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3rd Year - Reproductive Diseases > 6.1. Infections of the Genital Tract - Non-Sexually Transmitted Diseases > Flashcards

6.1. Infections of the Genital Tract - Non-Sexually Transmitted Diseases Flashcards

1
Q

What can cause Genital Symptoms?

A
  1. STI’s
  2. Microbial Problem that’s not an STI
  3. Dermatoses
  4. Structural Abnormalities - Congenital vs Acquired
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2
Q

What are the common presenting Symptoms of Abnormality?

A
  1. Vaginal Discharge
  2. Urethral Discharge
  3. Dysuria
  4. Genital Appearance - Temporary / More Persistent
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3
Q

What are some benign Anatomical Changes of the Genital Tract?

A
  1. Fox-Fordyce Spots
  2. Vulval Papillomatosis
  3. Penile Pearly Papules (Coronal Papillae)
  4. Tyson’s Glands
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4
Q

What forms the “Real Problems”?

A
  1. Organism exclusively transmitted during Sexual Contact - Condition predicted by Infecting Organism
  2. Organism only transmitted by Non-Sexual Means - Condition dependent on Host Factors, not the Organism
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5
Q

What are some Non-STI Microbial Problems?

A
  1. Vulvovaginal Candidosis (Thrush)
  2. Bacterial Vaginosis
  3. Balanitis
  4. Tinea Cruris
  5. Erythrasma
  6. Infectious Sebaceous Glands
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6
Q

What causes Vulvovaginal Candidosis (Thrush)?

A
  1. Candida Albicans (90%)
  2. Candida Glabrata
    Acquired from the Bowel
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7
Q

How does Vulvovaginal Candidosis (Thrush) present?

A

This is very common, usually trivial but can become a problem:

  1. Asymptomatic Carriage - Changes in the Host’s Environment trigger Pathogenicity
  2. Symptomatic - “Thrush”:
  3. a) Itch
  4. b) Discharge - Thick, “Cottage Cheese”
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8
Q

What predisposes people to getting Vulvovaginal Candidosis (Thrush)?

A
  1. Diabetes / Oral Steroids
  2. Immunosuppression - including HIV
  3. Pregnancy
  4. Reproductive Age Group
    Note - Many cases occur in women with no pre-disposing factors
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9
Q

How is Vulvovaginal Candidosis (Thrush) diagnosed?

A
  1. Characterized History
  2. Examination Findings:
  3. a) Fissuring
  4. b) Erythema with Satellite Lesions
  5. c) Characteristic Discharge
  6. Investigation:
  7. a) Gram-Stained Preparation - Low Sensitivity
  8. b) Culture - Low Specificity
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10
Q

How is Vulvovaginal Candidosis (Thrush)?

A

Azole Antifungals:

  1. Clotrimazole
  2. Fluconazole
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11
Q

What is the commonest cause of Abnormal Vaginal Discharge?

A

Bacterial Vaginosis

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12
Q

What are the Symptoms of Bacterial Vaginosis?

A
  1. Asymptomatic
  2. Watery Grey / Yellow “Fishy” Discharge
  3. May be worse after Period / Sex
  4. Sometimes Sore / Itch from Dampness
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13
Q

What causes Bacterial Vaginosis?

A

An imbalance of Bacteria - Not really an infection. It is a Biofilm problem:

  1. Increased Gardnerella / Ureaplasma / Mycoplasma / Anaeobes
  2. Reduced Lactobacilli
  3. Sexually Transmissibility Controversial
  4. Associated with Vitamin D deficiency
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14
Q

What are the problems associated with Bacterial Vaginosis?

A

Usually Trivial:

  1. Associated with Endometritis if Uterine Intrumentation / Delivery
  2. Associated with Premature Labour
  3. Increase risk of HIV acquisition
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15
Q

How is Bacterial Vaginosis Diagnosed?

A
  1. Charcteristic History
  2. Examination Findings - Thin, Homogenous Discharge
  3. Gram Stained smear of Vaginal Discharge
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16
Q

How is Bacterial Vaginosis treated?

A
  1. Metronidazole (Oral / Vaginal Gel)

2. Cindamycin (Vaginal)

17
Q

What are common Infective Diseases of the Genital Tract?

A
  1. Balanitis and Posthitis - Candidal Balanitis / Zoon’s Balanitis (Plasma Cell Balanitis)
  2. Impetigo - Staph Aureus (occasionally Strep. Pyogenes)
  3. Eryipelas - Group A Strep
  4. Dermatophyte Infection - Trichophyton Rubrum / Tinea Cruris
  5. Erythrasma - Corynebacterium Minutissimum
18
Q

What is Zoon’s Balanitis?

A

Chronic inflammation secondary to overgrowth of commensal organisms plus “Foreskin Malfunction”

19
Q

What are the other Genital Symptoms of Infective Diseases of the Genital Tract?

A
  1. Pain Syndromes - the “Dynias”
  2. Dermatoses
  3. Congenital
  4. Traumatic
  5. Neoplastic
  6. Manifestations of Systemic Disease

3rd Year - Reproductive Diseases (41 decks)

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