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Y3 Reproductive > Microbiology and STIs > Flashcards

Microbiology and STIs Flashcards

1
Q

What is the normal vaginal pH?

A

4-4.5 normal vaginal pH

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2
Q

Name the main commensal bacteria of the vagina?

A

Lactobacillus

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3
Q

What products does lactobacillus produce that suppress the growth of other bacteria?

A

Lactic acid +- hydrogen peroxide

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4
Q

What fungi is a commensal in the vagina of some women?

A

Candida

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5
Q

What is the infecting organism in genital thrush?

A

Candida albicans

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6
Q

Elevated levels of what hormone is a risk factor for genital thrush?

A

Estrogen

in pregnancy and contraception

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7
Q

Diabetes is a risk factor for genital thrush. T or F

A

F, poorly controlled diabetes is a risk factor for thrush

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8
Q

How does genital thrush present in a male?

A

Spotty rash balantitis

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9
Q

How does genital thrush present in a female?

A

Intense itch, white discharge

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10
Q

What is the common method of diagnosing genital thrush?

A

Clinical Dx

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11
Q

What are the Mx options for genital thrush?

A

1X PO fluconazole
OR
TOP clotramizole

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12
Q

Bacterial vaginosis is an STI. T or F

A

False

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13
Q

What is the main organism involved in bacterial vaginosis BV?

A

gardnerella vaginalis

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14
Q

Is gardnerella vaginalis aerobic or anaerobic? What is its shape?

A

anaerobic coccobacilli

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15
Q

What is the presentation of bacterial vaginosis?

A

Intense odour ‘fishy’

homogenous discharge

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16
Q

Is the pH raised or lowered in bacterial vaginosis?

A

Raised pH

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17
Q

Name an investigation for bacterial vaginosis?

A

Whiff test - 10% potassium hydroxide increases smell

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18
Q

What is the management of bacterial vaginosis?

A

7day metronidazole

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19
Q

30% of people with bacterial vaginosis have a recurrence. T or F

A

True

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20
Q

In a women with bacterial vaginosis, should you offer treatment to her partner as well?

A

No since not considered an STI

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21
Q

What condition presents with the S+S of a UTI plus lower abdo/ back/ perineal/ penile pain ONLY IN MEN?

A

Acute bacterial prostatitis

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22
Q

What are the main infecting organisms in acute bacterial prostatitis?

A

e.coli
enterococcus
chlamydia
gonococcus

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23
Q

What is the management of acute bacterial prostatitis?

A

28day ciprofloxacin

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24
Q

What is the management of acute bacterial prostatitis in a patient with a high c. diff risk?

A

28day trimethoprim

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25
Q

Which infections are tested for in a standard STI screen?

A

chlamydia, gonorrhea, HIV, syphilis

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26
Q

What is the incubation period of chlamydia?

A

2wk (hence don’t test if UPSI more recent)

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27
Q

What is the incubation period of gonorrhoea?

A

2wk (hence don’t test if UPSI more recent)

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28
Q

What is the incubation period of syphilis?

A

9day - 12wk

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29
Q

What is the incubation period of HIV?

A

4wk (hence don’t test if UPSI more recent)

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30
Q

What is the incubation period of trichomonas?

A

4wk

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31
Q

Partner notification is voluntary. T or F

A

True

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32
Q

What gram stain is chlamydia?

A

Doesn’t have one

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33
Q

Which parts of the body can chlamydia infect?

A

Urethra, rectum, pharynx, eyes

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34
Q

What is the commonest bacterial STI in the UK?

A

Chlamydia

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35
Q

Describe the methods of chlamydia transmission?

A

Oral sex, anal sex, vaginal sex

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36
Q

How does chlamydia present in 70-80% of female patients?

A

Asmptomatic

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37
Q

What % of males with chlamydia have no signs or symptoms?

A

50%

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38
Q

How can chlamydia present in females?

A

Lower abdo pain
Dyspareunia
Mucopurulent discharge
Intermenstrual bleeding

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39
Q

How can chlamydia present in males?

A

Urethral discharge
Dysuria
Urethritis
Epididymo-orchitis

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40
Q

What is the 1st line test for chlamydia?

A

NAAT (nucleic acid amplification test)

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41
Q

Where swabs taken from males and females for chlamydia Ix?

