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O&G: Gynaecology > Genital Tract Infections > Flashcards

Genital Tract Infections Flashcards

1
Q

How soon after unprotected sexual intercourse are chlamydia, gonorrhoea, HIV, and syphilis identifiable in tests?

A
  1. Chlamydia and gonorrhoea - 2-3 weeks
  2. HIV - 1 month
  3. Syphilis - 3 months
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2
Q

Which infections does a high vaginal swab detect?

A

BV, TV, candida

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3
Q

Which infections does an endocervical/vulvo-vaginal swab detect?

A

Chlamydia, gonorrhoea

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4
Q

What is this a presentation of?
Often asymptomatic. Female, recent unprotected sex, dyspareunia, dysuria, intermittent IMB/PCB, increased vaginal discharge.

A

Chlamydia trachomatis

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5
Q

What is this a presentation of?

Often asymptomatic. Male, recent unprotected sex, dysuria, urethral discharge.

A

Chlamydia trachomatis

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6
Q

How is chlamydia diagnosed?

A
  1. Female - NAAT on vulvo-vaginal swab

2. Male - first pass urine, then oral/anal swabs if had oral/anal sex.

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7
Q

What is the treatment for chlamydia infection?

A
  1. Azithromycin 1g PO single dose
  2. Or doxycycline 100mg BD for 1 week
  3. No sex for 1 week
  4. Contact tracing and treat partners
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8
Q

How is chlamydia treated in pregnancy?

A
  1. Erythromycin 500mg BD for 2 weeks

2. Can cause neonatal conjunctivitis

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9
Q

What are the complications of a chlamydia infection?

A
  1. PID
  2. Perihepatitis - Fitz-Hugh-Curtis syndrome
  3. Tubal infertility
  4. Increased ectopic pregnancy
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10
Q

What is this a presentation of?
Urethral/vaginal discharge, dysuria, lower abdominal pain, PCB, IMB, recent unprotected sex. Half of females asymptomatic.

A

Neisseria gonorrhoeae

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11
Q

What type of organism is Neisseria gonorrhoeae?

A

Gram -ve diplococcus

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12
Q

What are the complications of gonorrhoea infection?

A
  1. PID
  2. Bartholin’s/Skene’s abscess
  3. Tubal infertility
  4. Increased ectopic pregnancy
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13
Q

How is gonorrhoea diagnosed?

A
  1. Female - NAAT on vaginal swab
  2. Male - first pass urine
  3. Culture for sensitivities on chocolate agar if NAAT +ve
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14
Q

What is the management for gonorrhoea infection?

A
  1. Ceftriaxone 500mg IM and azithromycin 1g PO
  2. Contact tracing
  3. No sex for 1 week
  4. Treatment the same in pregnancy (can cause neonatal conjunctivitis)
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15
Q

What is this a presentation of?

Female, recent unprotected sex, grey/green frothy vaginal discharge, itch, strawberry cervix.

A

Trichomonas vaginalis infection

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16
Q

How many men are asymptomatic in trichomonas vaginalis infection?

A

70%, can have some discharge.

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17
Q

How is trichomonas vaginalis infection investigated?

A
  1. Saline drop wet slide microscopy

2. NAAT

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18
Q

What is the treatment for trichomonas vaginalis infection?

A
  1. Metronidazole 400mg BD for 5 days
  2. Contact tracing
  3. No sex for one week
19
Q

What is this a presentation of?

Female. Thin, white, fishy smelling vaginal discharge. No itch or soreness. Asymptomatic in half.

A

Bacterial vaginosis

20
Q

How is bacterial vaginosis investigated?

A
  1. Gram stain to examine vaginal flora

2. Clue cells, lack of lactobacilli, vaginal pH >4.5, mix with KCl = ammonia smell (positive whiff test)

21
Q

What is the treatment for bacterial vaginosis?

A

Oral or PV metronidazole

22
Q

What is this a presentation of?

Genital itch, burning, cottage cheese-like discharge, dyspareunia.

A

Genital candidiasis

23
Q

What are the risk factors for genital candidiasis?

A

Pregnancy, steroids, immunodeficiency, antibiotics, diabetes mellitus.

24
Q

How is genital candidiasis investigated?

A

Microscopy and culture for candida.

25
Q

What is the treatment for genital candidiasis?

A
  1. Clotrimazole 500mg pessary PV and cream for vulva and/or PO Fluconazole 150mg.
  2. Use topical regime alone if pregnant or breastfeeding.
26
Q

What is this a presentation of?
Flu-like prodrome followed by stinging and itching around genitals, anus and throat. Vesicles bursting and crust over. Local lymphadenopathy and dysuria. Can reoccur.

A

Genital herpes (HSV 1 and 2)

27
Q

How is genital herpes investigated?

A

Clinical investigation and PCR

28
Q

What is the management of genital herpes?

A
  1. Acyclovir 500mg 5 times per day for 5 days
  2. Lidocaine gel for analgesia
  3. Suppressive therapy if indicated - Acyclovir 400mg BD for 3 months
29
Q

What is this a presentation of?

Within 90 days of infection. Macule, papule, typically painless ulcer (chancre). Highly infectious.

A

Primary syphilis

30
Q

What is this a presentation of?
4-10 weeks after dissemination. Rash on palms/soles, warty genital/perioral growths, fever, headache, myalgia, lymphadenopathy, hepatitis.

A

Secondary syphilis

31
Q

What is this a presentation of?

20-40 years after infection. Focal neurological deficits, seizures, psychiatric problems, aortic regurgitation.

A

Tertiary syphilis

32
Q

How is syphilis investigated?

A
  1. PCR
  2. VDRL test +ve
  3. Congenital syphilis - Hutchinson teeth, deafness, keratitis
33
Q

What is the treatment for syphilis?

A

Benzathine penicillin IM

34
Q

Which organism is responsible for syphilis?

A

Treponema pallidum

35
Q

What is this a presentation of?

May be subclinical. External warts affecting vulva, perianus, and cervix. May be itchy.

A

Genital warts

36
Q

Which organism is responsible for genital warts?

A

Condylomata acuminate

37
Q

How is are genital warts diagnosed?

A

Clinical diagnosis

38
Q

What is the treatment for genital warts?

A
  1. No treatment is an option - spontaneous regression
  2. Topical podophyllin or imiquimod and/or cryotherapy
  3. In pregnancy - only treat with cryotherapy
39
Q

What is the treatment for mycoplasma genitalium?

A
  1. Azithromycin 1g STAT then 500mg OD for 2 days

2. Moxifloxacin

40
Q

Over what size is abnormal in lymphadenopathy?

A

> 2cm

41
Q

What are the most common causes of tender and non-tender lymphadenopathy?

A
  1. Tender - HSV

2. Non-tender - syphilis

42
Q

What is this a presentation of?

Retained tampon, high fever, hypotension, multisystem organ failure.

A

Toxic shock syndrome

43
Q

Which organism is responsible for toxic shock syndrome?

A

Toxin producing staphylococcus aureus

O&G: Gynaecology (48 decks)

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