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Year 3 > Common Genital Syndromes and their Non-STI Causes > Flashcards

Common Genital Syndromes and their Non-STI Causes Flashcards

1
Q

presenting complaints: genitals

A
  • Discharge from an orifice
  • Pain
  • Rashes
  • Lumps and swelling
  • Cuts sores and ulcers
  • Itching
  • Change in appearance
  • Vague symptoms
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2
Q

DDx genital symptoms

A 
• STD
o Public and individual health problem
o Treatable
o Not always curable
• Other microbial problem
o Individual health
o Treatable
o Usually curable
• Non-microbial
o Individual
• Perceived problem only
o Normal findings, sensations
• Dermatoses
• Structural abnormalities
o Congenital
o Acquired
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3
Q

Non-STD microbial conditions

A
  • Vulvovaginal candidosis
  • Bacterial vaginosis
  • Balanitis
  • Tinea cruris
  • Erythrasma
  • Infected sebaceous glands
  • Impetigo
  • Cellulitis
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4
Q

vulvovaginal candidosis: organism

A

candida albicans

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5
Q

vulvovaginal candidosis: source

A

bowel

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6
Q

vulvovaginal candidosis: symptoms

A

itch

thick “cottage chees” discharge

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7
Q

vulvovaginal candidosis: risk factors

A 
diabetes
oral steroids
immune suppression
regnancy
reproductive age group
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8
Q

vulvovaginal candidosis: examination findings

A

fissuring
erythema with satellite lesions
characteristic dischage

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9
Q

vulvovaginal candidosis: investigations

A

Gram stained preparation
o Low sensitivity – might look at an unrepresentative patch
• Culture – eg Sabouraud’s medium
o Low specificity – yeast is often commensal

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10
Q

vulvovaginal candidosis: treatment

A 
Azole antifungals
o Clotrimazole 500mg PV once
§ Plus, clotrimazole HC if vulvitis
o Fluconazole 150mg PO once
• Resistance – species and sensitivities
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11
Q

bacterial vaginosis: symptoms

A

asymptomatic

watery grey/yell “fishy” discharge

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12
Q

bacterial vaginosis: cause

A

imbalance of bacteria - biofilm
• Increased Gardnerella/ureaplasma/mycoplasma/anaerobes
• Reduced lactobacilli
• Sexual transmissibility controversial
• Associated with Vit D deficiency, in black women

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13
Q

bacterial vaginosis: may be associated with

A

endometritis if instrumental/delivery, premature labour

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14
Q

bacterial vaginosis: increases risk of what acquisition?

A

HIV

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15
Q

bacterial vaginosis: diagnosis

A

exam is rare, usually Hx alone
discharge is thin
homogenous discharge
gram stained smear

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16
Q

bacterial vaginosis: treatment

A

Treat with metronidazole oral (avoid ethanol) or vaginal gel. Clindamycin can be used vaginally. Can just leave and it will sort itself out.

17
Q

name tyoes ofbalanitis and prosthitis

A 
candidal balanitis
zoon's balanitis
impetigo
erysipelas
dermatophyte infection
tinea cruris
erythrasma
18
Q

what causes Zoon’s balanitis

A

plasma cell balanitis

chronic inflammation secondary to overgrowth of commensal organisms plus “foreskin malfunciton”

19
Q

what bacteria causes impetigo in the penis?

A

staph aureus

strep pyogenes

20
Q

what organism causes erysipelas of the penis?

A

group A strrp

21
Q

organism causing dermatophyte infections of the penis

A

trichophyton rubrum

22
Q

what organism cases erythrasma of the male genitalis

A

corynebacterium miniutissium

23
Q

what things related to genitals may people think they have wrong but are fine

A 
• Vaginal discharge
• Urethral discharge
• Dysuria
• Genital/pelvic discomfort
• Rashes
• Skin lumps
• Penis size. Scrotal lumps, labial shape
o Temporary
o More persistent – body dysmorphia
24
Q

lines of question if nothing to find on examination or tests (genitals)

A
  • Regretted sexual encounter
  • Problems in life
  • Co-existing mental ill health – anxiety
  • When did they notice the problem?
  • When were things last normal?
25
Q

other causes of genital symptoms

A 
lyphocele
congenital cyst
traumatic ruptured artery in frenulum
torn frenulum and infection
luchen sclerosis
lichen planus 
• Pain syndromes – the dynias
• Dermatoses
• Congenital
• Traumatic
• Neoplastic
• Manifestations of systemic disease
• Fox-Fordyce spots
o Glands
o Normal
• Vulval papillomatosis
o Normal
o Frong like appearance
o Worried about HPV
• Penile pearly papules – aka Coronal papillae
o Normal bumps around
• Tyson’s glands
o Sebaceous glands around frenulum

Year 3 (164 decks)

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