Genitourinary Flashcards by Harry Page

Define bacterial vaginosis

Overgrowth of bacteria in the vagina - speciffically anaerobic bacteria

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Risk factors for bacterial vaginosis

Multiple sexual partners
Excessive vaginal cleaning
Recent antibiotics
Smoking
Copper coil

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Presentation of bacterial vaginosis

Fishy-smelling watery grey discharge
No Itching, Irritation, Pain

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Investigation in bacterial vaginosis

Vaginal pH - >4.5
Vaginal swab
Clue cells on microscopy

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Management of bacterial vaginosis

Metronidazole

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Define candidiasis

Thrush - vaginal infection with a yeast of the candida family

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Risk factors for candidiasis

Increased oestrogen
Poorly controlled diabetes
Immunosuppression
Broad spectrum antibiotics

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Presentation of bacterial vaginosis

Thick white discharge
Erythema
Fissures
Vulval and vaginal itching, irritation and discomfort
Oedema
Pain during sex
Dysuria
Excoriation

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Investigations of candidiasis

Vaginal pH - <4.5
Charcoal swab

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Management of candidiasis

Antifungal creams
Antifungal pessary
Oral antifungals

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Define chlamydia

A gram-negative bacteria causing the most common STI in UK

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Presentation of chlamydia

Abnormal vaginal discharge
Pelvic pain
Abnormal bleeding
Painful sex
Painful urination

Urethral discharge
Painful urination
Epididymo-orchitis
Reactive arthritis

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Clinical signs of chlamydia

Pelvic or abdominal tenderness
Cervical motion tenderness
Inflamed cervix
Purulent discharge

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Management of chlamydia

Doxycycline 100mg BD for 7 days
(breast feeding - azithro, erythro, or amoxicillin)

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Define Neisseria gonorrhoeae

STI caused by a gram negative diplococcus bacteria infecting mucus membranes with columnar epithelium such as the endocervix, urethra, rectum, conjunctiva and pharynx.

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Presentation of Gonorrhoea

Odouless purulent discharge - green yellow
Dysuria
Pelvic pain
Testicular pain or swelling

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Test for gonorrhoea

NAAT tests - gonococcal RNA or DNA

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Management of gonorrhoea

IM ceftriaxone
Oral ciprofloxacin
Test of cure - DNA NAAT 14 days later
Abstain from sex
Test and treat contacts

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Define mycoplasma genitalium

Bacteria that causes non-gonococcal urethritis - STI

Management of mycoplasma genitalium

Doxycycline
Azithromycin

Define pelvic inflammatory disesae

Inflammation and infection of the organs of the pelvis caused by infcection spreading up through the cervix

Define endometritis

Inflammation of the endometrium

Define salpingitis

Inflammation of the fallopian tubes

Define oophoritis

Inflammation of the ovariea

Define perametritis

Inflammation of the parametrium - connective tissue around the uterus

Define peritonitis

Inflammation of the peritoneal membrane

Causitive organisms in PID

Gonnorrhoeae Chlamydia Mycoplasma

Risk factors for PID

Not using barrier contraception Multiple sexual partners Younger age Existing STI Previous PID Itrauterine device

Presentation of PID

Pelvic or lower abdominal pain Abnormal vaginal bleeding Pain during sex Fever Dysuria

Presentation of PID

Pelvic or lower abdominal pain Abnormal vaginal bleeding Pain during sex Fever Dysuria Pelvic tenderness Cervical motion tenderness Inflamed cervix Purulent discharge

Investigations in PID

Swabs! Pregnancy test Inflammatory markers

Management of PID

IM ceftriaxone Doxycycline MEtronidazole

Define Fitz-Hugh-Curtis syndrome

Complication of pelvic inflammatory disease - inflammation of the liver capsule leading to adhesions between the liver and peritoneum -

Define tricomoniasis

Parasite spread through sexual intercourse -

Presentation of tricomoniasis

Vaginal discharge - frothy and yellow green, may have fishy odour Itching Dysuria Dyspareunia Balanitis Examination reveals strawberry cervix pH >4.5

Management of tricomoniasis

Metronidazole

Define genital herpes

Caused by HSV-1 transmitted through orogenital sex, HSV-2 transmited by sexual intercourse

Presentation of genital herpes

Ulcers or blistering lesion Neuropathic type pain Flu-like symptoms Dysuria Inguinal lymphadenopathy

Management of genital herpes

Aciclovir Symptomatic management Paracetamol Topical lidocaine Cleaning with warm salt water Fluids Avoid intercourse

Define syphilis

Infection caused by treponema pallidum -

Syphilis transmission

Oral vaginal or anal sex Vertical transmission IVDU Blood transfusion

Stages of syphilis

Primary - painless ulcer Secondary - systemic symptoms Latent - symptoms disappear Tertiary - gummas and CVS or neuro issues Neurosyphilis - affects CNS

Presentation of primary syphilis

Painless genital ulcer Local lymphadenopathy

Presentation of secondary syphilis

Maculopapular rash Condylomata lata - grey wart like lesion around genitals and anus Low grade fever Alopecia Oral lesion

Presentation of tertiary syphilis

Gummatous lesion - gummas, granulomatous lesions affectiong skin organs and bones Aortic aneurysms Neurosyhpilis

Presentation of neurosyphilis

Headache Altered behaviours Dementia Tabes dorsalis - demyelination of posterior columns Ocular syphilis - argyll-Robertson pupil Paralysis Sensory impairment

Management of syphilis

Benzanthine benzylpenicillin Late - ceftriaxone, amoxicillin, doxycycline