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Obs and Gynae > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is bacterial vaginosis?

A

altered vaginal flora - pH becomes alkaline

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2
Q

Why does the vaginal pH change in bacterial vaginosis?

A

normal vaginal flora (lactobacillus - produces lactic acid) replaced with Gardnerella vaginalis and other anaerobic bacteria

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3
Q

How does bacterial vaginosis present?

A

fishy discharge

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4
Q

What can bacteria vaginosis increase the risk of?

A

preterm labour
intra amniotic infection in preg
susceptibility to HIV
2nd trimester miscarriage

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5
Q

How is bacterial vaginosis diagnosed?

A

mixed with 10% potassium hydroxide on a slide - whiff of ammonia
wet mount microscopy - clue cells (epithelial cells coated with coccobacilli)

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6
Q

What is the treatment of bacterial vaginosis?

A

metronidazole 7 days

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7
Q

What causes thrush?

A

candida albicans

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8
Q

What are risk factors for developing thrush?

A

pregnancy
diabetes
immunodeficiency
antibiotics

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9
Q

How does thrush present?

A

red, fissured, sore vulva and vaina
cottage cheese discharge
itch

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10
Q

How is thrush diagnosed?

A

clinical diagnosis

HVS, microscopy and culture

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11
Q

How is thrush treated?

A

topical - clotrimazole

oral - fluconazole

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12
Q

What is the most common bacterial STI in the UK?

A

chlamydia

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13
Q

what causes chlamydia?

A

Chlamydia trachomatis

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14
Q

Where does chlamydia infect?

A 
urethra
rectum 
throat
eyes 
endocervix
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15
Q

Why does chlamydia stain with gram?

A

no peptidoglycan in cell wall

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16
Q

What are the 3 serological groupings of chlamydia?

A

A-C: trachoma (eye) - not an STI
D-K: genital infections
L1-L3: lymphogranuloma venereum (rectal pain, discharge, bleeding, MSM)

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17
Q

What is the presentation of chlamydia in females?

A

usually asymptomatic
mucopurulent cervicitis
lower abdo pain
postcoital/intermenstrual bleeding, dyspareunia

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18
Q

What is the presentation of chlamydia in males?

A 
asymptomatic 
dysuria 
urethritis 
proctitis (LGV)
urethral discharge
19
Q

What are the complication of chlamydia infection?

A 
reactive arthritis 
PID 
tubal damage 
chronic pelvic pain 
transmission to neonate - pneumonia, conjunctivitis 
Fitz-Hugh-Curtis syndrome
20
Q

How is chlamydia diagnosed?

A

males: first void urine sample (add rectal swab if receptive anal sex)
females: HVS

for NAATs/ PCR

21
Q

What is the treatment of chlamydia?

A

aczithromycin - 1g oral dose (uncomplicated)

22
Q

What causes gonorrhoea?

A

Neisseria gonorrhoea

gram negative diplococcus

23
Q

Where can gonorrhoea infect?

A 
urethra
rectum 
eyes
throat
endocervix
24
Q

How does gonorrhoea present?

A

males: urethral discharge, dysuria, ?asymptomatic, rectal and pharyngeal symptoms
females: asymptomatic, dysuria, pelvic pain, altered vaginal discharge

25
Q

How is gonorrhoea diagnosed?

A

same as chlamydia

men: first void urine sample + rectal swab/pharyngeal swab
women: HVS

NAAT/PCR

26
Q

How is gonorrhoea treated?

A

IM ceftriaxone

oral azithromycin

27
Q

What organism causes syphilis?

A

Treponema pallidum

spirochaete

28
Q

Does Treponema pallidum stain with gram?

A

no

29
Q

What is the primary stage of syphilis?

A

chancre (painless ulcer, heals without treatment)

30
Q

What is the secondary stage of syphilis?

A

flu like symptoms
generalised rash
snail track mouth ulcers

31
Q

What is the latent stage of syphilis?

A

early latent stage: no symptoms

late latent stage: near and cardiac complications

32
Q

What is the treatment of syphilis?

A

penicillin benzathine

33
Q

How is syphilis diagnosed?

A

PCR and serological tests

dark ground microscopy

34
Q

What is trochomonas vaginalis?

A

single celled protozoal parasite

sexually transmitted

35
Q

How does trichomonas vaginalis present?

A

thin, bubbly, fish smelling discharge

36
Q

How is trichomonas vaginalis diagnosed?

A

HVS for microscopy

37
Q

How is trichomonas vaginalis treated?

A

oral metronidazole

38
Q

How are pubic lice treated?

A

malathion lotion

39
Q

What type of herpes simplex is sexually transmitted?

A 
type 2 
(type 1 - coldsores)
40
Q

How does herpes simplex present?

A

very painful blisters
dysuria
discharge

41
Q

How is HSV diagnosed?

A

swab of deroofed blister for PCR

42
Q

How is HSV treated?

A 
analgesia 
acyclovir (shortens symptoms and infectivity)
43
Q

What are the high risk HPVs?

A

16 and 18 (CIN)

Obs and Gynae (27 decks)

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