Gonococcal & Nongonococcal Urethritis MCQ Quiz | Sexually Transmitted Infections

Welcome to this multiple-choice quiz designed for MBBS students focusing on Sexually Transmitted Infections, specifically Gonococcal and Nongonococcal Urethritis. This quiz covers crucial aspects including etiology, clinical presentation, diagnosis, management, and potential complications of these common conditions. With 25 carefully curated questions, this assessment will test your understanding of key pathogens like Neisseria gonorrhoeae and Chlamydia trachomatis, as well as emerging organisms like Mycoplasma genitalium. Each question is designed to reflect the level of detail required for your medical curriculum. After submitting your answers, you will receive your score and a detailed review of the correct and incorrect responses. You can also download all questions with their correct answers in a PDF format for future reference and study.

1. A 24-year-old male presents with a copious, purulent urethral discharge and severe dysuria for two days. A Gram stain of the discharge reveals gram-negative intracellular diplococci. What is the most likely causative organism?

Chlamydia trachomatis Neisseria gonorrhoeae Trichomonas vaginalis Mycoplasma genitalium

2. Which diagnostic test is considered the gold standard for detecting both Chlamydia trachomatis and Neisseria gonorrhoeae due to its high sensitivity and specificity?

Gram stain Culture on Thayer-Martin agar Nucleic Acid Amplification Test (NAAT) Enzyme-linked immunosorbent assay (ELISA)

3. According to current CDC guidelines, what is the recommended first-line treatment for uncomplicated gonococcal urethritis?

Azithromycin 1g orally in a single dose Doxycycline 100 mg orally twice a day for 7 days Ceftriaxone 500 mg intramuscularly in a single dose Ciprofloxacin 500 mg orally in a single dose

4. A patient is diagnosed with nongonococcal urethritis (NGU). If chlamydial infection is confirmed, what is the preferred treatment regimen?

Metronidazole 2g orally in a single dose Ceftriaxone 500 mg IM in a single dose Penicillin G 2.4 million units IM in a single dose Doxycycline 100 mg orally twice a day for 7 days

5. Which of the following is a potential complication of untreated gonococcal urethritis in males?

Epididymo-orchitis Testicular torsion Benign prostatic hyperplasia Primary syphilis

6. Disseminated Gonococcal Infection (DGI) classically presents with a triad of symptoms. Which of the following is part of this triad?

Tenosynovitis, dermatitis, and polyarthralgia Fever, headache, and neck stiffness Urethritis, conjunctivitis, and arthritis Dysuria, pelvic pain, and infertility

7. A patient treated for gonococcal urethritis returns after one week with persistent symptoms. This condition is referred to as persistent urethritis. Which organism is increasingly recognized as a cause of persistent NGU, especially after treatment with doxycycline?

Ureaplasma urealyticum Herpes Simplex Virus Mycoplasma genitalium Gardnerella vaginalis

8. The incubation period for symptomatic gonococcal urethritis is typically:

Less than 24 hours 2 to 7 days 2 to 4 weeks 1 to 3 months

9. What is a key characteristic that distinguishes nongonococcal urethritis (NGU) from gonococcal urethritis in terms of clinical presentation?

NGU discharge is typically more purulent and copious. NGU is always associated with genital ulcers. NGU often presents with mucoid or clear discharge and milder dysuria. NGU has a much shorter incubation period than gonorrhea.

10. A “test of cure” is recommended for certain populations after treatment for gonorrhea. Which patient group most requires a test of cure?

All patients with uncomplicated urethritis. Asymptomatic male partners of infected females. Patients with pharyngeal gonorrhea. Patients treated with doxycycline alone.

11. Fitz-Hugh-Curtis syndrome (perihepatitis) is a potential complication of which infection in women?

Herpes Simplex Virus Human Papillomavirus Trichomonas vaginalis Chlamydia trachomatis and Neisseria gonorrhoeae

12. A Gram stain of urethral discharge shows >5 polymorphonuclear leukocytes (PMNs) per oil immersion field but no visible organisms. This finding is most suggestive of:

Gonococcal urethritis Nongonococcal urethritis A normal finding Urinary tract infection

13. Expedited Partner Therapy (EPT) is a strategy for treating the sex partners of persons with certain STIs. EPT is most commonly recommended for partners of patients diagnosed with:

HIV and Syphilis Gonorrhea and Chlamydia Herpes Simplex Virus Hepatitis B

14. Which of the following organisms causing NGU is an obligate intracellular bacterium?

Mycoplasma genitalium Ureaplasma urealyticum Chlamydia trachomatis Trichomonas vaginalis

15. A 28-year-old female presents with mucopurulent cervicitis. She is at high risk for STIs. In addition to testing for gonorrhea and chlamydia, testing for which other organism should be considered, as it is a common cause of cervicitis and urethritis?

Neisseria meningitidis Candida albicans Gardnerella vaginalis Trichomonas vaginalis

16. Why is dual therapy with ceftriaxone and azithromycin no longer routinely recommended for uncomplicated gonorrhea?

Due to the high cost of azithromycin. Due to concerns about increasing azithromycin resistance in N. gonorrhoeae and other organisms. Because ceftriaxone alone has a 100% cure rate. Because of severe side effects from the combination.

17. Reiter’s syndrome (reactive arthritis) is a classic triad of urethritis, conjunctivitis, and arthritis. It is most commonly triggered by which genitourinary pathogen?

Neisseria gonorrhoeae Chlamydia trachomatis Treponema pallidum Herpes Simplex Virus

18. The appropriate specimen for NAAT testing for urethritis in a male is:

Urethral swab First-catch urine Both urethral swab and first-catch urine are highly sensitive Mid-stream urine

19. A patient with known penicillin allergy (anaphylaxis) is diagnosed with gonorrhea. Which is the most appropriate alternative treatment?

Amoxicillin 500 mg orally Gentamicin 240 mg IM plus Azithromycin 2g orally Doxycycline 100 mg orally for 14 days Cefixime 800 mg orally

20. In cases of persistent or recurrent NGU, after ruling out re-infection, what is the recommended treatment if Mycoplasma genitalium is suspected or confirmed?

A repeat course of doxycycline Ceftriaxone 500 mg IM Metronidazole 2g orally Doxycycline followed by moxifloxacin, or azithromycin

21. The most common cause of nongonococcal urethritis (NGU) in men is:

Mycoplasma genitalium Chlamydia trachomatis Trichomonas vaginalis Ureaplasma urealyticum

22. A significant percentage of men with gonococcal urethritis and women with gonococcal cervicitis are co-infected with which other organism?

Syphilis Herpes Simplex Virus Type 2 Chlamydia trachomatis Human Papillomavirus

23. Ophthalmia neonatorum, a severe conjunctivitis in newborns, can be caused by vertical transmission of which of the following during childbirth?

Neisseria gonorrhoeae and Chlamydia trachomatis Only Herpes Simplex Virus Only Treponema pallidum Only Mycoplasma genitalium

24. What is the primary mechanism of action of ceftriaxone against Neisseria gonorrhoeae?

Inhibition of DNA gyrase Inhibition of protein synthesis at the 50S ribosomal subunit Inhibition of bacterial cell wall synthesis Disruption of the bacterial cell membrane

25. After being treated for chlamydial urethritis, when should a patient be advised to resume sexual activity?

Immediately after finishing the antibiotic course

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

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