10 - Gynae - Genital Tract Infections - Infections of Vulva and Vagina Flashcards
1
Q
in prepubertal and post meno women, lack of oestrogen results in…
A
thin atrophic epithelium, a higher pH (6.5-7.5 - normally <4.5) and a reduced resistance to infection
2
Q
non-STIs of vulva and vag? (3)
A
candidiasis (thrush)
Bacterial vaginosis
Infection ass with foreign body
3
Q
7 STIs of vulva and vag?
A
Chlamydia Gonorrhoea Trichomoniasis HIV Syphilis Genital warts Genital Herpes
4
Q
Candidiasis - infection with c ?
- found in ?%
- often without ?
- what 3 things are RFs?
- If Sx -> ?? discharge w vulval irritation and ?, ? dyspareunia and ? may occur
- recurrent more common/severe in two groups?
- diagnosis is by ? and trt with topical ? - clotrimazole or oral ?
A
albicans 20% Sx DM, Preg, ABx use cottage cheese itching superficial dysuria immocomp and uncontrolled DM culture imidazoles fluconazole
5
Q
Bacterial vaginosis - when normal flora overran
- found in ?%
- ?-? discharge present, but not ? or ?
- ? odour from bacterial ?
- Dx by ? vaginal ?, ?, positive ? test and presence of clue cells in ?
- trt with ? or ? cream
- these bacteria can cause 1’ infection in ?
- also ass with ? labour
A
12% grey-white red or itchy fishy, proteolysis raised pH discharge whiff microscopy metronidazole or clindamycin PID preterm
6
Q
Infection ass w FB
- often in who?
- consider ? ?
- but discharge more often from ? vaginitis from low ?
- ?? syndrome - rare complx of ?, superabsorbent ? - trt with ? where?
A
children sexual abuse atrophic oestrogen toxic shock retained, tampon ABx in ICU
7
Q
STI - MGMT principles
- ? for concurrent disease as >1 STI may be present, regular ?? should be trt and screened for other infections
- ?? (contact tracing) should be done by ?
- ? should be maintained - can’t inform ?? without permission - STIs can occur in ? r’ships, must handle sensitively and w adequate ?
- Education > freq changing ? incr risk of STIs including ?
- Advice - ? methods of ? greatly reduce risk of STIs
A
screening sexual partner partner notification patient confidentiality sexual partners monogamous explanation partners HIV barrier contraception
