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Obs + Gynae > GUM > Flashcards

GUM Flashcards

1
Q

What are some causes of discharge?

A

Physiological (pregnancy, arousal, puberty, COCP)
Foreign body
Infection

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2
Q

Describe the organism C. trachomatis:

A

Obligate intracellular gram-negative bacterium Serotypes D-K responsible for genitourinary infection

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3
Q

How can chlamydia present?

A

Often asymptomatic

Dysuria, discharge, dyspareunia, PCB/IMB

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4
Q

What diagnostic tests can be used for chlamydia?

A

Nucleic acid amplification test (NAAT) on vulvovaginal swab or endocervical swab
In men, first pass urine

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5
Q

What is the treatment for chlamydia?

A

Doxycycline 100mg BD for 7 days

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6
Q

What is the treatment for chlamydia in pregnancy?

A

Azithromycin 1g STAT or erythromycin 500mg BD for 10-14 days

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7
Q

If chlamydia goes untreated in pregnancy, what are the risks?

A

PPROM
Prematurity
Neonatal conjunctivitis (5-12 days after birth) Pneumonia (1-3 months after birth)

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8
Q

What are some complications of a chlamydia infection?

A 
PID
Fitz-Hugh-Curtis
Reiter’s (arthritis, conjunctivitis, urethritis)
Tubal infertility
Risk of ectopic
Epididymo-orchitis
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9
Q

Describe the organism Neisseria gonorrhoea:

A

Gram negative diplococcus

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10
Q

How can gonorrhoea present?

A

Often asymptomatic
Urethral/vaginal discharge
Dysuria, lower abdo pain, IMB/PCB

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11
Q

What diagnostic tests can be used for gonorrhoea?

A

NAAT on vaginal or endocervical swab

In males, first pass urine

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12
Q

What is the treatment for gonorrohea?

A

Ceftriaxone 1g IM

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13
Q

If gonorrhoea goes untreated in pregnancy, what are the risks?

A

PPROM
Prematurity
Chorioamionitis
Gonococcal conjunctivitis

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14
Q

What are some complications of a gonorrhoea infection?

A

PID, Bartholin’s abscess, tubal infertility, risk of
ectopic
Epididymitis, prostatitis, Reiter’s, infective endocarditis,
disseminated gonococcal infection

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15
Q

What type of organism is trichomonas vaginalis?

A

Protozoa

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16
Q

How might trichomonas vaginalis present?

A

Thin, fish-smelling discharge (yellow-green)
Itch
Cervix may have ‘strawberry’ appearance

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17
Q

How can TV be diagnosed?

A

NAAT (HVS), culture, microscopy

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18
Q

What is the treatment for TV?

A

Metronidazole 2g PO stat or 400mg/12h PO for 5 days

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19
Q

What organisms is bacterial vaginosis often caused by?

A

Gardnerella vaginalis, anaerobes and mycoplasmas

20
Q

What is the pathophysiology of bacterial vaginosis?

A

Disturbance in normal flora leading to reduction in numbers of lactobacilli, rise in pH and overgrowth of other species

21
Q

How can bacterial vaginosis present?

A

Thin, white, fish-smelling discharge

22
Q

How can bacterial vaginosis be diagnosed?

A

HVS is gram stained to examine vaginal flora, reduced lactobacilli, clue cells
Vaginal pH >4.5
KOH whiff test

23
Q

What is the treatment for bacterial vaginosis?

A

Metronidazole 2g PO/gel PV or clindamycin vaginal cream 7 nights

24
Q

Untreated bacterial vaginosis in pregnancy increases the risks of what?

A

Prematurity, miscarriage and chorioamnionitis

25
Q

How can genital candidiasis present?

A 
Genital itch
Burning
Cottage cheese like discharge
Dyspareunia
Vulval redness
26
Q

What are some risk factors for genital candidiasis?

A 
Pregnancy
Contraceptive
Steroids, immunodeficiencies
Antibiotics
Diabetes
27
Q

What is the treatment for genital candidiasis?

A

Topical azoles (clotrimazole 500mg pessary and cream) or oral fluconazole 150mg PO

28
Q

How should genital candidiasis be treated if pregnant or breastfeeding?

A

Topical azoles only

29
Q

What organism causes genital warts?

A

DNA human papilloma virus

30
Q

What are some risk factors for genital warts?

A

Early age at first intercourse, multiple partners, immunosuppression, smoking, diabetes

31
Q

What are some management options for genital warts?

A

Podophyllotoxin (clusters of small warts)
Imiquimod (larger warts)
Excision, cryotherapy, electrosurgery or laser surgery

32
Q

What viruses causes genital herpes?

A

HSV1 and 2

33
Q

How can genital herpes be spread?

A

Skin to skin genital contact
Sex
Oral sex with someone who suffers from cold sores

34
Q

How can genital herpes present?

A

Flu-like prodrome then vesicles/papules around genitals, anus and throat
Discharge, dysuria, urinary retention, proctitis, itch

35
Q

What is the treatment for genital herpes?

A

Analgesia, antivirals within 5d: acyclovir

36
Q

How can genital herpes be diagnosed?

A

PCR from swab of open sore

37
Q

Describe the organism that causes syphilis:

A

Gram negative Treponema pallidum

38
Q

What are some risk factors for developing syphilis?

A

Unprotected sex, multiple partners, MSM, HIV infection

39
Q

What is the primary stage of syphilis infecton?

A

Macule -> papule -> painless ulcer (chancre)

40
Q

What is the secondary stage of syphilis infection?

A

Dissemination 4-10 weeks after chancre.

Rash, mucous patches, condyloma lata (raised plaques), fever, headache, myalgia, lymphadenopathy

41
Q

What is the tertiary stage of syphilis infection?

A

20-40 year after infection

Neurosyphilis, gummatous syphilis

42
Q

How can syphilis be diagnosed?

A

PCR of swab from active lesion, serology

Dark ground microscopy of chancre fluid

43
Q

What is the treatment for syphilis?

A

Benzylpencillin IM

44
Q

What are the risks of untreated syphilis in pregnancy?

A

Miscarriage, stillbirth, pre-term labour, congenital syphilis

45
Q

What are some signs of neonatal syphilis?

A

Rhinitis, snuffles, rash, hepatosplenomegaly, lymphadenopathy, anaemia, jaundice, ascites, saddle nose

Obs + Gynae (4 decks)

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