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Reproduction Week 1 2018/19 > 6: Microbiology of genital tract infections > Flashcards

6: Microbiology of genital tract infections Flashcards

1
Q

Gonorrhoea produces a ___ discharge.

Chlamydia produces a ___ discharge.

A

gonorrhoea - purulent

chlamydia - watery

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2
Q

The normal vaginal pH is (acidic / basic).

A

acidic

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3
Q

Which commensal bacteria is most commonly found in the vagina?

A

Lactobacillus

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4
Q

Apart from Lactobacillus, what other organisms are found naturally found in the vagina?

A

Group B Strep

Candida

Strep viridans

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5
Q

Which fungal infection commonly affects the female genital tract?

A

Candida albicans

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6
Q

Non-albicans Candida infections are more common in ____ patients.

A

immunosuppressed

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7
Q

Poorly controlled ___ is a risk factor for Candida infection.

A

diabetes

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8
Q

What is the presentation of Candida infection?

A

White vaginal discharge

Itch

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9
Q

How is candida infection investigated?

A

Vaginal swab for culture

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10
Q

Which antifungal is used for Candida infection?

A

Clotrimazole

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11
Q

What causes bacterial vaginosis?

A

?Lack of balance

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12
Q

What is the presentation of bacterial vaginosis?

A

Intensely smelly, frothy vaginal discharge

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13
Q

In bacterial vaginalis, the normal vaginal bacteria are replaced with which bacteria?

A

Gardnerella vaginalis

and anaerobes

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14
Q

What happens to the vaginal pH in bacterial vaginosis?

A

Becomes alkaline

i.e the pH increases

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15
Q

Bacterial vaginosis is an imbalance of bacteria, not an infection.

Why is it treated regardless?

A

Risk of genital tract infection

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16
Q

Which antibiotic, effective against anaerobes, is effective for treating bacterial vaginosis?

A

Metronidazole

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17
Q

STIs tend to ___.

A

co-exist

so you test for all of them

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18
Q

What is the most common STI in the UK?

A

Chlamydia trachomatis

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19
Q

Chlamydia trachomatis can be split into subtypes depending on its ___.

A

serology

what it produces

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20
Q

How does Chlamydia appear on a Gram stain?

A

Doesn’t stain

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21
Q

Which serovars of chlamydia trachomatis cause genital tract infections?

A

D-K

22
Q

The guidance for antibiotic treatment of chlamydia trachomatis has just changed.

What is the empirical treatment?

A

Doxycycline 100mg BD for 7 days

23
Q

Before it became doxycycline 100mg, what was the antibiotic treatment for chlamydia?

A

Azithromycin 1g

24
Q

What are the investigations for genital chlamydia and gonorrhoea in

a) males
b) females?

A

a) First pass urine sample

b) Vulvo-vaginal swab

25
Q

What other investigations, apart from genital ones, exist for chlamydia and gonorrhoea?

A

Rectal swab

Throat swab

Eye swab

26
Q

What is the appearance of gonorrhoea on a Gram stain?

A

Gram -ve intracellular diplococcus

27
Q

What does neisseria gonorrhoeae look like on microscopy?

A

Gram negative diplococcus

“Two kidney beans facing one another”

28
Q

What type of media is used to culture neisseria gonorrhoeae?

A

Selective media

kills competitors

29
Q

The samples obtained from first pass urine samples or vulvovaginal swabs are sent for which type of testing?

A

Nucleic acid amplification tests (NAATs)

More sensitive for diagnosing chlamydia/gonorrhoea than culture

30
Q

Which antibiotic is given for gonorrhoea infection?

A

Ceftriaxone

31
Q

Neisseria gonorrhoea has recently become ___ in some places.

A

untreatable

resistant to all antibiotics

32
Q

Treated gonorrhoea infection is subjected to a ___ ___ ___ before discharging the patient.

A

test of cure

33
Q

What is lymphogranuloma venerum?

What is the causal organism?

A

Infection of the lymph nodes, usually presenting as prostatitis in MSM

Chlamydia trachomatis (serovars L1 - L3)

34
Q

How is bacterial prostatitis treated empirically?

A

Ciprofloxacin

One month course

35
Q

Which antibiotic is used to treat acute bacterial prostatitis?

A

Ciprofloxacin

36
Q

Which organism causes syphilis?

A

Treponema pallidum

37
Q

What is the appearance of Treponema pallidum on microscopy?

A

Spirochaete

38
Q

Does Treponema pallidum appear on Gram film?

A

No

39
Q

How is Treponema pallidum detected?

A

PCR

40
Q

Can treponema pallidum be grown in culture?

A

No

PCR

41
Q

What is the primary lesion of syphilis called?

A

Chancre

42
Q

What does a chancre look like?

A

Ulcer

43
Q

Are chancres painful?

A

Painless

44
Q

What is the baseline blood test for suspected syphilis?

A

Syphilis IgM & IgG test

45
Q

What antibiotic is used to treat syphilis?

A

Injectable, long-acting penicillin

i.e benzylpenicillin

46
Q

Which virus can cause genital infection?

A

Herpes simplex 1 & 2

47
Q

What structures does HSV infiltrate?

A

Nerves

48
Q

What is the investigation for genital herpes?

A

Genital swab > PCR

49
Q

What is the treatment for genital herpes?

A

Aciclovir

Analgesia

50
Q

Trichomonas vaginalis is a protozoan parasite which causes vaginal discharge and irritation.

How is it investigated and managed?

A

Ix: High vaginal swab for MICROSCOPY

Rx: ORAL METRONIDAZOLE

51
Q

What is the treatment for genital lice?

A

Malathion lotion

Reproduction Week 1 2018/19 (9 decks)

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