genital tract infections Flashcards
Bv - lt - ph? what kind of cells? buzzwords? 2 types of bacteria? treatment?
over 4.5,CLUE CELLS, thin, watery, fishy smelling vaginal discharge, mobiluncus and gardenia vaginalis, oral metronidazole
risk factors for thrush?4
poorly controlled diabetes, recent antibiotic treatment, high oestrogen, immunocompromised
how does it present?
intensely itchy with white vaginal discharge
organism responsible for thrush?
candida albicans
treatment? ol cf
topical clotrimazole, oral fluconazole
on penis…can get typical spotty rash of candida____?
balanitis
what would prostate be like in prostatitis?
tender
for acute bacterial prostatitis (C), what are the three most likely organisms?
E Coli, Coliforms, enterocoCCus
IF THEY ARE UNDER 35, WHAT DO YOU NEED TO REMEMBER TO CHECK FOR?
chlamydia and gonorrhoea (first pass)
what sort of test would you do for culture and sensitivity of prostate?
mid stream
whats the treatment for AB prostatitis?
Ciprofloxacin 28 days
if high c diff risk…try?
trimethoprim
normal bacterial flora. lactobacteria produce what, which suppresses growth of other bacteria?
lactic acid +/- hydrogen peroxide
what other organisms found in vagina? (sparta)
strep viridians and group b haemolytic strep (Bee ins)
possibly small numbers of candida species. what would you find around group b h s?
zones of complete haemolysis
obligate intracellular bacteria, infects urethra, rectum, throat, eyes, endocervix?
chlamydia
why does it not stain with gram stain?
no peptidoglycan in cell wall (water)
what is more common, chlamydia or gon?
chlamydia is much more common
gonorrhoea. where does it affect? how would you describe the bacteria, does it survive outside body?
urethra, rectum, throat and eyes. gram -ve diplococci (2 kidney beans facing each other), no
most common presentation?
purulent discharge
diagnosis?
NAAT or PCR
NAAT can be performed on?
swab or urine, better swab.
what urine test would you do for males?
first pass
for females?
high vaginal or VVS
Gonorrhoea - you can do microscopy of urethral/EC swabs, and you can also culture in agar plates (endocervical, rectal and throat swabs)
y
syphilis. why is there a difficulty in diagnosing?
doesn’t stain gram stain and also cannot be grown on culture. Diagnosis relies on PCR or blood testing
causative organism (nl)
treponema pallidum
how many stages in the ilness?
4
what is the first stage?
chancre lesion
is a chancre painful?
no
what is actually happening at this stage?
organism multiplies at inocculation site and gets in to blood stream
what happens at secondary stage?
large numbers of bacteria circulating in blood with multiple manifestations
latent stage? do you get symptoms?
no, low level multiplication of spirochaetes in the intimate of the small blood vessels.
Many years later, what do you get?
cardiovascular or neurovascular complications
microbiology of syphillis, what do you swab for PCR?
chancre
in terms of serology, what are you looking for?
specific and non specific antibodies to T Pallidum
What is the name of the non specific test that indicates tissue inflammation?
VDRL (non specific)
why is it useful?
in monitoring the response to therapy
2 specific serological test?
TPPA and TPHA
why are these not useful in monitoring response to therapy?
although they are specific for syphillis, they remain positive for life once you’ve had them
what are the two antibodies used as screening test for syphillis?
IgG and IgM ELISA
treatment is?
injectable long acting preparation of penicillin
which HPV causes genital warts?
6 and 11 (nyth)
describe the virus?
NON ENVELOPED icosohedral virus containing dsDNA
how are genital warts spread?
close genital skin contact
cryopodo, treatment for genital warts?
cryotherapy, podophylotoxin cream/ lotion
what vaccine is given to 11-13 year old girls and what does it immunise against?
quadrivalent vaccine, immunises against genital warts and cervical cancer
enveloped virus containing dsDNA?
genital herpes
which type of herpes simplex causes cold sores?
1
how is it spread?
genital/genital or genital/oral contact
in the primary infection, may be asymptomatic. where does virus replicate?
dermid and epidermis
where does it go from the skin?
gets into nerve endings of sensory autonomic nerves
what does it cause at the nerve endings?
inflammation, which causes pain. exquisitely painful multiple small vesicles
where does the virus migrate to, where it hides for life?
sacral root glanglion
how do you diagnose?
swab deroofed blister (PCR)
treatment?
aciclovir and pain relief
single celled protozoal parasite causing vaginal discharge and irritation in females?
trichomonas vaginalis
how does it divide?
binary fission
how do you test for it?
high vaginal swab for microscopy
treatment? (flush)
oral metronidazole
