genital tract infections

Question 1

Bv - lt - ph? what kind of cells? buzzwords? 2 types of bacteria? treatment?

Answer 1

over 4.5,CLUE CELLS, thin, watery, fishy smelling vaginal discharge, mobiluncus and gardenia vaginalis, oral metronidazole

Question 2

risk factors for thrush?4

Answer 2

poorly controlled diabetes, recent antibiotic treatment, high oestrogen, immunocompromised

Question 3

how does it present?

Answer 3

intensely itchy with white vaginal discharge

Question 4

organism responsible for thrush?

Answer 4

candida albicans

Question 5

treatment? ol cf

Answer 5

topical clotrimazole, oral fluconazole

Question 6

on penis…can get typical spotty rash of candida____?

Answer 6

balanitis

Question 7

what would prostate be like in prostatitis?

Answer 7

tender

Question 8

for acute bacterial prostatitis (C), what are the three most likely organisms?

Answer 8

E Coli, Coliforms, enterocoCCus

Question 9

IF THEY ARE UNDER 35, WHAT DO YOU NEED TO REMEMBER TO CHECK FOR?

Answer 9

chlamydia and gonorrhoea (first pass)

Question 10

what sort of test would you do for culture and sensitivity of prostate?

Answer 10

mid stream

Question 11

whats the treatment for AB prostatitis?

Answer 11

Ciprofloxacin 28 days

Question 12

if high c diff risk…try?

Answer 12

trimethoprim

Question 13

normal bacterial flora. lactobacteria produce what, which suppresses growth of other bacteria?

Answer 13

lactic acid +/- hydrogen peroxide

Question 14

what other organisms found in vagina? (sparta)

Answer 14

strep viridians and group b haemolytic strep (Bee ins)

Question 15

possibly small numbers of candida species. what would you find around group b h s?

Answer 15

zones of complete haemolysis

Question 16

obligate intracellular bacteria, infects urethra, rectum, throat, eyes, endocervix?

Answer 16

chlamydia

Question 17

why does it not stain with gram stain?

Answer 17

no peptidoglycan in cell wall (water)

Question 18

what is more common, chlamydia or gon?

Answer 18

chlamydia is much more common

Question 19

gonorrhoea. where does it affect? how would you describe the bacteria, does it survive outside body?

Answer 19

urethra, rectum, throat and eyes. gram -ve diplococci (2 kidney beans facing each other), no

Question 20

most common presentation?

Answer 20

purulent discharge

Question 21

diagnosis?

Answer 21

NAAT or PCR

Question 22

NAAT can be performed on?

Answer 22

swab or urine, better swab.

Question 23

what urine test would you do for males?

Answer 23

first pass

Question 24

for females?

Answer 24

high vaginal or VVS

Question 25

Gonorrhoea - you can do microscopy of urethral/EC swabs, and you can also culture in agar plates (endocervical, rectal and throat swabs)

Answer 25

y

Question 26

syphilis. why is there a difficulty in diagnosing?

Answer 26

doesn't stain gram stain and also cannot be grown on culture. Diagnosis relies on PCR or blood testing

Question 27

causative organism (nl)

Answer 27

treponema pallidum

Question 28

how many stages in the ilness?

Answer 28

4

Question 29

what is the first stage?

Answer 29

chancre lesion

Question 30

is a chancre painful?

Answer 30

no

Question 31

what is actually happening at this stage?

Answer 31

organism multiplies at inocculation site and gets in to blood stream

Question 32

what happens at secondary stage?

Answer 32

large numbers of bacteria circulating in blood with multiple manifestations

Question 33

latent stage? do you get symptoms?

Answer 33

no, low level multiplication of spirochaetes in the intimate of the small blood vessels.

Question 34

Many years later, what do you get?

Answer 34

cardiovascular or neurovascular complications

Question 35

microbiology of syphillis, what do you swab for PCR?

Answer 35

chancre

Question 36

in terms of serology, what are you looking for?

Answer 36

specific and non specific antibodies to T Pallidum

Question 37

What is the name of the non specific test that indicates tissue inflammation?

Answer 37

VDRL (non specific)

Question 38

why is it useful?

Answer 38

in monitoring the response to therapy

Question 39

2 specific serological test?

Answer 39

TPPA and TPHA

Question 40

why are these not useful in monitoring response to therapy?

Answer 40

although they are specific for syphillis, they remain positive for life once you've had them

Question 41

what are the two antibodies used as screening test for syphillis?

Answer 41

IgG and IgM ELISA

Question 42

treatment is?

Answer 42

injectable long acting preparation of penicillin

Question 43

which HPV causes genital warts?

Answer 43

6 and 11 (nyth)

Question 44

describe the virus?

Answer 44

NON ENVELOPED icosohedral virus containing dsDNA

Question 45

how are genital warts spread?

Answer 45

close genital skin contact

Question 46

cryopodo, treatment for genital warts?

Answer 46

cryotherapy, podophylotoxin cream/ lotion

Question 47

what vaccine is given to 11-13 year old girls and what does it immunise against?

Answer 47

quadrivalent vaccine, immunises against genital warts and cervical cancer

Question 48

enveloped virus containing dsDNA?

Answer 48

genital herpes

Question 49

which type of herpes simplex causes cold sores?

Answer 49

1

Question 50

how is it spread?

Answer 50

genital/genital or genital/oral contact

Question 51

in the primary infection, may be asymptomatic. where does virus replicate?

Answer 51

dermid and epidermis

Question 52

where does it go from the skin?

Answer 52

gets into nerve endings of sensory autonomic nerves

Question 53

what does it cause at the nerve endings?

Answer 53

inflammation, which causes pain. exquisitely painful multiple small vesicles

Question 54

where does the virus migrate to, where it hides for life?

Answer 54

sacral root glanglion

Question 55

how do you diagnose?

Answer 55

swab deroofed blister (PCR)

Question 56

treatment?

Answer 56

aciclovir and pain relief

Question 57

single celled protozoal parasite causing vaginal discharge and irritation in females?

Answer 57

trichomonas vaginalis

Question 58

how does it divide?

Answer 58

binary fission

Question 59

how do you test for it?

Answer 59

high vaginal swab for microscopy

Question 60

treatment? (flush)

Answer 60

oral metronidazole