Infections of the lower genital tract Flashcards
4 main types of diseases in women parts?
Infections, pregnancy complications, tumors and hormonally induced problems.
Top three organisms causing STDs?
Chlamydia, gonorrhea, and syphilis
4 pathogens causing ULCERATIVE STIs?
Granuloma inguinala, chancroid, chlamydia, treponema pallidum
In order of frequency, what 3 areas does HSV infect most commonly on the female parts?
Cervix, vagina, and vulva
HSV1 and HSV2 typically infect where, but what is the caveat?
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.
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.
Discharge with pus, pelvic pain, and painful urination.
What does the histo look like with HSV infection? 3 things.
Infected cells are multi-nucleated, you see the virus in the cell, and ground glass appearance.
What gender and race did the book talk about being more commonly infected with HSV2?
Women
Non Hispanic blacks
What 3 systemic symptoms so patients present with when they have HSV infection?
Fever, tired and tender inguinal LN
Explain the 3 step evolution of the formation of an HSV ulcer?
Red papule, vesicle, and then painful ulcer.
Explain the two types of phases of the HSV infection?
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.
What is the most dangerous consequences of HSV infection and why?
Mom transmitting it to baby when it is active and primary infection.
What are the two most common molluscum contagiosum infections?
MCV 1 most prevalent and 2 is most commonly sexually transmitted.
MCV infections are most common in what age group of patients?
2-12
What 3 areas of the body are most commonly affected by MCV infections?
Trunks, legs, and arms
MCV infections n adults typically have what type of transmission and affect what 4 areas of the body?
Sexually
Genitals, butt, lower ab, and inner thighs.
Diagnosis of MCV is based on the characteristic clinical appearance of what?
Pearly, dome shaped papule with a dimpled center.
Explain what is going on with yeast in a women’s parts and the dynamic there and the specific yeast the book talks about?
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.
What 4 scenarios can throw off the vaginal microbial ecosystem and lead to symptomatic fungal infections?
Diabetes, antibiotics, pregnancy and conditions compromising neutrophil or th17 T cell function.
5 symptoms of a women with a fungal infection like candidiasis?
Itch, red, swelling, pain, and disrachrge
What is discharge characteristic of candidiasis?
Curd like or cottage cheese like
How do we make the diagnosis of candidiasis infection?
Find the pseudohyphae on wet KOH or Pap smear
What does the discharge look like for trichomonas vaginalis? Also, what is characteristic of the cervix when you look at it via colposcopy?
Yellow and frothy
Strawberry cervix they call it because of the mucosa is fiery red.
Gardnerella vaginalis is the main cause of what and how is the vaginal discharge characteristically described?
Bacterial vaginitis.
Green-gray, fishy smelling discharge
What are the 5 main pathogens to remember for Lower genital infections?
HSV, MCV, Candida, Trichomonas, and Garnerella
3 pathogens found in the normal Microflora of female genital tract?
Candida (yeast), garnerella (bacteria), and lactobacilli
Where is chancroid most commonly seen and what is the most common cause of in these areas of the world? 2 places.
Most common cause of genital ulcers in Africa and Southeast Asia
How do we characterize lymphogranuloma venereum and what causes it?
Chronic ulcerative disease
Caused by a genital infection with L seotypes of chlamydia trachomatis
How do we characterize granuloma inguinale and what pathogen causes it?
Sexually transmitted chronic inflammatory disease caused by klebsiella granulomatis
Where did he say granuloma is uncommon and where is it endemic?
Uncommon in US and Western Europe
Endemic in developing countries
2 clinical characteristic of granuloma inguinale?
Extensive scarring and elephantiasis of the external genitalia
What two stains are used to diagnose granuloma and what will we see?
Giemsa stained or silver stained Encapsulated coccobacilli (Donovan bodies) in macrophages
