Genital Infections Flashcards
How is vaginal pH maintained?
- Oestrogen / Progesterone stimulate secretion of glycogen.
- Lactobacilli convert glycogen into lactic acid.
- Lactic acid production maintains vaginal pH at 3.5-4.5.
Outline gram positive bacteria and how they stain.
Gram-positive bacteria have a thick meshlike cell wall made of peptidoglycan and as a result are stained purple by crystal violet.
Outline Gram-negative bacteria and how they stain.
Gram-negative bacteria have a thinner layer so do not retain the purple stain.
What is the condition described?
Offensive fishy smelling vaginal discharge, not associated with soreness, itching, or irritation.
Thin, white, homogeneous discharge, coating the walls of the vagina and vestibule.
Bacterial vaginosis
Summary of Bacterial vaginosis:
What bacteria cause bacterial vaginosis?
This condition is characterized by replacement of vaginal lactobacilli with predominantly anaerobic microorganisms such as Gardnerella vaginalis and Mobiluncus morphotypes.
What are the risk factors of bacterial vaginosis?
Vaginal douching Overwashing Receptive cunnilingus Black race Recent change of sex partner Smoking Presence of an STI e.g. chlamydia or herpes.
What is the likely condition described?
Itchy white discharge?
Vulvovaginal candidiasis (thrush)
What is the most common cause of Vulvovaginal candidiasis (thrush)?
Candida albicans >90%
What are the symptoms of Vulvovaginal candidiasis (thrush)?
- Vulval itching
- Vulval soreness
- Vaginal discharge
- Superficial dyspareunia
- External dysuria
What is the likely diagnosis in a women with these symptoms?
- 10-50% are asymptomatic
- Profuse vaginal discharge
- Vulval itching
- Dysuria
- Strawberry cervix
Trichomonas vaginalis
Trichomonas vaginalis
Trichomoniasis is a type of sexually transmitted infection caused by a tiny parasite.
Symptoms of trichomoniasis include pain when peeing, sore or itchy genitals, and abnormal discharge from your vagina or penis.
What are the symptoms of chlamydia?
- Post coital / intermenstrual bleeding
- PV discharge
- Lower abdominal pain
- Dysuria
What are the complications chlamydia can cause?
- Cervicitis
- Pelvic Inflammatory Disease
How does Pelvic inflammatory disease present?
- Lower abdominal pain, typically bilateral.
- Deep dyspareunia.
- Abnormal vaginal bleeding, including post coital, intermenstrual and menorrhagia.
- Abnormal vaginal or cervical discharge, often purulent.
How does chlamydia present in men?
- Asymptomatic ~50%
- Urethral discharge
- Dysuria
What are the complications of chlamydia in men?
- Epidydimo-orchitis
- Non specific urethritis
- Conjunctivitis (adult / newborn)
• Sexually Acquired Reactive Arthritis (SARA) (Reiter’s syndrome).
• LGV