Infections of the lower genital tract

Question 1

4 main types of diseases in women parts?

Answer 1

Infections, pregnancy complications, tumors and hormonally induced problems.

Question 2

Top three organisms causing STDs?

Answer 2

Chlamydia, gonorrhea, and syphilis

Question 3

4 pathogens causing ULCERATIVE STIs?

Answer 3

Granuloma inguinala, chancroid, chlamydia, treponema pallidum

Question 4

In order of frequency, what 3 areas does HSV infect most commonly on the female parts?

Answer 4

Cervix, vagina, and vulva

Question 5

HSV1 and HSV2 typically infect where, but what is the caveat?

Answer 5

1 is usually in the mouth and 2 is more seen in genital and skin, but depending on sexual practices, both can be found in either place.

Question 6

Lesions of HSV infection are clearly visible on the vulva, but what if the infection is in the vagina or cervix, what does the patient present with? 3 things.

Answer 6

Discharge with pus, pelvic pain, and painful urination.

Question 7

What does the histo look like with HSV infection? 3 things.

Answer 7

Infected cells are multi-nucleated, you see the virus in the cell, and ground glass appearance.

Question 8

What gender and race did the book talk about being more commonly infected with HSV2?

Answer 8

Women

Non Hispanic blacks

Question 9

What 3 systemic symptoms so patients present with when they have HSV infection?

Answer 9

Fever, tired and tender inguinal LN

Question 10

Explain the 3 step evolution of the formation of an HSV ulcer?

Answer 10

Red papule, vesicle, and then painful ulcer.

Question 11

Explain the two types of phases of the HSV infection?

Answer 11

There is an active phase and a latent phase. The pathogen just hangs out in the nervous system and can cause reactivation of the virus and lesions all over again. Basically any decrease in immune function, stress, injury can trigger it.

Question 12

What is the most dangerous consequences of HSV infection and why?

Answer 12

Mom transmitting it to baby when it is active and primary infection.

Question 13

What are the two most common molluscum contagiosum infections?

Answer 13

MCV 1 most prevalent and 2 is most commonly sexually transmitted.

Question 14

MCV infections are most common in what age group of patients?

Answer 14

2-12

Question 15

What 3 areas of the body are most commonly affected by MCV infections?

Answer 15

Trunks, legs, and arms

Question 16

MCV infections n adults typically have what type of transmission and affect what 4 areas of the body?

Answer 16

Sexually

Genitals, butt, lower ab, and inner thighs.

Question 17

Diagnosis of MCV is based on the characteristic clinical appearance of what?

Answer 17

Pearly, dome shaped papule with a dimpled center.

Question 18

Explain what is going on with yeast in a women’s parts and the dynamic there and the specific yeast the book talks about?

Answer 18

Yeast are part of many women’s normal vaginal flora, so basically having symptomatic infection of candida means there is a disturbance in the patients vaginal microbial ecosystem.

Question 19

What 4 scenarios can throw off the vaginal microbial ecosystem and lead to symptomatic fungal infections?

Answer 19

Diabetes, antibiotics, pregnancy and conditions compromising neutrophil or th17 T cell function.

Question 20

5 symptoms of a women with a fungal infection like candidiasis?

Answer 20

Itch, red, swelling, pain, and disrachrge

Question 21

What is discharge characteristic of candidiasis?

Answer 21

Curd like or cottage cheese like

Question 22

How do we make the diagnosis of candidiasis infection?

Answer 22

Find the pseudohyphae on wet KOH or Pap smear

Question 23

What does the discharge look like for trichomonas vaginalis? Also, what is characteristic of the cervix when you look at it via colposcopy?

Answer 23

Yellow and frothy

Strawberry cervix they call it because of the mucosa is fiery red.

Question 24

Gardnerella vaginalis is the main cause of what and how is the vaginal discharge characteristically described?

Answer 24

Bacterial vaginitis.

Green-gray, fishy smelling discharge

Question 25

What are the 5 main pathogens to remember for Lower genital infections?

Answer 25

HSV, MCV, Candida, Trichomonas, and Garnerella

Question 26

3 pathogens found in the normal Microflora of female genital tract?

Answer 26

Candida (yeast), garnerella (bacteria), and lactobacilli

Question 27

Where is chancroid most commonly seen and what is the most common cause of in these areas of the world? 2 places.

Answer 27

Most common cause of genital ulcers in Africa and Southeast Asia

Question 28

How do we characterize lymphogranuloma venereum and what causes it?

Answer 28

Chronic ulcerative disease

Caused by a genital infection with L seotypes of chlamydia trachomatis

Question 29

How do we characterize granuloma inguinale and what pathogen causes it?

Answer 29

Sexually transmitted chronic inflammatory disease caused by klebsiella granulomatis

Question 30

Where did he say granuloma is uncommon and where is it endemic?

Answer 30

Uncommon in US and Western Europe

Endemic in developing countries

Question 31

2 clinical characteristic of granuloma inguinale?

Answer 31

Extensive scarring and elephantiasis of the external genitalia

Question 32

What two stains are used to diagnose granuloma and what will we see?

Answer 32

Giemsa stained or silver stained
Encapsulated coccobacilli (Donovan bodies) in macrophages