Genital symptoms and Intro to STIs Flashcards
What are the 3 main categories for genital symptoms causes?
STI
Other microbial problem
Non-microbial
How does vulvovaginal candidosis usually present?
Itch
Thick, cottage cheese like, discharge
What usually causes vulvovaginal candidosis?
Candida albicans mostly
Sometimes c. glabrata
Name some conditions which may predispose someone to vulvovaginal candidosis?
Diabetes
Immunosuppression
Pregnancy
Oral steroids
Along with history and symptoms, what are some tests which can help diagnose vulvovaginal candidosis?
Vaginal pH
Gram stain
Culture (
How can candida albicans be identified on gram stain?
Egg like blastospores
They grow true hyphe (long strands of mycelium)
How is candida treated?
Doesn't need treatment if mild Azole antifungals (Clotrimazole, fluconazole)
What is the most common cause of abnormal vaginal discharge?
Bacterial Vaginosis
What are some common symptoms of bacterial vaginosis?
Watery grey/yellow fishy discharge
May be worse after sex
May be itchy/sore from dampness
How is BV thought to be caused by?
Lack of lactobacilli
Reduction in hydrogen peroxide and lactic acid
Raised pH
Overgrowth in bacteria
How is BV diagnosed?
History
Thin homogenous discharge
pH
Gram stained discharge smear
How is BV treated?
Metronidazole (oral, vaginal gel)
Clindamycin (vaginal)
Probiotics
Vaginal acidification
What is balanitis?
Inflammation of the head of the penis
Dry blotchy spots
What are some useful questions to use if examination and tests are inconclusive?
Regretted sexual encounter?
Problems in life? (Family, friends, media story etc.)
Co-existing mental health problem
List some factors in the management of non-microbial problems which are good to keep in mind.
Acknowledge the patient’s perception, never deny
Reassure where logic and findings allow
Discuss limits of medical approach
Allow conditions to be covered and ruled out, like cancer or HIV
What are fox-fordyce spots?
Sebaceous glands under the skin on the penis
Can be mistaken for disease/infection
Completely normal
What is vulval papillomatosis?
Soft frond like projections sometimes mistaken for warts
Benign
Normal
What are coronal papillae?
Small bumps around the corona
Normal feature
What are Tyson’s glands?
Small vestigial glands either side of the frenulum
Normal
What is vulvodynia?
Persistent burning or aching
Possibly caused by pelvic pain syndrome
What are some non-microbial causes of genital symptoms?
Cancer
Trauma
Perceived pain or discomfort due to social or psych factors
What is a commensal micro-organism?
One that derives food or other benefits from another organism without hurting or helping it
What is a pathogen?
A micro-organism that can cause disease
What is an STI?
A pathogen spreads through sex, with risk of causing harm, and is unlikely to be spread by non-sexual means
What is an STD?
A disorder of structure or function caused by an STI
Which pathogen causes syphilis?
Treponema pallidum
Which pathogen causes gonorrhoea?
Neisseria gonorrhoea
What is an implication of asymptomatic STI?
Can’t eradicate by just treating symptoms
Name some STI’s which can be transmitted just by skin contact?
Pubic lice
Scabies
Warts
Herpes
How may non-genital discharge present?
Gonorrhoea can cause eye discharge
Can STI’s cause infertility?
Yes
Chlamydia
Can STI’s cause cancer?
Yes
HPV
Cervical cancer
What is a major factor in HIV survival?
More resource rich places have higher survival rates
How do you calculate the reproductive number(R0)?
Likelihood of transmission(Beta) x Rate of acquiring new partners(c) x Duration of infectivity(D)
What does R0 mean?
>1 = infection sustained <1 = infection reduces
What is the best way to reduce transmissibility?
Vaccinate before exposure
What are some factors to consider in long term risk?
Time and nature of sexual contact Male or female? Nature of sex act Condom use Other contraceptive use Nationality of contact Injected drugs Paid sex
What are 2 kinds of contact tracing?
Patient tells contacts to get checked (client referral) Provider referral (NHS tells contacts)
What are some factors in health promotion in sexual health?
Condom use Oral sex risks Hazardous drug use Vaccination HIV pre-exposure prophylaxis
