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FINALS - OBS, GYNAE, BREAST > gynae infection - bacterial > Flashcards

gynae infection - bacterial Flashcards

1
Q

natural pH of vagina

A

acidic

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2
Q

which bacteria keeps vaginal pH

A

lactobacillus –> acidic pH

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3
Q

most common organism thrush

A

candida albicans (yeast infection)

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4
Q

RF thrush

A

DM // antibiotics, steroids // pregnant // immunosuppressed eg HIV

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5
Q

symptoms thrush

A

cottage cheese discharge // not smelling // itch!! // superficial dyspareunia, dysuria // vulva redness, fissures

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6
Q

invx thrush

A

usually clinical (can do high vaginal swab)

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7
Q

1st line mx thrush

A

oral fluclonazole 150mg +/- topical imidazole

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8
Q

2nd line mx thrush

A

pessary clotrimazole 500mg +/- topical imidazole

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9
Q

mx thrush in pregnancy

A

pessary (oral contraindicated)

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10
Q

what defines recurrent thrush

A

4 in a year

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11
Q

invx recurrent thrush

A

high vaginal swab // consider glucose for diabetes

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12
Q

mx recurrent thrush

A

induction maintenance regime // oral fluconazole every 3 days –> 0ral fluclonazole weekly for 6 months

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13
Q

organism VB

A

gardnerella vaginalis (anaerobe)

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14
Q

who gets BV

A

sexually active women (not an STI)

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15
Q

amstel criteria for BV

A

3/4: smelly, thin discharge // clue cells on microsocpy // pH >4.5 // whiff test

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16
Q

mx BV

A

oral metronidazle 5-7 days // (topical metro or clinda if oral CI)

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17
Q

mx BV in pregnancy

A

oral metro at all stages

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18
Q

complications of BV in pregnancy

A

preterm, low birth weight, chorioamnionitis

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19
Q

what organism causes trichomonas

A

protozoan (STI)

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20
Q

features trichomonas (F)

A

smelling, yellow discharge // strawberry cervix!!! // pH >4,5

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21
Q

features trichomonas (M)

A

asymptomatic, maybe urethritis

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22
Q

invx trichomonas

A

microscopy –> wet mounds + motile trophozoite

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23
Q

mx trichomonas

A

oral metro 5-7 days

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24
Q

symptoms chlamydia

A

asymptomatic // F: cervicitis, bleeding, dysuria // M: discharge, dysuria

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25
Q

complications chlamydia

A

epidiymitis // PID // endometritis // ectopic pregnancy // reactive arthritis // Fitz hugh curtis (hepatitis)

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26
Q

invx + swab chlamydia

A

M: first void urine // F: vulvovaginal swab // NAAT // 2 weeks after exposure if known contact

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27
Q

screening for chlamydia

A

all sexually active people aged 15-24

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28
Q

1st line mx chlamydia

A

doxy 7 days // (or azithro 1 day –> 500mg OD for 2 days)

29
Q

chlamydia mx if pregnant

A

azithro, erythro, amoxicillin

30
Q

contact timeline chlamydia for symptomatic men

A

4 weeks prior to symptoms and all after

31
Q

contact timeline chlamydia for women and asymptomatic men

A

6 months prior

32
Q

mx for chlamydia contacts

A

offer treatment before test comes back

33
Q

what type of bactiera is chlamydia

A

gram -ive + intracellular

34
Q

what does chlamydia serovaris A-C cause

A

ocular infection in africa (not an STI) // endemic trachoma

35
Q

what does chlamydia serovaris D-k cause

A

STI // neonatal disease

36
Q

what does chlamydia serovaris L1-L3 cause

A

Lymphogranuloma venereum

37
Q

RF Lymphogranuloma venereum

A

MSM // HIV // tropics and developing countries

38
Q

symptoms Lymphogranuloma venereum

A

1 = painless pustules to ulcers –> 2 painful inguinal lymph (rarely fistula) –> 3 protocolitis + rectal bleeding

39
Q

mx Lymphogranuloma venereum

A

doxycycline

40
Q

what is PID

A

infection and inflammation of pelvic organs

41
Q

common causes PID

A

chlamydia most common // gonorrhoea, mycoplasma

42
Q

symptoms PID

A

lower abdo pain // fever // deep dyspareunia // dyruria // menstrual changes // discharge

43
Q

o/e PID

A

cervical excitation

44
Q

invx PID

A

pregnancy // high vagial swab (often negative)

45
Q

complications PID

A

Fitz-Hugh Curtis (perihepatitis) // infertility // ectopic

46
Q

mx PID

A

oral ofloxacin + oral metro // IM ceftriaxone + oral doxy + oral metro

47
Q

what type of bacteria is gonorrhoea

A

gram -ive dipplococcus

48
Q

symptoms gonorrhoea

A

M: urethral discharge, dysuria // F: cervicitis, vaginal discharge // pharyngeal or rectal asymptomatic

49
Q

complications gonorrhoea

A

urethral strictures // epididymitis + PID –> infertility // disseminated gonorrhoea –> septic arthritis

50
Q

symptoms disseminated gonorrhoea

A

tenosynovitis, polyarthritis, dermatitis –> septic arthritis, endocarditis, perihepatits

51
Q

invx gonorrhoea

A

NAATS screening // urethral in males, endocervical in women

52
Q

1st line mx gonorrhoea

A

single IM dose

53
Q

2nd line mx gonorrhoea

A

oral ceftriazone 400mg (single dose) + oral azithro 2g (single dose)

54
Q

causes urethritis (men only)

A

chlamydia , gonorrhoea, ureaplasma or mycoplasma

55
Q

invx urethritis

56
Q

mx urethritis

A

oral doxy 7 days OR single dose oral azithro

57
Q

what causes genital chancroids

A

Haemophilus ducreyi

58
Q

symptoms chancroid

A

painful genital ulcer (sharply defined) + unilateral, painful lymph nodes

59
Q

incubation syphilis

A

trep pallidum 9-90 days

60
Q

primary symptoms syphilis

A

painless chancre (ulcer) - may be on cervix // non-tender lymph

61
Q

symptoms secondary Syphilis

A

(6-10 weeks later) // fever, lymph // rash on trunk, palms, soles // buccal ulcers // condylomata lata (painless warts on genitals)

62
Q

tertiary symtpoms Syphilis

A

gummas (granuloma on skin and bone) // aortic aneurysm // paralysis of insane // argyll roberston pupil

63
Q

symptoms congenital syphillis

A

blunted inciesors // rhagades (linear scar at mouth) // keratitis // deaf

64
Q

non-trep serological sesting

A

non-specific // shows number of antibodies // negative after treatment // uses cardiolipin to test

65
Q

trep speceific serological sesting

A

TP-EIA // shows reactivity

66
Q

what causes false negative non-trep serology

A

pregnancy // SLE, APS // TB // leprosy // malaria // HIV

67
Q

1st line mx syphilis

A

IM penicillin (doxy alternative)

68
Q

what needs to be tested after treatment of syphillis

A

non-trep serology (RPR or VDLR) should DECREASE

69
Q

what reaction is sometimes seen after syphillis testing

A

Jarisch-Herxheimer reaction // fever, rash, tachycardia after 1st dose // conservative mx

FINALS - OBS, GYNAE, BREAST (27 decks)

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