Genital Symptoms Flashcards
What are possible causes of genital symptoms?
Microbial Other -Trauma -Cancer -Neuromuscular -Iatrogenic -Idiopathic
Genital symptoms - presenting complaints
Discharge Pain Rashes Lumps and swelling Cuts, sores, ulcer Itching Change in appearance
What could be causing the symptoms?
STD = public and individual health problem, treatable but not always curable
Other microbial problem = individual health problem, treatable and usually curable
Non-microbial = individual health issue
What is vulvovaginal candidosis?
C. albicans and glabrata
Often asymptomatic
If symptomatic ‘thrush’ = itch and a discharge
More likely in: diabetes, steroids, immune suppression, pregnancy and reproductive age
Diagnosis = characteristic history, examination findings (fissuring, erythema and discharge), investigations (staining and culture)
Treatment = Azole antifungals
What is bacterial vaginosis?
Asymptomatic in 50%
Watery/yellow fishy discharge
May be worse after period
Sometimes itch and sore
Associated with endometritis, premature labour and it increases risk of HIV acquisition
Diagnosis = characteristic history with a thin homogenous discharge, pH, gram stained smear of vaginal discharge
Treatment = antibiotics (metronidazole), probiotics and vaginal acidification
What is balanitis and posthitis?
Blotchy pattern
Chronic inflammation secondary to overgrowth of commensal organisms plus foreskin malfunction
What causes Impetigo?
Staph aureus or pyogenes
What can herpes lead to?
Cellulitis
Erysipelas strep pyogenes
What are symptoms of non-microbial origin?
Perceived problem only - no clinical findings
Real problems
-Dermatoses and structural abnormalities
What are symptoms but nothing can be found?
Discharge Dysuria Genital/pelvic discomfit Rashes and lumps Penis size, scrotal lumps and labial shape
What are the lines of questioning if nil found on examination or test results?
Regretted sexual encounter Problems in life Mental ill-health When did they notice the problem? When were things last normal?
What is the management approach to symptoms but nothing can be found?
Acknowledge the perception
What do they think might be causing the symptom?
Reassure them
Discuss limitations of medical approach
What are things that do show change but not abnormal?
Fox-fordyce spots
Vulval papillomatosis
Penile pearly papules (coronal papillae)
Tysons glands
What is vesibulodynia?
intoital tenderness
What is Vulvodynia ?
persistant burning or aching
Chronic pelvic pain syndrome
