Genital discharge Flashcards
Urethral discharge history?
Duration of symptoms
Colour/amount
Other urinary symptoms
Testicular symptoms
Systemic symptoms
Sexual history (history of STIs)
What is dysuria?
Pain on urination
Clinical features of cystitis?
Inflammation of bladder
Dysuria
Frequency
Urgency
Nocturia
Haematuria
Suprapubic pain
Systemic
A feature of gut bacteria (Interstitial cystitis)
Clinical features of urethritis?
Dysuria
Discharge
No bladder symptoms
Nil systemic
Feature of:
Chlamydia
Gonorrhoea
Non-specific urethritis
Clinical features of dermatitis?
Dermatitis = inflammation of the skin
“External dysuria”
Discomfort +/- itch
Rash or ulcers
Feature of:
Candidiasis
Trichomoniasis
Herpes simplex
Dermatoses
Discharge for gonococcal urethritis?
Quantity: Profuse purulent
Colour: Yellow/green
Discharge for non-gonococcal urethritis?
Quantity: Scant (very little)
Colour: Milky/clear
Treatment for gonorrhoea?
First-line: Ceftriaxone 1G IM or Ciprofloxacin500mg orally as a single dose (only where antimicrobial sensitivities are known prior to treatment)
Second-line: Cefixime 400 mg oral plus Azithromycin 2G (only if IM injection is contra-indicated or refused by patient)
Test of cure in all patients (after 2-3/52)
Partner notification
Urethritis in men is usually caused by a sexually transmitted infection. true/false?
True
Dysuria can arise from inflammation in the bladder, inflammation in the urethra or inflammation on the genital skin. true/false?
True
Cause of candidiasis?
Fungal infection caused by Candida sp
80-90% Candida albicans
Risk factors for candidiasis?
Diabetes mellitus
SGLT2i (Type 2 DM)
Recent antibiotic use
Immunosuppression
Management of candidiasis?
Genital skin care advice (soap substitutes)
Azole anti-fungal (cure rate >80%)
Fluconazole capsule stat dose
Clotrimazole pessary 500mg stat dose PV
Clotrimazole Cream for external symptoms x 2/52
+/- hydrocortisone
Manage risk factors
Consider HIV test if recurrent
Suppressive therapy if recurrent
