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Infection > Lecture 7.1: Infections of the Genital Tract > Flashcards

Lecture 7.1: Infections of the Genital Tract Flashcards

1
Q

Where are microorganisms commonly found in the male genitals?

A

Microorganisms commonly found at foreskin at the hood of the penis

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2
Q

Why is the female genitourinary tract so susceptible to infections?

A
  • Many openings in one place (3)
  • Short urinary tract (4 times shorter than males)
  • No particular cleansing mechanisms
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3
Q

What does Venereal mean?

A

Relating to sexual desire or sexual intercourse

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4
Q

Infections of the Reproductive Tract​: Non-Venereal

A
  • Bacterial Vaginosis
  • TSS
  • Bartholin Gland Infections
  • Vulvo-Vaginal Candidiasis (Thrush)
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5
Q

Infections of the Reproductive Tract​: Venereal Types

A
  • Bacterial
  • Viral
  • Parasitic
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6
Q

Infections of the Reproductive Tract​: Venereal [Bacterial]

A
  • Syphills
  • Gonorrhoea
  • Chlamydia
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7
Q

Infections of the Reproductive Tract​: Venereal [Viral]

A
  • HPV
  • HIV
  • Herpes
  • Hep B
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8
Q

Infections of the Reproductive Tract​: Venereal [Parasitic]

A
  • Trichomoniasis
  • Public Lice
  • Scabies
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9
Q

What are some Vaginal Defences​? (7)

A
  • High oestrogen states cause proliferation of vaginal epithelium​
  • Increased glycogen encourages Lactobacilli to produce lactic acid.
  • Normal vaginal pH 3.8-4.5
  • Epithelial mucosal barrier​
  • Produces hydrogen peroxide ​
  • Produces bacteriocins ​
  • Normal vaginal discharge: Contains IgA and IgG, mucins
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10
Q

Risk Factors for Dysbiosis: Individual (6)

A
  • Genetic
  • Sexual Practices
  • Diet
  • Smoking
  • Hygiene
  • Race
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11
Q

Risk Factors for Dysbiosis: Relational (4)

A
  • Sexual Network
  • Social Network
  • Housing Arrangement
  • Behavioural Norms (polygamy…etc)
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12
Q

Risk Factors for Dysbiosis: Community (4)

A
  • Built Environment
  • Poverty
  • Food Alert
  • Stress
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13
Q

Risk Factors for Dysbiosis: Societal (3)

A
  • Racism
  • Politics
  • Segregation
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14
Q

What is Bacterial Vaginosis?

A
  • Vaginal inflammation caused by dysbiosis
  • Most common cause is Gardnerella vaginalis
  • Most prevalent cause of vaginal discharge or malodor
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15
Q

Bacterial Vaginosis: Signs and Symptoms (3)

A
  • Fishy smell​
  • Thin grey/white discharge​
  • 50% asymptomatic
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16
Q

Bacterial Vaginosis: Investigation (4)

A
  • History of new vaginal products​
  • Test the pH of the discharge​
  • Whiff test (add KOH to sample)​
  • High vaginal swab: Clue cells
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17
Q

Bacterial Vaginosis: Treatment and Management (4)

A
  • Stop using products on vagina​
  • Oral metronidazole ​
  • Intravaginal metronidazole gel​
  • STI screen – higher risk
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18
Q

What is Vulvo-Vaginal Candidiasis (Thrush)?

A
  • A symptomatic inflammation of the vagina and/or vulva
  • Caused by a superficial fungal infection, usually with Candida albicans
  • Candida is opportunistic and competes with lactobacilli within the vagina
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19
Q

Vulvo-Vaginal Candidiasis (Thrush): Signs and Symptoms (5)

A
  • Vulval/vaginal itching​
  • Vaginal soreness​
  • White ‘cheese-like’ discharge​
  • Dysuria​
  • Superficial dyspareunia
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20
Q

Vulvo-Vaginal Candidiasis (Thrush): Investigations (2)

A
  • Diagnosis by examination​

* Swabs done to EXCLUDE alternate diagnosis

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21
Q

Vulvo-Vaginal Candidiasis (Thrush): Treatment and Management (5)

A
  • Avoid irritants on the vagina ​
  • Loose fitting undergarments ​
  • Topical antifungals: Clotrimazole Cream​
  • Oral Fluconazole ​
  • Control underlying conditions? T2DM
22
Q

What are Bartholin’s Glands?

A
  • The Bartholin’s glands are a pair of pea-sized glands

* Located at entrance of the vagina at 5 o’clock and 7 o’clock

23
Q

Abscess of Bartholin’s Glands

A

They are usually unilateral, tense, and nonpainful

24
Q

Abscess of Bartholin’s Glands: Signs and Symptoms (4)

A
  • Erythema
  • Acute Tenderness
  • Oedema
  • Occassionally cellulitis of the surrounding subcutaneous tissue
25
Q

Abscess of Bartholin’s Glands: Treatment (4)

A
  • Classical surgical treatment – Marsipulisation​
  • Cut and drain abscess​
  • Stitch skin edges to form ‘kangaroo pouch’​
  • Allows for drainage
26
Q

The Five P’s​ of Diagnosing STIs

A

1) Partners​
2) Practices​
3) Prevention of Pregnancy​
4) Protection from STDs​
5) Past history of STDs

27
Q

What is Chlamydia? How does it cause Infection? (5)

