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Infections of the Genital Tract Flashcards

1
Q

What factors affect the genital tract infections?

A
  1. Age: 15-24 most likely.
  2. Ethnicity: black/black British higher rates.
  3. Low socio-economic status.
  4. Increased number of sexual partners.
  5. Sexual orientation, e.g. MSM.
  6. Lack of barrier contraception.
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2
Q

What bacteria causes Chlamydia?

A

Chlamydia Trachomatis.

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3
Q

Does Chlamydia Trachomatis show up in a gram-stain?

A

No,chlamydia trachomatis doesn’t have a cell wall.

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4
Q

How does Chlamydia present in men?

A
  1. Mild urethritis.
  2. Dysuria.
  3. Inflammation: epididymitis, prostatitis.
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5
Q

How does Chlamydia present in women?

A

Asymptomatic.

  1. Vaginal discharge,
  2. Dyspareunia,
  3. Post-coital bleeding.
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6
Q

What complications can Chlamydia cause?

A
  1. PID,

2. Infections at sites outside the genital tract-> conjunctivitis and reactive arthritis.

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7
Q

How is Chlamydia investigated?

A

Nucleic acid amplification tests.

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8
Q

How do you treat Chlamydia?

A

Doxycycline or azithromycin, except in pregnancy/allergy where erythromycin issued.

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9
Q

Describe the Neisseria Gonorrheae bacteria structure.

A

Gram negative, intracellular diplococcus.

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10
Q

How do males with Gonorrhoea present?

A
  1. Discharge.

2. Dysuria.

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11
Q

How do females with Gonorrhoea present?

A

Asymptomatic.

  1. Vaginal discharge.
  2. Lower abdominal pain.
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12
Q

What are the complications associated with Gonorrhoea?

A
  1. Epidiymo-orchitis.
  2. PID.
  3. Disseminated gonorrhoea infection.
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13
Q

How do you treat Gonorrhoea?

A

Ceftriaxone and azithromycin (boost effect, reduce resistance and treat potential co-infection of chlamydia).

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14
Q

What spirochete bacterium causes syphilis?

A

Treponema Pallidum.

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15
Q

Who are commonly effected by syphilis?

A

White men ages 25-33, likely co-infected with HIV.

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16
Q

What are the stages of syphilis?

A

Stage 1: painless ulcer in the genitals or other site of sexual contact. Very infectious but disappears.
Can become latent for a bit.
Stage 2: develop weeks later, with an associated rash or affect other symptoms of the body. They then disappear.
Latent.
Stage 3: infection can remain latent and reactive later in life, e.g. in pregnancy which can cause congenital syphilis. Neurosyphilis and CVS problems can occur.

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17
Q

How do you diagnose syphilis?

A

Swabs can be taken, blood tests can confirm the infection and monitor the treatment,

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18
Q

How do you treat early syphilis (within 2 years)?

A

Benzathine Penicillin, single dose IM.

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19
Q

How do you treat late syphilis (after 2 years)?

A

Benzathine Penicillin, 3 doses.

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20
Q

How do you treat neurosyphilis?

A

IM Procaine penicillin and probenecid over 14 days.

21
Q

What is Anogenital warts caused by?

A

Human Papillomavirus, commonly strains 6 and 11.

22
Q

How does Anogenital warts present?

A
  1. Painless genital warts on penis, vulva, vagina, cervix and perianal skin.
23
Q

How do you diagnose Anogenital warts?

A

Clinical, regress without treatment.

24
Q

How do you treat Anogenital warts?

A

Regress without treatment, topical treatments are available.

25
Q

Describe the 2 strains of Herpes Simplex Virus.

A
  1. HSV-1: oral and genital herpes.
  2. HSV-2: genital herpes and often leads to infection. Dangerous in pregnancy as vaginal delivery means the baby can develop complications of herpes.
26
Q

How can Herpes Simplex Virus present?

A

Asymptomical

  1. Painful ulcers,
  2. Dysuria,
  3. Discharge.
27
Q

How can HSV be diagnosed?

A

Using swabs or serology.

28
Q

How do you treat HSV?

A

Acyclovir (antiviral).

29
Q

What strains of HSV are oncogenic?

A

HSV-16, HSV-18.

30
Q

What strains of HSV have vaccines?

A

6, 11, 16, 18.

31
Q

What is Trichomonas Vaginalis?

A

A protozoa that is sexually transmitted.

32
Q

How do Trichomonas Vaginalis infections present in men?

A

Asymptomatic.

  1. Dysuria.
  2. Discharge.
33
Q

How do Trichomonas Viginalis infection present in women?

A
  1. Vaginal discharge (yellow),

2. Irritation of the vulva and vagina.

34
Q

How do you diagnose Trichomonas Vaginalis?

A

Swabs.

35
Q

How do you treat Trichomonas Vaginalis?

A

Metronidazole.

36
Q

How do you investigate STIs in men?

A

First catch of urine to test for gonorrhoea/chlamydia.
Mid-stream urine for culture and sensitivities.
Urethral sampling can be carried out if the patient is symptomatic.
Take rectal and pharyngeal sampling for MSM.
Swabs on ulcer site.
Blood tests can be used to test syphilis and blood bone viruses.

37
Q

How do you investigate STIs in women?

A

Urine sample to rule out UTI.
High vaginal swab for trichomonas vaginalis.
Endocervical for chlamydia/gonorrhoea.
Vulvovaginal (asymptomatic) for chlamydia/gonorrhoea.
Ulcer swabs.
Rectal/pharyngeal swabs.
Serology.

38
Q

Give 2 examples of infections of the genital tract which aren’t sexually transmitted.

A
  1. Bacterial Vaginosis.

2. Vulvovaginal Candidiasis.

39
Q

What is the most common cause of vaginal discharge in women?

A

Bacterial Vaginosis.

40
Q

What causes Bacterial Vaginosis?

A

Inbalance of pH allowing growth of certain bacteria, especially Gardnerella Vaginalis (other anaerobes can cause it).

41
Q

What are the risk factors of Bacterial Vaginosis?

A

Practices that disrupt the vaginal flora, e.g. washing the vagina/vaginal douching.

42
Q

How does a patient present with Bacterial Vaginosis?

A
  1. Offensive vaginal discharge.

2. No pruritus or pain.

43
Q

How is BV diagnosed?

A

High vaginal swab.

44
Q

How do you treat BV?

A

Metronidazole.

45
Q

What commonly causes Vulvovaginal Candidiasis?

A

Candida albicans.

46
Q

What are the risk factors of Vulvovaginal Candidiasis?

A
  1. Immunosupression (like pregnancy and HIV).
  2. Diabetes.
  3. Antibiotics.
    4, Oestrogen containing oral contraceptives.
47
Q

What are the symptoms of Vulvovaginal Candidiasis?

A
  1. White non-offensive vaginal discharge.
  2. Pruritus.
  3. Pain.
  4. Dyspareunia.
48
Q

How do you investigate Vulvovaginal Candidiasis?

A

High vaginal swabs.

49
Q

How do you treat Vulvovaginal Candidiasis?

A

Oral and/or topical azoles.

Reproduction (9 decks)

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