10 - Gynae - Genital Tract Infections - STIs of Vulva and Vagina Flashcards
Chlamydia - how common in developed world? 5-10% of women aged ?-? have been infected.
Usually ? but urethritis and ? may occur.
1’ complx = ? infection - which may also be ?
Can cause ? damage -> ? and / or CPP
? used on urine for screening.
Trt with ? or ?
most common STI in dev world 20-30 aSx discharge pelvic silent tubal subfertility PCR azithromycin or doxy
Gonorrhoea - gram ? diplococcus. common esp where? what is also commonly infected? Commonly aSx, but discharge, ?, bartholinitis and ? can occur.
Systemic complx incl ? and acute, usually monoarticular septic ?
Dx from culture of ? swabs
What is on the increase? what drug and route usually required?
Trt and ?? are essential.
-ve common esp in dev world pelvis urethritis cervicitis bacteraemia arthritis endocervical ABx resistance IM ceftriaxone partner notification
Genital Warts - Condylomata Acuminata - caused by ?
- v common, appearance varies from tiny flat ? in ? skin to small ? swellings
- usually ? and may affect ? where certain ? types (16+18) are ass w dev of ?
- trt w topical ? or ? cream (ext warts only)
- for resistant warts what 2 things can be done?
- ? recurrence rate
- vaccines vs HPV now given to who?
HPV patches vulval papilliform multiple cervix oncogenic CIN podophyllin imiquimod electrocautery + cryo high (25%) adolescent girls
Genital Herpes - Mostly w ? (though type 1 incr implicated - ? ? virus)
- what is worse, primary or secondary infection?
- multiple small ? vesicles and ? around ? - local ?, ? and systemic Sx common
- lies ? but recurs in ?%
- recurring attacks are ? severe and often preceded by ?
- Dx from ? and ? swabs
- ? used in severe infection - reduces ? of Sx if started ? in reactivation
- ? herpes has high mortality and can be prevented
HSV2 cold sore primary painful ulcers introitus lymphadenopathy dysuria dormant 75% less tingling Ex and viral swabs Aciclovir duration early neonatal
Syphilis - incidence ? in UK
- 1’ syph: ? painless ? ulcer (chancre) - untrt leads to ??
- 2’ syphilis - dev ? later, often with ?, ?-like Sx, and ? genital/perioral growths
- now, ? of other ? leading to variety of Sx
- Latent syphilis - follows, resolves ?
- 1’/2’ during ? carries high risk of ? infection.
- 3’ s now very ?, dev many ? later, affecting any ?
- Trt at any stage with parenteral (IM) ?
incr solitary vulval 2' syph weeks rash flu-like warty infiltration organs spont preg congen rare years organ penicillin
Trichomoniasis - T ?. Very prev ? but ? in UK
Typical Sx : ? grey-? discharge, ? irritation, ? dyspareunia but can be ?
-Cervicitis has ? appearance
-Dx from ? ? microscopy, special staining or ? of vaginal swabs
-Trt with ?
vaginalis worldwide rare offensive green vulval sf aSx strawberry wet film culture metronidazole
HIV - infection with ? causes ? - ? acquired HIV infections has incr and is now more than from ?
Therefore more ? infected.
->70% Dx in UK heterosexually were infected ?, mostly in ??
-RFs - multiple ??, migration from ???, failure to use ??, presence of other ?, ?, sexual contact with high risk ?
retrovirus AIDS heterosexually MSM women abroad subsaharan africa sex partners high prev countries barrier contraception STIs IVDU males
HIV - most HIV + women are ?, although seroconversion can be accomp by ?-? Sx with a ?
- What 3 things are diagnostic of AIDS?
- yearly ? done as ? progression to ? is more rapid
- vertical trans to ? prevented by ?, ? caesarian and not ? ?
- with current ART regimes, HIV is increasingly a ? ? condition
aSx flu like rash CD4 <200, dev opportunistic infections or dev malignancy smear CIN malig fetus ART elective breast feeding chronic controllable
