

What can PID lead to as a result of gonorrhoea?

- Infertility
- Chronic pelvic pain
- Ectopic pregnancy

43

What can gonorrhoea in pregnancy be associated with?

- Premature labour
- Miscarriage
- Corneal scarring and blindness due to neonatal ophthalmic infection

44

What are the potential complications of gonorrhoea that could be caused in men or women?

- Haematogenous dissemination
- Increased risk of HIV infection

45

What can dissemination of gonorrhoea lead to?

- Skin lesions
- Reiter’s syndrome
- Meningitis
- Endocarditis
- Myocarditis

46

What are the features of Reiter’s syndrome?

- Arthralgia
- Arthritis
- Tenosynovitis of ankle, wrists, hands and feet

47

How can gonorrhoea be prevented?

- Safer sex
- Consistent condom use
- Testing for those at risk