Genitourinary Infections Flashcards
Features of bacterial vaginosis:
- fishy, offensive discharge
- 50% asymptomatic
- not sexually transmitted but seen in sexually active women
Amsel’s criteria of bacterial vaginosis:
3/4 out of:
- thin, white homogenous discharge
- clue cells on microscopy: stippled vaginal epithelial cells
- ph >4.5
- positive whiff test
What is the most prevalent STI in the UK?
Chlamydia
What is chlamydia caused by, incubation period and main features:
- chlamydia trachomatis
- 7-21 dys
- asymptomatic
- women: cervicitis, dysuria
- men: urethral discharge, dysuria
Complications of chlamydia:
- epididymitis
- PID
- endometritis
- increased ectopic pregnancies
- infertility
- reactive arthritis
- perihepatitis (Fitz-Hugh-Curtis)
Investigations of chlamydia:
- NAAT
- first void urine (men), vulvovaginal swab or cervical swab
- test 2 weeks after potential exposure
What is lymphogranuloma venereum caused by and risk factors:
- chlamydia trachomatis serovars L1, L2 and L3
- mwhswm, developed countries HIV, historically in tropics
Stages of lymphogranuloma venereum:
- small painless pustules - ulcers
- painful inguinal lymphadenopathy (may have fistulating buboes)
- proctocolitis
Features of genital herpes:
- painful genital ulceration (dysuria and pruritus)
- primary infection more severe (systemic)
- tender inguinal lymphadenopathy
- urinary retention
Investigations for genital herpes:
- NAAT
- HSV serology - recurrent genital ulceration with unknown cause
What is genital warts caused by and what are the features?
- condylomata accuminata
- HPV 6 and 11
- HPV 16, 18 and 33 - cervical cancer
- small fleshy protuberances which are slightly pigmented
- may bleed or itchy
What is gonorrhoea caused by and what is the incubation period?
- gram negative diplococcus neisseria gonorhoeae
- incubation period: 2-5 dyas
Features of gonorrhoea:
- males: urethral discharge and dysuria
- females: cervicitis
- rectal and pharyngeal infection usually asymptomatic
- urethral strictures, epididymitis and salpingitis (infertility)
Complications of gonorrhoea:
- disseminated gonococcal infection - tenosynovitis, migratory polyarthritis, dermatitis
- gonococcal arthritis - most common cause septic arthritis in young adults
- DGI later complications- septic arthritis, endocarditis and perihepatitis (Fitz-Hugh-Curtis syndrome)
Most common organisms causing non-gonococcal urethritis:
- chlamydia trachomatis most common
- mycoplasma genitalium
What causes genital herpes?
HSV2
What causes oral herpes?
HSV1
Incubation period of syphilis?
9-90 days
What is a chancroid?
- tropical disease
- haemophilus ducreyi
- painful genital ulcers - sharply defined, ragged
- unilateral, painful, inguinal lymph node enlargement
Management of pearly penile papules:
- benign
- no treatment or investigations
What causes granuloma inguinale?
klebsiella granulomatis
Primary stage of syphilis:
- chancre: painless ulcer at site
- local non-tender lymphadenopathy
- often not in women (lesion on cervix)
Secondary stage of syphilis:
- 6-10 weeks after primary
- systemic features: fever, lymphadenopathy
- rash on trunk, palms and soles
- buccal snail track ulcers
- condylomata lata
Tertiary stage of syphilis:
- gummas (granulomatous lesions on skin and bones)
- ascending aortic aneurysms
- general paralysis of insane
- tabes dorsalis
- Argyll-Robertson pupil
