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Revision > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

ABx for cervicitis

A

Chlamydia
1- doxycycline 100mg BID 7 days
2- azithromycin 1g PO + 500mg PO OD 2 days

Neiserria
- ceftriaxone 1g IM single dose stat - TOC
Or
- cipro 500mg PO single dose

If genotypes anti microbial data suggests susceptibility to cipro - give cipro only , if unknown give ceftriaxone

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2
Q

PID treatment
Outpatient
Inpatient

A

Out-
Oral Ofloxacin +oral metronidazole
Or
IM ceftriaxone + oral doxy + oral metronidazole

In- CDM
Ceftriaxone + doxy + metronidazole

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3
Q

Yellow greenish, smelly vaginal discharge + itching
On exam - strawberry cervix
Vaginal pH >4.5
Dx + treatment ?

A

Trichomoniasis

Oral metronidazole

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4
Q

Grey white fishy vaginal discharge
Positive whiff test
Vaginal pH>4.5
Dx + tx?

A

Bacterial vaginosis - Gardnerella vaginalis

Metronidazole +clindamycin

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5
Q

Treatment of vulvovaginal candidiasis

A

Clotrimazole

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6
Q

What is normal vaginal pH

A

3.8 -4.5

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7
Q

Amsel’s criteria

A 
Diagnosis of bacterial vaginosis 
3/4 of :
1. Homogenous grey - white discharge 
2. +ve whiff test (fishy smell w/ KOH)
3. Clue cells under microscopy 
4.vaginal ph> 4.5
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8
Q

HPV 6 and 11 are responsible for

A

Genital warts

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9
Q

HPV 16 & 18 are responsible for

A

Most cervical cancers in UK

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10
Q

Prevention of genital warts

A

Gardasil

If vaccinated and warts still develop its of no help

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11
Q

Treatment of genital warts

A

Ablation/ cryotherapy

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12
Q

Multiple painful genital ulcers + dysuria

Dx +Treatment

A

HSV

Give acyclovir

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13
Q

Single non painful genital ulcer

Dx?

A

Syphilis - treponema pallium

Chancre

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14
Q

Single painful genital ulcer

Dx>

A

Haaemophilus Ducreyi (chancroid)

^ can be multiple and painful, like HSV - do PCR or viral culture to differentiate
PCR better **

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15
Q

Motile flagellate on microscopy of vaginal discharge

Dx?

A

Trichomoniasis vaginalis

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16
Q

Chlamydia presentation in males

Complications

A

Urethritis
Unilateral testicular pain

  • untreated chlamydia - epididymis-orchitis or epididiymitis
17
Q

Major complication of untreated chlamydia in females

A

Saplingitis

18
Q

Most common STI in the UK

A

Chlamydia

19
Q

Complications of syphilis

A

Aortic aneurysm

Granulomatous lesions of skin and bone - 3ry stage syphilis

20
Q

Treatment of cervical ectropion

A

Resolves spontaneously

If tx required - cauterise with silver nitrate

21
Q

Anogenital warts are caused by

A

HPV 6 & 11

22
Q

Single best investigation in the case of a 20 YO with a new sexual partner and complaints of yellow green vaginal discharge that is increasing

A

Endocervical and high vaginal swab

23
Q

HVS, endocervical, and self collected vulvovaginal swabs uses

A

self collected - chlamydia, n.gonorrhoea screening
^ suspected case , asymptomatic

Signs and sx of chlamydia or gonorrhoea
- endocervical swab

Suspected trichomoniasis - HVS

To cover all @ once = endocervical + HVS

24
Q

Most sensitive screening test for chlamydia and gonorrhoea

A

Self collected vulvovaginal swab for NAAT

25
Q

HSV investigations

A

1st line - NAAT testing
Others = viral culture + DNA PCR

If negative and the ulcers are recurrent/atypical - Anti HSV antibody

26
Q

Treatment of HSV

A

Oral acyclovir

27
Q

Rashes on the palms and soles of feet occurs in (3)

A
  1. HFMD - coxsackie
  2. Rocky Mountain spotted fever - rickettsia
  3. Secondary syphilis - treponema pallidum
28
Q

Primary stage of syphilis

A

Chancre - single painless ulcer

29
Q

2ry stage of syphilis
- when does it occur
Features (3)

A

6 weeks after chancre

Fever lymphadenopathy malaise - systemic symptoms
Rashes on soles palms and faced
Condyloma lata

30
Q

3ry stage of syphilis

3

A

Gumma - granulomatous lesion ; commonly affects skin & bones
Cardiovascular - ascending aortic aneurysm , aortic regurgitation
Neuro - dementia/ tabes dorsalis

31
Q

Management of syphilis

A

1st line - IM benzathine penicillin

Alternatively , if allergic
Doxycycline

32
Q

Investigations of syphilis

A

Ulcer still present + presents to GU clinic - dark microscopy
Ulcer present + GP clinic - PCR
Healed chancre (disappeared) - syphilis serology
Healed chancre + oral ulcers present - mouth swab for PCR

33
Q

Investigation after anal intercourse (insertive & receptive )

A

Receptive = NAAT
Rectal swab for screening of chlamydia and gonorrhoea - NAAT

Insertive
Urethral swab + first void sample urine

*receptive much riskier for getting HIV
Screen fro HIV Hep B chlamydia and gonorrhoea

34
Q

Treatment of pregnancy woman w/ UTI

A

Cefalexin

35
Q

Condyloma accuminatum vs Condyloma latum

A

Accumiantum - HPV = painless, skin coloured, cauliflower like
Latum - 2ry syphilis = painless hypopigmented , firm moist , pink/reddish , papules containing spirochetes

36
Q

Chancre vs chancroid

A

Chancre - T.pallidum (syphilis)
Painless, single , bilateral regional lymphadenopathy
Exude serum
Hard and indurated, sloping edges

Chancroid = H.Ducreyi
Painful, multiple, unilateral regional lymphadenopathy
Purulent exudate
Soft base, undermined edges

Revision (31 decks)

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