Genital tract infections

Question 1

Cottage cheese

Itch

Answer 1

Candidasis
20%
Rx fluconazole

Question 2

Fishy

No itch

Answer 2

Vaginosis

Rx Met, clinda

Question 3

Retained tampon

high fever, hypotension, multi-organ failure (sepsis picture)

Answer 3

Staph causing toxic shock

Rx Abx and ITU

Question 4

Multiple keritinous Genital warts

Answer 4

HPV 6 + 11

Guardasil vaccine - 6, 11, 16,18

Question 5

Painful vesicles and ulcers
Lympadenopathy
Dysuria
Systemic

Answer 5

HSV2

Viral culture

Aciclovir

Question 6

Solitary PAINLESS vulval ulcer

Answer 6

Chancre - syphylis

2’ - rash, warty growthy perioral and perigenital
3’ - neuro

Vaginal swab, enzyme immuno/Ab detection

IM Penicillin

Question 7

Grey green discharge

Strawberry cervix

Answer 7

Trichomoniasis

Usually asymptomatic

Dx Wet film microscopy

Rx Met

Question 8

Heavy bleeding, pain, tender uterus, open os, fever, sepsis

Answer 8

Endometritis

Instrumentation, pregnancy (not clearing)

Cause by sex pathogens or e coli/staph

Rx Broad spectrum, ERPC if indicated

Question 9

Tachycardia, fever, bilateral adnexal tenderness, cervical excitation

can also have RUQ pain

Answer 9

Acute PID

Ddx - appendicits, ectopic, ruptured ovarian cyst

Ix - Bloods, cultures, pregnancy test, swabs, pelvic USS

Rx - cef, doxy + met

Question 10

Chronic pelvic pain, chronic discharge

Answer 10

Chronic PID

abdo & adnexal tenderness, fixed retroverted uterus