Genital symptoms and what causes them

Question 1

What are genital symptoms?

Answer 1

Discharge
Pain
Rashes
Lumps and swellings
Cuts, sores, ulcers
Itching
Change in appearance

Question 2

What are he causes of genital symptoms?

Answer 2

STI
Other microbial causes
Non microbial causes

Question 3

What are microbial causes of genital symptoms?

Answer 3

STI
Vulvovaginal candidiasis 
Bacterial vaginosis
Balanoposthitis
Tinea cruris
Erythrasma
Infected sebaceous gland
Impetigo
Cellulitis

Question 4

Where is vulvovaginal candidiasis often acquired from?

Answer 4

Bowel

Asymptomatic carriage

Question 5

What is the most common causative organism of vulvovaginal candidiasis?

Answer 5

90% candida albicans

Question 6

What are the risk factors for vulvovaginal candidiasis?

Answer 6

Diabetes 
Oral steroids
Immune suppression
Pregnancy
Reproductive age

Question 7

What is the symptomatic stage of vulvovaginal candidiasis?

Answer 7

Thrush

Question 8

What are the symptoms of thrush?

Answer 8

Itch

Thick, cottage cheese discharge

Question 9

How is vulvovaginal candidiasis diagnosed?

Answer 9

Characteristic history
Exam- characteristic discharge, fissuring and erythema with satellite lesions
Gram stained preparation and culture

Question 10

What are the limitations of a gram stained prep in diagnosing vulvovaginal candidiasis?

Answer 10

low sensitivity

Question 11

What are the limitations of a culture in diagnosing vulvovaginal candidiasis?

Answer 11

Low specificity

Question 12

What is the treatment of vulvovaginal candidiasis?

Answer 12

Azole antifungals- clotrimazole PV once and fluconazole PO once
Treat any dermatitis
Determine species if resistant

Question 13

What is the most common cause of abnormal vaginal discharge?

Answer 13

Bacterial vaginosis

Question 14

What causes bacterial vaginosis?

Answer 14

Imbalance of bacteria

Question 15

What are the signs and symptoms of bacterial vaginosis?

Answer 15

Asymptomatic in 50%
Watery grey/yellow fishy discharge
Smell may be worse after period or sex
Pain or itching

Question 16

How is bacterial vaginosis diagnosed?

Answer 16

Characteristic history

Exam- thin homogenous discharge, gram stain smear of vaginal discharge

Question 17

What is the treatment of bacterial vaginosis?

Answer 17

Metronidazole- oral or vaginal

Clindamycin- vaginal

Question 18

What are the complications of bacterial vaginosis?

Answer 18

Associated with endometriosis
Premature risk
Increased risk of HIV acquisition

Question 19

What is balanitis?

Answer 19

Inflammation of glans

Question 20

What is prosthetis?

Answer 20

Inflammation of foreskin

Question 21

What are the types of balanitis?

Answer 21

CAndidial

Plasma cell- chronic inflammation secondary to commensal organism plus foreskin malfunction

Question 22

What is tinea cruris?

Answer 22

Athletes’ groin

Question 23

What is the appearance of tinea cruris?

Answer 23

Red area with flaked edge

Question 24

What is the appearance of erythrasma?

Answer 24

Red area with diffuse edge

Question 25

What are the causative organisms of impetigo?

Answer 25

Staph aureus

Strep pyogenes

Question 26

What are the non microbial causes of genital symptoms?

Answer 26

Dermatoses
Congenital
Traumatic
Neoplastic
Manifestations of systemic disease
Percieved problem

Question 27

What should be taken in a history with a perceived genital issue?

Answer 27

Regretted/unwanted sexual encounter
Problems in other areas of life
Mental health
When did they notice problem
When were things last normal?- family/friend illness, media story

Question 28

What is the management of a perceived problem?

Answer 28

Acknowledge problem
Cover and specifically rule out condiitions causing concern
Provide alternative, benign explanation
Discuss limitations of medical approach