A
  • Chlamydia trachomatis
  • Gram-negative bacterium​
  • Can only replicate WITHIN a host cell
  • No cell wall, just two cell membranes​
  • Enters by breaks in mucous membranes​
  • 2 forms in its life cycle:​ Elementary body (EB) & Reticulate body (RB)
28
Q

Chlamydia in Women: Signs and Symptoms (7)

A
  • Purulent vaginal or cervical discharge​
  • Post-coital bleeding​
  • Intermenstrual bleeding​
  • Deep dyspareunia​
  • Dysuria ​
  • Pelvic pain and tenderness​
  • Cervical motion tenderness
29
Q

Chlamydia in Women: Investigations (4)

A
  • Speculum – hypertrophic cervix ​
  • Endocervical swab​
  • First catch urine sample ​
  • Self-taken vulvo-vaginal swab
30
Q

Why is Chlamydia so hard to diagnose?

A
  • 70% Asymptomatic in Women
  • 50% Asymptomatic in Men
31
Q

Chlamydia in Men: Signs and Symptoms (5)

A
  • Mucopurulent urethral discharge​
  • Urethritis​
  • Dysuria ​
  • Epididymo-orchitis ​
  • Reactive arthritis
32
Q

Chlamydia in Men: Investigations (2)

A
  • First catch urine sample ​
  • Urethral swab
33
Q

What is a Nucleic Acid Amplification Test (NAAT)?

A

A nucleic acid test is a technique used to detect a particular nucleic acid sequence and thus usually to detect and identify a particular species or subspecies of organism

34
Q

Chlamydia: Treatment and Management (6)

A
  • 7 days of oral doxycycline BD
  • Or a single dose of azithromycin)
  • Avoid intercourse and oral sex until treatment completed ​
  • Treat patient AND partner(s)​
  • Reinforce healthcare education ​
  • Offer repeat testing 3-6 months after treatment
35
Q

Complications of Chlamydia (7)

A
  • Lymphogranuloma Venereum ​
  • Conjunctivitis
  • Reactive Arthritis
  • Pelvic Inflammatory Disease
  • Infertility
  • Peri-Hepatitis (Fitz-Hugh-Curtis Syndrome)​
  • Vertical Transmission in Pregnancy (Blindness, Pneumonia, Low Birth Weight)
36
Q

What is Gonorrhoea?

A
  • Gram- Negative Organism
  • Neisseria Gonorrhoea
37
Q

Gonorrhoea in Women: Signs and Symptoms (7)

A
  • Asymptomatic in 50%​
  • Vaginal discharge ​
  • Rarely dysuria​
  • Dyspareunia​
  • Rarely intermenstrual bleeding​
  • Bartolin gland infection​
  • PID – pain, infertility
38
Q

Gonorrhoea in Men: Signs and Symptoms (3)

A
  • Symptoms appear 2-5 days post-exposure​
  • Muco-purulent urethral discharge​
  • Dysuria
39
Q

Gonorrhoea: Investigations

A
  • Endocervical swab (women)​
  • First catch urine (men)
40
Q

Gonorrhoea: Treatment and Management (6)

A
  • Await cultures and sensitivities before prescribing​
  • Single dose Ciprofloxacin oral or IM Ceftriaxone​
  • Abstain till 7 days post-treatment​
  • Treat patient AND partner(s)​
  • Reinforce healthcare education ​
  • Offer follow-up 7 days post treatment
41
Q

Complications of Gonorrhoea: Disseminated ​Gonococcal Infection (6)

A
  • Bacteria multiply in neutrophils ​
  • Travel via blood stream ​
  • Endocarditis​
  • Meningitis​
  • Septic arthritis​
  • Pustular/Petechial lesions
42
Q

Complications of Gonorrhoea: During Pregnancy (6)

A
  • 30% transmission rate​
  • Conjunctivitis​
  • Disseminated gonococcal infection ​
  • Scalp abscess ​
  • Vaginal and rectal infections​
  • Pharyngeal infections
43
Q

What is Syphilis?

A
  • Caused by Treponema pallidum​ bacterium
  • Helical cell spirochete​
  • Too small for gram-staining​
  • Spread through contact with lesions​
  • Mother-to-baby transmission
44
Q

Stages of Syphilis: First Few Years (1)

A

• No signs and symptoms

45
Q

Stages of Syphilis: Primary Stage (2)

A
  • Sore/chancre found in genital area
  • Chancres do not result in pain and disappear without treatment
46
Q

Stages of Syphilis: Secondary Stage (9)

A
  • Skin Rash (reddish brown spots on back, palms and soles of feet)
  • Mucous membrane lesions throughout body but no itchiness
  • Fever
  • Sore Throat
  • Headache
  • Swollen Glands
  • Weight Loss
  • Myalgia
  • Fatigue
47
Q

Stages of Syphilis: Tertiary Stage

A
  • Blood Vessel Problems
  • Cardiac Problems
  • Nervous System Problems
  • Damaged Organs
  • Gummatous syphilis
  • Death
48
Q

Stages of Syphilis: Latent Stage (2)

A
  • Symptoms disappear for 1-20 years
  • Relapse Symptoms
49
Q

Syphilis: Investigations (3)

A
  • Lesion Swabs
  • Treponemal Enzyme Immunoassay (EIA)
  • Blood Test
50
Q

Syphilis: Treatment and Management (3)

A
  • Penicillin ​
  • Contact tracing​
  • Follow-up over 2 years

Infection (21 decks)

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