Microbiology Flashcards
what organisms make up the normal vaginal flora
lactobacillus
Strep viridian’s
Group B strep
Candida
why is lactobacillus important for the vaginal flora
produces lactic acid + hydrogen peroxide which suppresses the growth of other bacteria
what are the non-sexually transmitted genital tract infections
candida infection- vaginal thrush
bacterial vaginosis
prostatitis
predisposing factors for candida infection
recent antibiotic therapy
poorly controlled diabetes
High oestrogen levels ( e.g. pregnancy, certain types of contraceptive)
Immunocompromised patients
symptoms of candida infection
intensely itchy white vaginal discharge- cottage cheese discharge
spotty rash
diagnosis of candida infection
clinical diagnosis
High vaginal swab (HVS) for culture
1st line treatment for candida infection
topical clotrimazole 500mg (2-3 times daily)
2nd line treatment for candida infection
oral fluconazole 150mg + topical clotrimazole 500mg
what is the appearance of candida ablicans
yeast structure with budding
symptoms of bacterial vaginosis
thin, watery, fishy smelling discharge
investigation of bacterial vaginosis
clinical diagnosis
Raised vaginal pH (pH >4.5)
HVS
Treatment of bacterial vaginosis
metronidazole 500mg twice daily
classification of prostatitis
- acute
- chronic
- chronic prostatitis/chronic pelvic pain syndrome
symptoms of prostatitis
UTI symptoms- dysuria, increased frequency, nocturia, haematuria
Lower abdominal pain, back pain, penile pain
Tender prostate on examination
what organism causes bacterial prostatitis
E.Coli
if a patient has acute bacterial prostatitis, what else should you test for
STI if <35, gonorrhoea, chlamydia
investigation for acute bacterial prostatitis
Clinical signs
Mid-stream Urine sample (MSSU)
What type of urine sample is used to test for STI
First pass urine
1st line treatment for acute bacterial prostatitis
Ciprofloxacin for 28 days
2nd line treatment for acute bacterial prostatitis
Trimethoprim for 28 days if high C.Diff risk
commonest bacterial STI in the UK
Chlamydia
where can chlamydia affect
urethra, throat, rectum, eyes
how does chlamydia stain with gram stain
NO stain, as there is no peptidoglycan in the cell wall
which serovars of chlamydia cause lymphogranuloma venereum
L1-L3
What is lymphogranuloma venereum
inflammation of the rectum- can mimic crohn’s
rectal pain, discharge + bleeding
treatment of chlamydia
Azithromycin 1g oral
Doxycycline 100mg bd 7 days for complicated case
how is chlamydia diagnosed
NAAT
How does neisseria gonorrhoea appear on gram staining
gram -ve diplococcus- like two kidney beans facing eachother
where does gonorrhoea affect
mucous membranes of urethra, endocervix, rectum + pharynx
male symptoms of gonorrhoea
purulent discharge
dysuria
1st line treatment of gonorrhoea
IM ceftriaxone 500mg
2nd line treatment of gonorrhoea
Cefixime 400mg oral
co-treatment of gonorrhoea + chlamydia
IM ceftriaxone + oral azithromycin
most common viral STI
Genital warts
what causes genital warts
HPV 6 + 11
Which type of HPV causes cancer
HPV 16 + 18
How are genital warts spread
close contact
treatment of genital warts
Cryotherapy
Imiquimod cream
Podophyllotoxin
appearance of genital warts
whiter than the surrounding skin with a rough surface
who gets a HPV vaccine
girls 11-13
men who have sex with men
people with HIV
Vaccinates against 6, 11, 16, 18
what causes genital herpes
HSV 1
HSV 2
Which form of HSV causes recurrent genital herpes
HSV 2
which form of HSV causes cold sores
HSV 1
how are genital herpes spread
genital-genital contact
oropharyngeal-genital contact
presentation of genital herpes
painful multiple small vesicles that are easily deroofed
investigation for genital herpes
swab of deroofed blister for PCR
Treatment for genital herpes
Aciclovir
pain relief
topical lidocaine if very painful
What is trichomonas vaginalis
single celled protozoal parasite
symptoms of trichomonas vaginalis
vaginal discharge
irritation
urethritis in males
Investigation of trichomonas vaginalis
HVS (females)
Mid-stream urine sample (males)
treatment of trichomonas vaginalis
oral metronidazole
treatment for lice
mathalion lotion
