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
What is the emprical treatment for Trichomoniasis?
Metronidazole
What is the emprical treatment for Gonorrhea?
Ceftriaxone
What is the emprical treatment for Chlamydia?
Doxycycline / azythromycin
What are the common non-viral infectious causes of vulvo-vaginitis?
- Candidiasis
- Bacterial vaginosis
What are the common non-viral infectious causes of cervicitis?
- Trichomoniasis
- Gonorrhea
- Chlamydia
What other STI needs to be tested for if a patient is symptomatically presenting for Chlamydia Gonorrhea? and what is its significance
- M. genitalium
- High rates of macrolide resistance (needs test of cure 2W post treatment)
- Same complications as Chlamydia
