Imfrctions Of The Reporductive Tract Flashcards
Who is most commonly affected by STIs and which is most common?
15-24yrs
Black ppl more commonly
Men who sleep with men (anal)
Lower socio-economic status
Chlamydia
What is Chlaymdia’s full name, how does it work, symptoms in men and women, diagnosis?
Chlamydia trachomatis
Most common STI UK
Obligate intracellular bacterium
Unique cell wall, inhibits phagolysosome fusion (virulence factor)
Men- typically asymptomatic (can testicular pain, dysuria, May discharge)
urine samples NAATs
Women - discharge, postcoital/ intermenstrual bleeding, dyspareunia, neonatal conjunctivitis vaginal delivery
Vulvo- vaginal swabs (VVs), endocervical speculum
What is Gonorrhoeas full name, describe the bacterium, symptoms and detection men and women?
Neisseria gonorrhoeae
Gram -ve, diplococci, unencapsulated ,
Pilated (adhere to mucosal membranes)
Symptoms :
Men- most common cause discharge, 90% symptomatic, thick/ yellow discharge +/- dysuria, disseminated infection -> reactive arthritis, itchy, burning
Urine sample - microscopy and culture, NAATs/ urethral swab
Women - 50% symptomatic, yellow discharge, dyspareunia, dysuria, intermenstrual bleeding, abdo pain, itchy (pruritic) , burning
VVS, endocervical speculum
What is non- gonococcal urethritis? what causes it?
Inflation of the urethra with associated discharge not caused by gonoccal in men
Can be sexually transmitted (chlamydia trichromatis, mycoplasm genitalium, trichomonas vaginalis)
OR
Can be pathogen negative (less common, older men)
NAATs urine sample ‘first catch’ (nuclei acid amplification tests)
What could be a cause for thick mucus discharge in women?
Progesterone in the secretory phase (post-ovulation) causes thicker cervical mucus
It would be cyclical, no other associated symptoms and clear
What is the full name for trichomoniasis? Describe the pathogen, what are the symptoms? diagnosis? How do you treat?
Tichomoniasis vaginalis
Protozoa (flagellates), flagella, optimal growth PH6 (vagina pH4) so increased alkalinity favours disease
Copious yellow odourless discharge (cause of non-gonococcal discharge men)
High vaginal swab
✅metronidazole
What is the full name for candidiasis? Risk factors? Symptoms? Diagnosis
Candida albicans
Yeast part normal vaginal flora, activated immunocompromised states, favours high oestrogen (COCP), v itchy, white thick discharge, non-offensive (odour)
HVS, microscopy > culture
What causes bacterial vaginosis? symptoms and treatment? Diagnosis
healthy vaginal mucosa is lactobacillus 95%, G vaginalis present commonly
If gardnerella vaginalis overgrows = bacterial vaginosis = inflammation
From altered flora, XS washing, increased risks of contracting STIs
Offensive smelling, white discharge
Gram staining, KOH test (whiff test)
✅antibiotics
What is HPV? What are the types? What can they cause? How to prevent?
Human papillomavirus
DNA virus (non-enveloped)
Causes Genital/ cutaneous warts
Types:
6/11 - 90% genital infections
16/18 - highest association cervical cancer
PCR identify high risk types (biopsy/ swab)
Vaccinations (men and WM):
Gardasil (6/11/16/18)
Cervarix (16/18)
What is herpes simplex virus? symptoms? Types? Diagnosis? Management?
DNA virus enveloped
Lifelong infection, initial then recurrent. Direct contact, sexual, vertical transmission
Can be asymptomatic initially or painful ulcers/ blisters (usually multiple) + systemic symptoms (fever, myalgia, malaise)
HSV-1 associated with cold sores too
HSV-2 more likely become infected HIV
Check: genitals, mouth, anus
Swabs: PCR/ NAATs
Management: antivirals e..g aciclovir, can’t eradicate but reduces severity and duration
What is treponema pallidum? How is it transmitted, who is most at risk, symptoms, diagnosis and management?
Syphilis bacteria infection
Spirochete shape
Direct contact, vertical transmission (across placenta)
40% co-infected with HIV, most common older gay men
Primary syphilis - painless ulcers typically ->
Secondary- 25% untreated cases, 4-10 weeks after initial infection, multi-system (kidneys, liver, rashes) can -> latent stage
Microscopy/ PCR/ serology
✅penicillin- bases antibiotics
Why might you give multiple antibiotics if someone has an STI? Give examples
Targets different organisms and co-infections are common
+ one antibiotic can augment the effect of the other
E.g. azithromycin (gonorrhoea/ Chlamydia) , ceftriaxone (chlamydia/ PID)
What is PID?what causes it?
Pelvic inflammatory disease
Infection of uterus/ Fallopian tubes/ ovaries
Caused by ascending infection typically e..g chlamydia trachomatis, neisseria gonorrhoeae, gardenerella vaginalis, mycoplasm genitalium
(Often polymicrobial)
Other sources of infection: intrauterine contraceptives, investigations, surgery
What are the symptoms and signs of PID?
Symptoms:
- lower abdo pain
- dyspareunia
- purulent discharge
- abnormal uterine bleeding (intermenstrual/ postcoital)
Signs:
- pyrexia (+/-)
- pain on palpitation abdomen, bimanual vaginal examination (one hand abdo fundus uterus and one palpate cervix - cervical tenderness -> STI/ PID)
- evidence discharge/ cervicitis (speculum)
What are some differentials for PID pain?
Endometriosis Pancreatitis Duodenal ulcer Musculo-skeletal Constipation Ectopic pregnancy Ovarian cyst UTIs Appendicitis IBD CANCER
