Genital Tract Infections Flashcards
What can cause a genital tract infection?
STI
Trauma
How do you test for STIs in men?
Urinalysis
- first catch
- midstream
Urethral sampling
Rectal sampling
Ulcer swab
Bloods
How do you test for STIs in women?
Vulvovaginal swabs High vaginal swab Endocervical swab Urinalysis Rectal sampling Ulcer swab Bloods
How do you manage STIs?
Treat cause
Contact tracing
STI prevention - discuss contraception
What are the common STIs?
Chlamydia
Gonorrhoea
Syphilis
Herpes
What is the causative organism of chlamydia?
Chlamydia trachomatis
What is type of organism is chlamydia trachomatis?
Gram negative obligate intracellular bacterium
What are the symptoms of chlamydia in males?
Urethritis
Dysuria
Proctitis
Epididymitis
What are the symptoms of chlamydia in females?
Often asymptomatic
Increased discharge
Post coital bleeding
Dyspareunia
What is dyspareunia?
Painful intercourse
Where else can chlamydia trachomatis infect?
Eye - conjunctivitis
Pharynx
How is chlamydia diagnosed in males?
First catch urine
How is chlamydia diagnosed in females?
Vulvovaginal swab
First catch urine
How is chlamydia managed?
Doxycycline or azithromycin
What organism causes gonorrhoea?
Neisseria gonorrhoeae
What type of organism is Neisseria gonorrhoeae?
Gram negative diplococcus
What are the primary sites of gonorrhoea infection?
Urethra Endocervix Rectum Pharynx Conjunctiva
What are the symptoms of gonorrhoea in men?
Urethral discharge
Dysuria
Anal discharge
What are the symptoms of gonorrhoea in women?
Often asymptomatic
Altered discharge
Lower abdo pain
What are potential complications of gonorrhoea?
Epididymo-orchitis
Prostatitis
PID
Disseinated gonococcal infection
How is gonorrhoea diagnosed?
NAATs
Cultures
What is NAAT?
Nucleic acid amplification test
How is gonorrhoea managed?
IM ceftriaxone + oral azithromycin
What organism causes syphilis?
Treponema pallidum
What type of organism in treponema pallidum?
Gram negative spirochete bacterium
What are the stages of syphilis?
Primary = painless ulcer
Secondary = (4-10 weeks later) rash + multisystem involvement
Latent
Tertiary = (up to 40 years later) neurosyphilis, parenchymous, gummatous
How is syphilis diagnosed?
History + examination
Dark ground microscopy
How is syphilis managed?
Early = benzathine penicillin G IM single dose
Latent = benzathine penicillin G *3
Neurosyphilis = IM procaine penicillin
What types of herpes virus are there?
2
HSV 1 = usual cause of oro-labial herpes
HSV 2 = more likely to cause recurrent symptoms
What type of organism is herpes simplex?
Double stranded enveloped DNA virus
What are the symptoms of herpes?
Shallow ulcers
Fever
How is herpes diagnosed?
History + examination
Virus detection in ulcer swab
Type specific serology
How is herpes managed?
Aciclovir
What is trichomonas vaginalis?
Flagellated protozoa
What are the symptoms of trichomonas in men?
Can be asymptomatic
Urethral discharge
Dysuria
What are the symptoms of trichomonas in women?
Vaginal discharge
Vulvitis
Vaginitis
How is trichomonas diagnosed?
Vaginal wet preparation
NAATs
How is trichomonas managed?
Metronidazole
How is scabies managed?
Permethrin
How is pubic lice managed?
Malathion
What causes anogenital warts?
HPV
Which types of HPV are oncogenic?
HPV 16
HPV 18
What is bacterial vaginosis?
Most common cause of abnormal discharge in women
Bacterial infection of vagina
What are risk factors for bacterial vaginosis?
Vaginal douching
Recent sexual partner change
Smoking
STI
What are the symptoms of bacterial vaginosis?
Offensive fishy discharge
No itching
How is bacterial vaginosis diagnosed?
High vagina gram stained smear
How is bacterial vaginosis managed?
Metronidazole
What causes vulvovaginal candidiasis?
Candida albicans
What are the risk factors for candidiasis?
Pregnancy Antibiotics Oestrogen oral contraceptives Diabetes Immunosuppression
What are the symptoms of candidiasis?
Vaginal discharge - curdy
Vulval itch
Soreness
Dyspareunia
How is candidiasis diagnosed?
High vaginal smear
How is candidiasis managed?
Topical/oral azoles
What are complications of STIs?
PID
Epididymo-orchitis
SARA - sexually acquired reactive arthritis
Prostatitis
What is epididymo-orchitis?
Clinical syndrome of pain, swelling + inflammation of epididymis and testes
What is Reiter’s syndrome?
Triad of urethritis, conjunctivitis and arthritis
