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Reproductive System > Infections And PID > Flashcards

Infections And PID Flashcards

1
Q

What is the difference between an STI and an STD?

A

STIs can be symptomatic or asymptomatic

STDs are symptomatic cases only

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2
Q

Give some of the at risk groups for STIs

A 
Young people
More sexual activity 
Low socio-economic status 
Number of partners
Unsafe sex
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3
Q

Give some complications of STIs

A

Pelvic inflammatory disease
Infertility
Reproductive tract cancers

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4
Q

How do we manage an STI?

A

Abx treatment - preferable single dose/short course
Co-infections common so screen for others
Contact tracing
Education/advice on contraception

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5
Q

What is the most common viral STI?

A

Human papilloma virus

Warts

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6
Q

What are the 2 types of HPV warts?

A

Benign (6 and 11) - painless

High risk/oncogenic (16 and 18)

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7
Q

When do we give HPV vaccine?

A

Girls 12-13 years (2 doses)

For prevention of 16 and 18 mainly

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8
Q

What is the most common bacterial STI?

A

Chlamydia trachomatis

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9
Q

Which gender is most commonly asymptomatic with chlamydia?

A

Females

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10
Q

What is the medical term for infection of Fallopian tubes?

A

Salpingitis

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11
Q

Which methods do we use to diagnose chlamydia?

A

Endocervical and urethral swabs

1st void urine

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12
Q

What is the treatment for chlamydia?

A

Doxycycline or azithromycin

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13
Q

If under 18 with chlamydia what treatment should be given?

A

Erythromycin

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14
Q

How do we diagnose herpes?

A

PCR of vesicle fluid

And/or ulcer base

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15
Q

What is the treatment for herpes?

A

Aciclovir

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16
Q

What would neisseria gonorrhoeae look like under gram stain?

A

Gram negative
Intracellular
Diplococcus

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17
Q

Which gender is more likely to be asymptomatic with gonorrhoea?

A

Females

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18
Q

How do we diagnose gonorrhoea?

A

Swab/urine

Gram stain

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19
Q

What is the treatment for gonorrhoea?

A

IM ceftriaxone

And treat them for chlamydia with azithromycin

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20
Q

What organism causes syphilis?

A

Treponema pallidum

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21
Q

Who is most likely to get syphilis?

A

Men

And MSM

22
Q

Describe the stages of syphilis

A 
Primary = painless ulcer (chancre)
Secondary = systemic illness, fever, rash, lymphadenopathy 
Latent = symptom free years 
Tertiary = neurosyphilis, CVS syphilis and gummas
23
Q

How can we diagnose syphilis?

A

Dark field microscopy

Antibody testing

24
Q

What is the treatment for syphilis?

A

Penicillin

25
Q

What is trichomonas vaginalis?

A

A protozoa cause of vaginitis

26
Q

Describe Sx of vaginitis

A

Thin, frothy, offensive discharge
Irritation
Dysuria
Redness

27
Q

What is the treatment for vaginitis?

A

Metronidazole

28
Q

What are the risk factors for vaginal candida?

A 
Abx use
Oral contraceptives
Pregnancy 
Obesity 
Steroids
Diabetes
29
Q

What are the Sx of vaginal candida?

A

Profuse, white, itchy, curd-like discharge

30
Q

How do we diagnose candida?

A

High vaginal smear and culture

31
Q

What is the treatment for vaginal candida?

A

Topical azoles or nystatin

32
Q

What is bacterial vaginosis?

A

Perturbed normal flora

33
Q

Which species are likely to cause bacteria vaginosis?

A

Gardnerella
Anaerobes
Mycoplasmas

34
Q

How do we diagnose bacterial vaginosis?

A

KOH whiff test

Gram stain smear

35
Q

What is the treatment for bacterial vaginosis?

A

Metronidazole

36
Q

How does PID arise?

A

An infection ascending from the endocervix

Causing inflammation and damage

37
Q

What are the most common problems with PID?

A

Endometritis
Salpingitis
Tube-ovarian abscess

38
Q

What is the main presenting Sx of salpingitis?

A

Pain

39
Q

How does a turbo-ovarian abscess occur?

A

Neutrophils invade submucosa
Fills lumen with exudate
Walls off to form abscess
Exudate can become attached to pelvic side walls

40
Q

What are the complications of PID?

A 
Ectopic pregnancy risk 
Infertility 
Chronic pelvic pain (adhesions) 
Fits-Hugh-Curtis syndrome 
Reiter syndrome
41
Q

What is Fitz-Hugh-Curtis syndrome?

A

RUQ pain and peri-hepatitis following chlamydia

Stringy adhesions

42
Q

What is Reiter syndrome?

A

Disseminated chlamydia infection

43
Q

What are the most common STIs to cause PID?

A

Chlamydia

Gonorrhoea

44
Q

What are the risk factors for PID?

A 
Young age (20-30)
Lack of barrier contraception 
Multiple sexual partners
Low socio-economic class
IUCD (copper coil)
45
Q

Describe a typical Hx for PID

A

Pyrexia, pain
Abnormal discharge/vaginal bleeding
Sexual Hx, prior STI

46
Q

What could you find on examination for PID?

A

Fever
Lower abdo tenderness - usually bilateral
Bimanual exam - adnexal (tube) tenderness, cervical motion tenderness
Speculum exam - lower genital tract infection, purulent discharge

47
Q

What do we need to have in our differential diagnosis with suspected PID?

A 
Ectopic pregnancy 
Endometriosis 
Ovarian cyst complications 
IBS
Appendicitis 
UTI
48
Q

What investigations might you do for suspected PID?

A 
Pregnancy test 
Endocervical and high vaginal swabs
Blood tests - WBC and CRP
Screen for STIs
Diagnostic laparoscopy
49
Q

How do we treat mild PID?

A

Quickly (less chance of complications)

Sx management = rest and analgesics

50
Q

How do we treat severe PID?

A

IV Abx for 14 days

Ceftriaxone and doxycycline and metronidazole

51
Q

Give some factors that would cause us to think the PID was severe

A

Temp > 38
Signs of tube-ovarian abscess or peritonitis
Not responding to therapy
Increased risk group

Reproductive System (17 decks)

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