28 - STIs & Genital Symptoms Flashcards
8 genital symptoms?
Discharge from an orifice
Pain
Rashes
Lumps and swellings
Cuts, sores, ulcers
Itching
Change in appearance
Vague sense of things not being right
3 main causes for genital symptoms?
STD
other microbial problem
non-microbial problem
describe STD in terms of treatment and cure?
public and individual health issue
treatable
not always curable
describe other microbial problems in terms of treatment and cure?
Individual health problem
Treatable
Usually curable
give 3 examples of microbial conditions which are NOT classed at STDs?
Vulvovaginal candidosis
Bacterial vaginosis
Balanoposthitis – anaerobic/candidal
Tinea cruris
what is the main causative organism of vulvovaginal candidosis?
Candida albicans
what is another less common causative organism for vulvovaginal candidosis?
C. glabrata
how is vulvovaginal candidosis acquired?
from the bowel
is vulvovaginal candidosis symptomatic? if so what are the symptoms?
Often asymptomatic -
however, can be symptomatic -
Itch
Discharge – thick, cottage cheese
name 3 groups of people who are most at risk of getting vulvovaginal candidosis?
diabetes
immune suppression incl HIV
pregnancy
clinical diagnosis of vulvovaginal candidosis?
Characteristic history
Examination findings
2 investigations for diagnosis of vulvovaginal candidosis?
Gram stained preparation - Low sensitivity
Culture – eg Sabouraud’s medium - Low specificity – yeast are commensal organisms
2 treatments for vulvovaginal candidosis?
1 - azole antifungals
(clotrimazole 500 mg once/ fluconazole 150 mg once)
2 - maintenance of skin - avoid irritants and treat dermatitis
what is the most common cause of abnormal vaginal discharge?
bacterial vaginosis
symptoms of bacterial vaginosis?
asymptomatic
watery grey/yellow ‘fishy’ discharge
may be worse after period / sex
sometimes sore/itch from dampness
describe 2 factors associated with overgrowth of BV bacteria?
redcution of lactobacilli (reduced H2O production)
raised pH
3 possible severe risks associated with bacterial vaginosis?
endometritis
premature labour
increased risk of HIV
clinical diagnosis of BV?
Characteristic history
Thin homogenous discharge on examination
investigations diagnosis of BV?
pH
Gram stained smear of vaginal discharge
name 2 antibiotics which are used to treat BV and their routes of admin?
Metronidazole - oral/ vaginal gel
Clindamycin - vaginal
name 2 other types of treatment for BV?
probiotics
vaginal acidification
causative organism for balanitis and posthitis?
candidal balanitis
how does Zoon’s balanitis present?
Chronic inflammation secondary to overgrowth of commensal organisms plus ‘foreskin malfunction’.
2 causative organisms for impetigo?
staph aureus
strep pyogenes
causative organism for Erysipelas?
strep pyogenes
causative organism for dermatophyte infection?
trichophyton rubrum
causative organism for tinea cruris?
dermatophytes
what is tinea cruris AKA?
athlete’s groin
causative organism for erythrasma?
Corynebacterium minutissimum
give 3 examples of questions to ask if nil found on a perceived problem?
Regretted sexual encounter?
When did they notice the problem?
Co-existing mental ill-health?
3 things which should be done in terms of management for patients with perceived problem but nil found?
acknowledge it - never tell them they’re not experiencing it
ask what they think might be causing it
give them reassurance
what are coronal papillae?
pearly papules on the penis
4 examples of conditions which may seem like an STD but are not?
Fox-Fordyce spots
vulval papillomatosis
coronal papillae
Tyson’s glands
4 examples of other causes of genital symptoms?
Pain syndromes
Dermatoses
Congenital
Traumatic
3 examples of pain syndromes affecting the genitals?
Vestibulodynia
Vulvodynia
Chronic Pelvic Pain Syndrome
