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Women's health > Genitourinary tract infections > Flashcards

Genitourinary tract infections Flashcards

1
Q

Pelvic inflammatory disease : definition

A
  1. Ascending infection from the endocervix
  2. Infection and inflammation of the pelvic organs including; Uterus, Fallopian tube, ovaries and surrounding pertoneus
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2
Q

Pelvic inflammatory disease : Most common causes

A
  1. Chlamydia Trachomatis
  2. Neisseria Gonorrohea
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3
Q

Pelvic inflammatory disease : Clinical features

A
  1. Lower abdominal pain
  2. Fever
  3. Deep dyspareunia
  4. Vaginal and cervical discharge
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4
Q

Pelvic inflammatory disease : Clinical signs

A

Cervical excitation

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5
Q

Pelvic inflammatory disease : Investigation

A
  1. Pregnancy test } exclude Ectopic pregnancy
  2. High vaginal swab
  3. Screen for Chlamydia and Gonorrhea
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6
Q

Pelvic inflammatory disease : Management

A

Oral : Ofloxacin + Metronidazole
IM : Ceftriaxone + Doxycycline + Metronidazole

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7
Q

Pelvic inflammatory disease : Complication

A

Inflammation causes adhesions and stricture to form leading to;
1. Ectopic pregnancy
2. Infertility
3. Fitz- Hugh- curtis syndrome : inflammation of the liver capsule with adhesions forming

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8
Q

Bacterial vaginosis : definition

A

Overgrowth of anaerobic Gardnerella vaginalis in the vagina.

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9
Q

Bacterial vaginosis : pathophysiology

A
  1. Normal vaginal flora has lactobacillus species which produce lactic acid and maintain acidic PH
  2. In BV there is decrease in lactobacilli
  3. Leading to more alkaline environment which can cause colonisation of other bacteria
  4. Raising vaginal PH and leading to infection
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10
Q

Bacterial vaginosis : Clinical features

A

‘Fishy’ - Offensive vaginal discharge

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11
Q

Bacterial vaginosis : Diagnosis

A

Amsel’s criteria for diagnosis of BV - 3 of the following 4 points should be present
1. thin, white homogenous discharge
2. clue cells on microscopy: stippled vaginal epithelial cells
3. vaginal pH > 4.5
4. positive whiff test (addition of potassium hydroxide results in fishy odour)

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12
Q

Bacterial vaginosis : Management - If asymptomatic

A

Treatment not required

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13
Q

Bacterial vaginosis : Management - If symptomatic

A
  1. Oral metronidazole 5-7 days
  2. 2nd line : Topical metronidazole or clindamycin
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14
Q

Bacterial vaginosis : Management - If Pregnant

A
  • if asymptomatic: discuss with the woman’s obstetrician if treatment is indicated
  • if symptomatic: either oral metronidazole for 5-7 days or topical treatment
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15
Q

Bacterial vaginosis : Risks in pregnancy

A
  1. Increased risk of preterm labour,
  2. Low birth weight
  3. Chorioamnionitis
  4. late miscarriage
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16
Q

Vaginal candidiasis : Causative organism

A

Candida albicans

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17
Q

Vaginal candidiasis : Risk factors

A
  • diabetes mellitus
  • drugs: antibiotics, steroids
  • pregnancy
  • immunosuppression: HIV
18
Q

Vaginal candidiasis : Discharge + Clinical features

A
  • ‘Cottage cheese’, non-offensive discharge
  • vulvitis: superficial dyspareunia, dysuria
  • Itch
19
Q

Vaginal candidiasis : Investigations

A

High vaginal swab and microscopy

20
Q

Vaginal candidiasis : Management

A

First line : PO Fluconazole 150mg

Second line: 500mg Clotrimazole pessary

21
Q

Vaginal candidiasis : Management - If pregnant

A

500mg Clotrimazole pessary

22
Q

Trichomonas Vaginalis : Definition

A
  • Sexually transmitted infection
  • Flagellated protozoan parasite
23
Q

Trichomonas Vaginalis : Vaginal discharge

A
  1. Offensive
  2. yellow/green, frothy discharge
24
Q

Trichomonas Vaginalis : Clinical features

A
  1. Vulvovaginitis
  2. Strawberry cervix
  3. Urethritis in men
25
Q

Trichomonas Vaginalis : investigations

A

Microscopy of a wet mount ; shows motile trophozoites

25
Q

Trichomonas Vaginalis : Management

A

Oral metronidazole for 5-7 days

25
Q

Chlamydia : Clinical features

A

Mainly asymptomatic

  1. Women:
    * Cervicitis (discharge, bleeding),
    * Dysuria
  2. Men:
    * Urethral discharge, dysuria
25
Q

Chlamydia : Complications

A
  1. Epididymitis
  2. Pelvic inflammatory disease
  3. Increased incidence of ectopic pregnancies
  4. Infertility
25
Q

Chlamydia : Investigations

A
  1. NAAT tests
    Women : Vulvovaginal swab
    Men : First void urine
25
Q

Chlamydia : Management

A
  1. First line : Doxycycline } 7 days
  2. Second line : Azithromycin stat dose
    (1g, 500mg,500mg } 3 day course)
  3. Pregnancy : 1g stat Azithromycin
25
Q

Chlamydia : Partner notification

A
  1. Symptomatic men } 4 weeks prior
  2. Women/Asymptomatic men } 6 months prior
26
Q

Gonorrhoea : causative organism

A

Gram-negative diplococcus /Neisseria gonorrhoeae/

27
Q

Gonorrhoea : Clinical features

A
  • males: urethral discharge, dysuria
  • females: cervicitis e.g. leading to vaginal discharge
28
Q

Gonorrhoea : Management

A

First line : IM Ceftriazone

29
Q

Gential herpes : Causative organisms

A
  • HSV-2
    (HSV1 : oral lesions/cold sores)
30
Q

Gential herpes : Clinical features

A
  1. Systemic features in primary infection:
    -Headache, fever, malaise
  2. Painful genital ulceration :
    * Dysuria
  3. Tender inguinal lymphadenopathy
31
Q

Gential herpes : Investigation

A

NAAT culture : swab genital ulcer

32
Q

Gential herpes : Management

A
  1. Oral aciclovir
33
Q

Genital warts : Causative organisms

A

HPV type 6 and 11

34
Q

Genital warts : Management

A
  • First line
    1. Topical Podophyllum
    2. Cryotherapy
  • Second line
    1. Imiquimod cream
35
Q
A

Women's health (12 decks)

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