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PM Infectious Disease > Genitourinary Infections > Flashcards

Genitourinary Infections Flashcards

1
Q

Features of bacterial vaginosis:

A
  • fishy, offensive discharge
  • 50% asymptomatic
  • not sexually transmitted but seen in sexually active women
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2
Q

Amsel’s criteria of bacterial vaginosis:

A

3/4 out of:

  • thin, white homogenous discharge
  • clue cells on microscopy: stippled vaginal epithelial cells
  • ph >4.5
  • positive whiff test
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3
Q

What is the most prevalent STI in the UK?

A

Chlamydia

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4
Q

What is chlamydia caused by, incubation period and main features:

A
  • chlamydia trachomatis
  • 7-21 dys
  • asymptomatic
  • women: cervicitis, dysuria
  • men: urethral discharge, dysuria
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5
Q

Complications of chlamydia:

A
  • epididymitis
  • PID
  • endometritis
  • increased ectopic pregnancies
  • infertility
  • reactive arthritis
  • perihepatitis (Fitz-Hugh-Curtis)
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6
Q

Investigations of chlamydia:

A
  • NAAT
  • first void urine (men), vulvovaginal swab or cervical swab
  • test 2 weeks after potential exposure
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7
Q

What is lymphogranuloma venereum caused by and risk factors:

A
  • chlamydia trachomatis serovars L1, L2 and L3

- mwhswm, developed countries HIV, historically in tropics

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8
Q

Stages of lymphogranuloma venereum:

A
  1. small painless pustules - ulcers
  2. painful inguinal lymphadenopathy (may have fistulating buboes)
  3. proctocolitis
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9
Q

Features of genital herpes:

A
  • painful genital ulceration (dysuria and pruritus)
  • primary infection more severe (systemic)
  • tender inguinal lymphadenopathy
  • urinary retention
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10
Q

Investigations for genital herpes:

A
  • NAAT

- HSV serology - recurrent genital ulceration with unknown cause

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11
Q

What is genital warts caused by and what are the features?

A
  • condylomata accuminata
  • HPV 6 and 11
  • HPV 16, 18 and 33 - cervical cancer
  • small fleshy protuberances which are slightly pigmented
  • may bleed or itchy
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12
Q

What is gonorrhoea caused by and what is the incubation period?

A
  • gram negative diplococcus neisseria gonorhoeae

- incubation period: 2-5 dyas

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13
Q

Features of gonorrhoea:

A
  • males: urethral discharge and dysuria
  • females: cervicitis
  • rectal and pharyngeal infection usually asymptomatic
  • urethral strictures, epididymitis and salpingitis (infertility)
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14
Q

Complications of gonorrhoea:

A
  • 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)
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15
Q

Most common organisms causing non-gonococcal urethritis:

A
  • chlamydia trachomatis most common

- mycoplasma genitalium

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16
Q

What causes genital herpes?

A

HSV2

17
Q

What causes oral herpes?

A

HSV1

18
Q

Incubation period of syphilis?

A

9-90 days

19
Q

What is a chancroid?

A
  • tropical disease
  • haemophilus ducreyi
  • painful genital ulcers - sharply defined, ragged
  • unilateral, painful, inguinal lymph node enlargement
20
Q

Management of pearly penile papules:

A
  • benign

- no treatment or investigations

21
Q

What causes granuloma inguinale?

A

klebsiella granulomatis

22
Q

Primary stage of syphilis:

A
  • chancre: painless ulcer at site
  • local non-tender lymphadenopathy
  • often not in women (lesion on cervix)
23
Q

Secondary stage of syphilis:

A
  • 6-10 weeks after primary
  • systemic features: fever, lymphadenopathy
  • rash on trunk, palms and soles
  • buccal snail track ulcers
  • condylomata lata
24
Q

Tertiary stage of syphilis:

A
  • gummas (granulomatous lesions on skin and bones)
  • ascending aortic aneurysms
  • general paralysis of insane
  • tabes dorsalis
  • Argyll-Robertson pupil
25
Q

Congenital symptoms of syphilis:

A
  • blunted upper incisors (Hutchinson’s teeth), mulberry molars
  • rhagades (linear scars at angle of mouth)
  • keratitis
  • saber shins
  • saddle nose
  • deafness
26
Q

What are the investigations for syphilis: (false positive tests)

A
  • cardiolipin test e.g. VDRL (negative after treatment)
  • treponemal specific antibody test e.g. TPHA (positive after treatment)
  • false positive: pregnancy, SLE, anti-phospholipid, TB, leprosy, malaria, HIV
27
Q

What is a Garish Herxheimer reaction:

A
  • fever, rash, tachy
  • no wheeze or hypotension like anaphylaxis
  • due to endotoxins released during bacterial death
  • no treatment
28
Q

What is trichomonas vaginalis?

A
  • highly motile, flagellated protozoan parasite

- trichomoniasis is an STI

29
Q

Features of trichomonas vaginalis:

A
  • vaginal discharge: offensize, yellow/green, frothy
  • vulvovaginitis
  • strawberry cervix
  • pH >4.5
  • men asymptomatic but may cause urethritis
30
Q

Investigations for trichomonas vaginalis:

A

microscopy of a wet mount shows motile trophozoites

31
Q

Most common causes of urethritis:

A
  • chlamydia trachomatis
  • ureaplasma urealyticum
  • mycoplasma genitalium
32
Q

Investigations for urethritis:

A
  • urethral swab - gram stained, presence of leukocytes and gram negative diplococci
  • chlamydia now NAAT
33
Q

Complications of urethritis:

A
  • epididymitis
  • subfertility
  • reactive arthritis
34
Q

Treatment for pubic lice:

A

malathion

PM Infectious Disease (6 decks)

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