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Reproductive System > Genital Symptoms > Flashcards

Genital Symptoms Flashcards

1
Q

What are examples of genital symptoms?

A
  • Discharge from an orifice
  • Pain
  • Rashes
  • Lumps and swellings
  • Cuts, sores, ulcers
  • Itching
  • Change in appearance
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2
Q

What are the different categories of causes for genital symptoms?

A
  • STD
  • Other microbial problem not regarded as STD
  • Non-microbial
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3
Q

What are some examples of microbial infections not regarded as STIs in the UK?

A
  • Vulvovaginal candidosis
  • Bacterial vaginosis
  • Balanoposthitis – anaerobic/candida
  • Impetigo
  • Erisipelas
  • Dermatophyte infections
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4
Q

What is the aetiology of vulvovaginal candidosis?

A
  • 70% candida albicans
  • 30% other species such as C. Glabrate
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5
Q

What are risk factors for vulvovaginal candidosis?

A
  • Diabetes
  • Oral steroids
  • Immune suppression
  • Pregnancy
  • Reproductive age group
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6
Q

Describe the epidemiology of vulvovaginal candidosis (common/rare)?

A

Very common

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7
Q

What is the presentation of vulvovaginal candidosis?

A
  • Often asymptomatic
  • If symptomatic
    • Thrush
      • Itch
      • Discharge – classically thick, ‘cottage cheese’
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8
Q

What is the discharge due to vulvovaginal candidosis usually decribed as?

A
  • Discharge – classically thick, ‘cottage cheese’
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9
Q

How is vulvovaginal candidosis diagnosed (including investigations)?

A
  • Characteristic history
  • Vaginal pH
  • Examination findings
    • Fissuring
    • Erythema with satellite lesions
    • Characteristic discharge
  • Investigations
    • Gram stained
      • Low sensitivity
    • Culture
      • Higher sensitivity, low specificity
    • PCR
      • Highest sensitivity, lowest specificity
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10
Q

What are some possible examination findings for vulvovaginal candidosis?

A
  • Fissuring
  • Erythema with satellite lesions
  • Characteristic discharge
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11
Q

Which of gram staining, culture and PCR has greatest sensitivity and specificity?

A
  • Gram stained
    • Low sensitivity
  • Culture
    • Higher sensitivity, low specificity
  • PCR
    • Highest sensitivity, lowest specificity
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12
Q

What is the treatment for vulvovaginal candidosis?

A
  • Often does not require any
  • Azole antifungals
    • Clotrimazole 500mg PV once
    • Fluconazole 150mg PO once
  • If resistant case
    • Determine species and sensitivities and treat accordingly
  • Other management
    • Maintain skin – avoid irritants, treat dermatitis
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13
Q

What does BV stand for?

A

Bacterial vaginosis

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14
Q

What is the aetiology of bacterial vaginosis?

A
  • Increased gardnerella vaginalis, enterococcus faecalis and actinomyces neuii
  • Reduced lactobacalli
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15
Q

Describe the epidemiology of bacterial vaginosis (common/rare)?

A
  • Commonest cause of vaginal discharge
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16
Q

Describe the pathophysiology of bacterial vaginosis?

A
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17
Q

What is the presentation of bacterial vaginosis?

A
  • Asymptomatic in 50%
  • Watery grey/yellow ‘fishy’ discharge
  • May be worse after period/sex
  • Sometimes sore/itch from dampness
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18
Q

Describe the diagnosis of bacterial vaginosis?

A
  • Characteristic history
  • Examination findings
    • Thin, homogeneous discharge
  • Investigations
    • pH
    • Gram stained smear of vaginal discharge
19
Q

What are possible complications of bacterial vaginosis?

A
  • Associated with endometritis if uterine instrumentation/delivery
  • Associated with premature labour
  • Increases risk of HIV acquisition
20
Q

What is the treatment of bacterial vaginosis?

A
  • Antibiotics
    • Metronidazole
    • Clindamycin
  • Probiotics
  • Vaginal acidification
21
Q

What is balanitis?

A

Balanitis = inflammation of the head of the penis

22
Q

What is postitis?

A

Postitis = inflammation of the foreskin

23
Q

What is the aetiology of balanitis and posthitis?

A
  • Usually candida lanitis
24
Q

What is impetigo?

A

Is a common and highly contagious skin infection

25
What is the aetiology of impetigo?
* Usually staph aureus or strep pyogenes
26
What is erysipelas?
Superficial form of cellulitis
27
What is the aetiology of erysipelas?
* Usually strep pyogenes
28
What are examples of yeast (dermatophyte) infections?
* Trichophyton rubrum * Known as athletes penis * Treated with antifungal * Tinea cruris * Known as athletes groin * Erythrasma
29
What is trichophyton rubrum known as?
Athletes penis
30
What is tinea cruris known as?
Athletes groin
31
What can non-microbial conditions that cause 'genital symptoms' be categorised into?
* Perceived problems only (normal findings) * No clinical findings * Only findings are physiological * ‘Real problems’ * Structural abnormalities * Dermatoses
32
What are possible perceived problems?
* Vaginal discharge * Urethral discharge * Dysuria * Genital/pelvic discomfort * Rashes * Skin lumps * Penis size, scrotum lumps, labial shape
33
What are some examples of things that are normal but can be perceived as an STI?
* Fox-Fordyce spots * Vulval papillomatosis * Coronal papillae * Also known as penile pearly papules * Tyson’s glands
34
Describe the management approach to 'perceived problems'?
Questions to understand why this is occurring: * Regretted sexual encounter * Problems in life * Mental health problems such as anxiety Management approach: * Acknowledge their perception * Ask what they think is going on to rule out worries * Reassurance * Provide explanation of symptoms * Discuss limitations of medical approach
35
What are some non-microbial causes of genital symptoms?
* Pain syndromes * Dermatoses * Congenital * Traumatic/iatrogenic * Neoplastic * Neuromuscular * Manifestations of systemic disease * Idiopathic
36
What are some different pain syndromes that can cause genital symptoms?
* Vestibulodynia * Provoked introital tenderness * Vulvodynia * Persistent burning or aching * Chronic pelvic pain syndrome * Cause unclear but muscular dysfunction implicated
37
What are some causes of non-microbial genital symptoms?
Pain syndromes Lymphocoele Congenital cyst Torn frenulum and ecchymosis Lichen sclerosus Lichen planux Penile carcinoma
38
What is lymphocoele?
Blocked lymph duct
39
What is a congenital cyst?
Cyst forms in-utero Can be left or removed
40
What is the most common aetiology of torn frenulum and ecchymosis?
Torn during sex
41
What is lichen sclerosus?
Autoimmune disease causing scarring and thinning of the skin
42
What kind of condition is lichen planus?
Autoimmune condition
43
What is penile carcinoma?
Cancer of the penis

Reproductive System (31 decks)

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