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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
What is the treatment for genital candidiasis?
1. Clotrimazole 500mg pessary PV and cream for vulva and/or PO Fluconazole 150mg. 2. Use topical regime alone if pregnant or breastfeeding.
26
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.
Genital herpes (HSV 1 and 2)
27
How is genital herpes investigated?
Clinical investigation and PCR
28
What is the management of genital herpes?
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
What is this a presentation of? | Within 90 days of infection. Macule, papule, typically painless ulcer (chancre). Highly infectious.
Primary syphilis
30
What is this a presentation of? 4-10 weeks after dissemination. Rash on palms/soles, warty genital/perioral growths, fever, headache, myalgia, lymphadenopathy, hepatitis.
Secondary syphilis
31
What is this a presentation of? | 20-40 years after infection. Focal neurological deficits, seizures, psychiatric problems, aortic regurgitation.
Tertiary syphilis
32
How is syphilis investigated?
1. PCR 2. VDRL test +ve 3. Congenital syphilis - Hutchinson teeth, deafness, keratitis
33
What is the treatment for syphilis?
Benzathine penicillin IM
34
Which organism is responsible for syphilis?
Treponema pallidum
35
What is this a presentation of? | May be subclinical. External warts affecting vulva, perianus, and cervix. May be itchy.
Genital warts
36
Which organism is responsible for genital warts?
Condylomata acuminate
37
How is are genital warts diagnosed?
Clinical diagnosis
38
What is the treatment for genital warts?
1. No treatment is an option - spontaneous regression 2. Topical podophyllin or imiquimod and/or cryotherapy 3. In pregnancy - only treat with cryotherapy
39
What is the treatment for mycoplasma genitalium?
1. Azithromycin 1g STAT then 500mg OD for 2 days | 2. Moxifloxacin
40
Over what size is abnormal in lymphadenopathy?
>2cm
41
What are the most common causes of tender and non-tender lymphadenopathy?
1. Tender - HSV | 2. Non-tender - syphilis
42
What is this a presentation of? | Retained tampon, high fever, hypotension, multisystem organ failure.
Toxic shock syndrome
43
Which organism is responsible for toxic shock syndrome?
Toxin producing staphylococcus aureus

O&G: Gynaecology (48 decks)

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