Inflammation of the Female Genital Tract

Question 1

Describe the 2 categories of inflammatory conditions of the female genital tract?

Answer 1

1. Specific - ones are due to infection usually sexually transmitted
2. Non specific - An inflammatory reaction, but negative for a microbiological agent

Question 2

Give examples of sequelae of infections of the female genital tract?

Answer 2

infertility, miscarriages and cancer

Question 3

Which structures are considered to be part of the lower genital tract?

Answer 3

vulva, vagina and cervix

Question 4

What is the term for inflammation of the vulva?

Answer 4

vulvitis

Question 5

What is the term for inflammation of the vagina?

Answer 5

vaginitis

Question 6

What is the term for inflammation of the vulva + vagina?

Answer 6

vulvovaginitis

Question 7

What is the term for inflammation of the cervix?

Answer 7

cervicitis

Question 8

What is the term for inflammation of the endometrium?

Answer 8

endometritis

Question 9

What is the term for the inflammation of the fallopian tubes?

Answer 9

salpingitis

Question 10

What is the term for the inflammation of the ovaries?

Answer 10

oophritis

Question 11

What is the term for the inflammation of the fallopian tubes + ovaries?

Answer 11

salpingoophritis

Question 12

List common infections of the female genital tract?

Answer 12

1. viruses - Herpes simplex, Human papilloma virus (HPV).
2. bacteria - Gonorrhoea, chancroid, granuloma inguinale, lymphogranuloma venereum, gardnerella vaginalis
3. syphilis
4. Mycoplasmal infection
5. Chlamydial infection
6. Trichomoniasis (protozoa)
7. Candidiasis

Question 13

Name the microbial infections that are confined to the lower genital tract?

Answer 13

1. Herpes simplex
2. Chanchroid
3. Lymphogranuloma venereum,
4. Granuloma inguinale
5. Candidiasis
6. Trichomonas vaginalis
7. Gardnerella vaginalis

Question 14

Describe the epidemiology of candidiasis?

Answer 14

Common infection in women

- 10% of women thought to be carriers

Question 15

In which physiological conditions is candidiasis considered to be enhanced?

Answer 15

1. diabetics
2. oral contraception use
3. pregnancy

Question 16

What is the clinical presentation of candidiasis?

Answer 16

1. Causes leukorrhoea - white discharge
2. pruritus - itching
3. Lesions can be small to large white patches

Question 17

How can candida organisms be visualized?

Answer 17

1. wet mounts - a sample of vaginal discharge is observed by wet mount microscopy by placing the specimen on a glass slide and mixing with salt solution
2. cervical pap smears

Question 18

What is Trichomoniasis?

Answer 18

infection caused by Trichomonas vaginalis

- a large flagellated ovoid protozoan

Question 19

What is the clinical presentation of Trichomoniasis?

Answer 19

1. a purulent vaginal discharge and discomfort with pruritus

2. Vaginal or cervical mucosa is inflamed with a red appearance termed strawberry cervix

Question 20

Organisms of Trichomoniasis can be visualised by?

Answer 20

wet mounts or cervical Pap smears

Question 21

What is Gardnerella vaginitis?

Answer 21

infection caused by G. vaginalis

- gram negative coccobacillus

Question 22

What is the clinical presentation of Gardnerella vaginitis?

Answer 22

Presents as thin milky discharge with a fish like smell

Question 23

Gardnerella vaginitis is associated with?

Answer 23

shift in vaginal flora

- Replacement of normal lactobacilli by G. vaginalis

Question 24

What do cervical smears + wet mounts of Gardnerella vaginitis show?

Answer 24

clue cells = coccobacilli adhere to squamous cells completely covering them

Question 25

What is the clinical term for infections involving upper + lower genital tract?

Answer 25

pelvic inflammatory disease (PID)

Question 26

Common causative pathogens of PID include?

Answer 26

gonococci, chlamydia and enteric bacteria | - Gonococci is the common cause of PID

Question 27

Name situations in which PID can arise?

Answer 27

1. as a complication of miscarriage or abnormal deliveries | 2. sexually transmitted

Question 28

What is the clinical presentation of PID?

Answer 28

1. Pelvic pain 2. Adnexual tenderness on bimanual palpation 3. Cervical excitation tenderness 4. Fever 5. Vaginal discharge 6. Septic shock - Severe cases

Question 29

Describe the course of infection for Gonoccocal PID?

Answer 29

- Begins in Bartholin gland and other vestibular glands , or periurethral glands - Cervix involvement is common but asymptomatic - Organisms then spread upward through mucosal surface to involve tubes and tubo- ovarian regions - For obscure reasons, the endometrium is usually spared

Question 30

What is the clinical presentation of Gonoccocal PID?

Answer 30

an acute suppurative inflammation with abscess formation in severe cases - Acute suppurative salpingitis - salpingo-oophritis - Tubo-ovarian abscesses can form - Tubes can from a pyosalpinx

Question 31

Non Gonoccocal bacterial PID results as a complication of?

Answer 31

1. Induced miscarriage 2. Dilatation and curettage 3. Complicated deliveries 4. Surgical procedures on the female genital tract

Question 32

Organisms that cause non gonoccocal bacterial PID include?

Answer 32

1. Streptococci 2. staphylococcus 3. coliform bacteria 4. Clostridium perfringes

Question 33

How does non gonoccocal bacterial PID spread?

Answer 33

lymphatics + veins

Question 34

What are the complications of PID?

Answer 34

1. Peritonitis 2. Intestinal adhesions between bowel and pelvic organs 3. Bacteremia which can produce endocarditis, meningitis 4. Infertility with blockage of fallopian tubes