6. Infections Of Reproductive Tracts

Question 1

What STIs can cause urethral discharge in men?

Answer 1

Chlamydia trachomatis - obligate intracellular bacterium

Neisseria gonorrhoeae - gram -ve, mucosal surfaces

Question 2

What are the symptoms of chlamydia trachomatis in men?

Answer 2

Can be asymptomatic

Testicular pain, dysuria, discharge

Question 3

What are the symptoms of gonorrheoea in men?

Answer 3

Discharge

Possible dysuria

Question 4

What is a non-sexually transmitted infection that can cause male urethral discharge?

Answer 4

Non-gonococcal urethritis

Question 5

What are the investigations for male urethral discharge?

Answer 5

FBC, CRP
Urine sample - gonorrhoea, exclude UTI, NAATs
Urethral swab - chlamydia

Question 6

What are the features of physiological vaginal discharge?

Answer 6

Secretory phase (progesterone)
Thicker cervical mucus
Cyclical
Colour/consistency

Question 7

What STIs can cause vaginal discharge?

Answer 7

N. gonorrhoeae
C. trachomatis
Trichomonas vaginalis

Question 8

How can C. trachomatis present in females?

Answer 8

Can be asymptomatic
Can present with post-coital bleeding or intermenstrual bleeding
Discharge
Dyspareunia

Question 9

What are the symptoms of Trichomonas vaginalis?

Answer 9

Yellow, offensive discharge

Question 10

What non-STIs can cause vaginal discharge?

Answer 10

Candida albicans - yeast, normal flora

Bacterial vaginosis - caused by gardnerella vaginalis and low lactobacillus

Question 11

When can Candida albicans increase?

Answer 11

In immunocompromised people
Diabetes
Increased oestrogen (COCP)
Recent antibiotics

Question 12

What are the symptoms of Candida albicans?

Answer 12

Itchy

Thick, white discharge

Question 13

What are the symptoms of bacteria vaginosis?

Answer 13

Offensive, white discharge

Question 14

What are the investigations for vaginal discharge?

Answer 14

Vulvovaginal swabs - chlamydia, gonorrhoea
Endopelvic also swabs - chlamydia, gonorrhoea
High vaginal swabs - trichomoniasis, BV, candida

Question 15

What are genital lesions diseases?

Answer 15

HPV
Herpes simplex virus (HSV)
Treponema pallidum (syphilis)

Question 16

What is HPV?

Answer 16

DNA virus
Non-enveloped 
Genital warts
Type 6 + 11 - 90%
Type 16 + 18 - cervical cancer

Question 17

How do you identify HPV?

Answer 17

PCR - swab, biopsy

Question 18

What are the features of HSV?

Answer 18

Mucosal surface
Genital/oral/anus
HSV-1 or HSV-2
HSV-2 higher association with HIV
Lifelong

Question 19

What are the symptoms of HSV?

Answer 19

Initially asymptomatic
Painful ulcers
Some systemic symptoms
Recurrent

Question 20

How do you test for HSV?

Answer 20

PCR/NAAT

Question 21

How do you treat HSV?

Answer 21

Antivirals e.g. aciclovir

Helps to reduce duration and severity, and reduce frequency and severity of recurrent episodes

Question 22

How is syphilis transmitted?

Answer 22

Direct and vertical

Bacterial

Question 23

What is primary syphilis?

Answer 23

Painless ulcer

Question 24

What is secondary syphilis?

Answer 24

4-10 weeks after initially infection
Glomerulonephritis
Hepatitis
Neurological symptoms
Rash

Question 25

How s syphilis detected?

Answer 25

Microscopy
PCR
Given penicillin

Question 26

What is given for bacterial STIs?

Answer 26

Azithromycin and ceftriaxone