GUT Infections Flashcards
What is the most common presentation for Vulvovaginitis?
- Discharge which is different in colour, consistency, amount, or smell
- Itchiness of the vulva and opening of the vagina
- Irritation, dryness, and discomfort
- Odour of discharge or area
What is the typical presentation for Cervicitis?
- Post coital bleeding
- Friable cervix - bleeds easily
- Cervical ectopy / ectopion on exam
- Soft collumnar cells on the endocervix spreat out through the os, joining the hard squamous epithelium
What are specific risks and complications associated with candidiasis?
- Vaginal oedema
- Excoriation
- Fissures
- Srtictures
- Fibroids
- If recurrent –> treatment resistance
What are the specific risks and complications of Bacterial Vaginosis?
-
Pregnancy risks
- Spontaneous abortion
- Premature labour
- Chorioamnionitis (infects amniotic fluid)
- Post-partum endometritis and PID
- Higher risk after termination and insertion of IUD
-
Increased risk of aquiring STI
- 2-3x (Chlamydia, Gonorrhoea, HSV, HIV)
- More infective to partners if HIV+
What are the specific risks and complications of Trichomoniasis?
- PROM
- Pre-term delivery
- Low birth weight
- Post-partum sepsis
What are the specific risks and complications of Chlamydia?
- PID
- Ectopic pregnancy
- Tubal infertility
- Reactive arthritis
What is the typical discharge appearance in candidiasis
Cottage Cheese
What is the typical discharge appearance in Bacterial Vaginosis?
Thin, white/grey, fishy smelling
What is the typical discharge appearance in Trichomonas Vaginalis
- Frothy green-yellow
- Profuse
- Foul smelling
What is the typical discharge appearance in Gonorrhea?
- Purulent, creamy,
- odourless
What is the typical discharge appearance in Chlamydia?
- Purulent
- Bloody
- Odourless
Besides discharge, what other symptoms are typically present in Candidiasis?
- Vulval itch
- Discomfort
- excoriation
- Superficial dyspareunia (painful intercourse)
Besides discharge, what other symptoms are typically present in Bacterial Vaginosis?
- Mostly asymptomatic
- no itch
- mild irritation
Besides discharge, what other symptoms are typically present in Trichomoniasis?
- Vulval itch
- Pain
Besides discharge, what other symptoms are typically present in Gonorrhea?
- Deep dyspareunia
- Painful defacation
- Conjuctivitis
What is Vulvovaginitis and what are some non-infectious causes of it?
Infection / inflammation of the vulva and vaginal epithelium
Causes:
- HSV
- Dermatoses (eczema and psoriasis)
- Allergic reaction
- Atrophic vaginitis
- Vulvar vestibulitis
Besides discharge, what other symptoms are typically present in Chlamydia?
- 50% asymptomatic
- Pelvic pain
- Bleeding (intermenstrual, post coital)
- Dysuria
How is diagnoisis made for Candidiasis?
- High vaginal swab / self collected vaginal swab
- MCS
- Gram stain
- Culture for pseudohyphae
How is diagnoisis made for Bacterial Vaginosis?
- AMSEL criteria (three of)
- Thin white discharge
- pH>4.5
- Clue cells on wet prep / gram stain (coccobacilli over edges of epithelial cells)
- whiff test (smells fishy with KOH addition)
- Needs swab
- Does not need culture if AMSEL criteria are met
How is diagnoisis made for Trichomoniasis?
- High vaginal swab (wet prep or PCR)
- first pass urine
How is diagnoisis made for Gonorrhea?
- First pass urine
- endocervical swab . vaginal swab (PCR and culture)
How is diagnoisis made for Chlamydia?
- First pass urine
- Vaginal swab (Culture and PCR)
What is the emprical treatment for Candidiasis?
Fluconazole / clomtrimazole
What is the emprical treatment for Bacterial Vaginosis?
Metronidazole
