A - MSRA Gynaecology [8] > [3] Gonorrhoea > Flashcards

[3] Gonorrhoea Flashcards

(47 cards)

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1
Q

What is gonorrhoea?

A

A sexually transmitted infection caused the bacterium Neisseria gonorrhoea

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2
Q

What type of bacteria is Neisseria gonorrhoea?

A

A gram -ve diplococcus

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3
Q

What does Neisseria gonorrhoea infect?

A

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

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4
Q

What parts of the body can be affected by gonorrhoea?

A
  • Genitals
  • Mouth
  • Rectum
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5
Q

How does gonorrhoea spread?

A

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

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6
Q

When can gonorrhoea be transmitted?

A

Usually sexually but can occur perinatally

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7
Q

What is the incubation period of gonorrhoea?

A

2-5 days but can be up to 10

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8
Q

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

A

44,000

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9
Q

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

A

MSM

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10
Q

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

A
  • More young men coming forward for testing

- Increasing unsafe sex

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11
Q

Where is gonorrhoea more common?

A

URban areas

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12
Q

What are the risk factors for gonorrhoea?

A
  • 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
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13
Q

What sexual activities are particularly risky for gonorrhoea transmission?

A
  • Anal intercourse

- Frequent insertive oral sex

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14
Q

Which sex is gonorrhoea more commonly symptomatic in?

A

Men (90-95%)

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15
Q

What percentage of women with gonorrhoea are symptomatic?

A

50%

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16
Q

What do symptoms of gonorrhoea depend on?

A

The site of infection

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17
Q

What are the symptoms of urethral gonorrhoea infection in men?

A
  • Discharge
  • Dysuria
  • Asymptomatic in <10% of cases
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18
Q

What are the symptoms of rectal gonorrhoea infection in men?

A
  • Usually asymptomatic
  • Anal discharge
  • Perianal/anal pain
  • Pruritis
  • Bleeding
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19
Q

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

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A

Usually asymptomatic

20
Q

How does endocervical gonorrhoea infection present?

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A
  • Up to 50% asymptomatic
  • Increased or altered vaginal discharge (up to 50% of cases)
  • Lower abdominal pain
  • Intermenstrual bleeding or menorrhagia
21
Q

What are the symptoms of urethral gonorrhoea infection in women?

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A
  • Dysuria without frequency
22
Q

How does rectal gonorrhoea infection present in women?

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A

Usually asymptomatic

23
Q

What are the differentials for gonorrhoea?

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A
  • Chlamydia
  • Thrichomonas
  • Candidiasis
  • Bacterial vaginosis
  • Urinary tract infection
24
Q

How was gonorrhoea traditionally investigated?

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A

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
A - MSRA Gynaecology [8]
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