A

M - 1st pass urine sample

F - vulvo-vaginal swab or endocervical

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42
Q

What is the Tx of chlamydia?

A

1wk PO doxycycline

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43
Q

What rheumatological condition is a potential complication of chlamydia?

A

Reiter’s synd - reactive arthritis

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44
Q

If chlamydia is passed from mother to neonate during childbirth, how may this present?

A

Conjunctivitis

Pneumonia

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45
Q

What gynae condition is a complication of chlamydia?

A

PID

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46
Q

Chlamydia trachomatis is an obligate intracellular organism. T or F

A

True

47
Q

Neisseria gonnorrhea is an intracellular organism. T or F

A

True

48
Q

What is the gram stain and shape of n. gonorrhea

A

gram -ve intracellular

49
Q

How does n. gonorrhea appear on gram stain? (shape)

A

2 kidney beans facing each other

50
Q

Which parts of the body can gonococcus infect?

A

urethra, rectum, pharynx, eye, endocervix

51
Q

What gender is gonococcus more common in?

A

males

52
Q

What part of the body does gonorrhoea infect in 3-7% of heterosexual men and 10-30% of MSM and females?

A

pharynx

53
Q

Is gonnorrhea more likely to be asymptomatic in males or females?

A

Females (50%)

54
Q

Is gonorrhoea or chlamydia more likely to be asymptomatic?

A

Gonorrhea

55
Q

How does gonococcus present in males?

A

Dysuria

Purulent urethral discharge

56
Q

How does gonococcus present in females?

A

Discharge
Dysuria
Pelvic pain

57
Q

Proctitis is due to inflammation of the _____.

A

rectum

58
Q

Proctitis is always infectious. T or F

A

False

59
Q

What is the Ix of choice for gonorrhoea?

A

NAAT

60
Q

MSM who present with STI type symptoms should be screened for rectal gonorrhoea, true or false.

A

True

61
Q

What is the 1st line Mx of gonorrhoea?

A

IM ceftriaxone single dose

62
Q

Is a test of cure indicated for chlamydia?

A

No

63
Q

Is a test of cure indicated for gonorrhoea?

A

Yes

64
Q

Where is a swab taken from in females when for gonorrhoea Ix?

A

Endocervix (double check)

65
Q

What is the name of the infecting organism in syphilis?

A

Treponema pallidum

66
Q

What shape and gram stain is the infecting organism syphilis?

A

spirochaete

no gram stain

67
Q

What are the methods of syphilis transmission?

A

Sex
Birth
Blood product

68
Q

How does primary syphilis present?

A

Chancre - painless ulcer at site of contact

Lymphadenopathy

69
Q

Does a chancre heal without Tx?

A

Yes

70
Q

Name the stages of syphilis infection in order?

A

Primary
Secondary
Latent
Late/tertiary

71
Q

How does someone present in the secondary stage of syphilis?

A

snail track mouth ulcers, generalised rash, flu like S+S, patchy alopecia

72
Q

How does someone present in the latent stage of syphilis?

A

Asymptomatic

73
Q

How does someone present in the late or tertiary stage of syphilis?

A

CVD or neuro comp

74
Q

What is the 1st screening test for syphilis?

A

IgM and IgG ELISA

75
Q

If syphilis IgM and IgG are positive, what test should you do next?

A

Serology, VDRL, TPPA

TPPA non-specific

76
Q

What antibody is used to monitor syphilis response to Tx?

A

RPR

77
Q

What is the treatment of syphilis?

A

IJ long acting penicillin

78
Q

What is the commonest viral STI?

A

Genital warts

79
Q

What is the infecting organism in genital warts?

A

HPV (subtypes 6 and 11)

80
Q

What is the incubation period for genital warts?

A

3wk-9mth (but subclinical phase can last years)

81
Q

Where is the most common location of genital warts in the male and female?

A

F - labia

M - glans

82
Q

30% of genital warts clear without Tx. T or F

A

True

83
Q

20% of genital warts persist despite Tx. T or F

A

True

84
Q

What is the 1st line Mx of genital warts?

A

Podophyllotoxin

85
Q

What is the 2nd line Mx of genital warts?

A

Imiquimod aldara

86
Q

What is the 1st line management of genital warts affecting the anus?

A

Imiquimod aldara

87
Q

What is the only method of genital wart treatment safe in pregnancy?

A

Cryotherapy

88
Q

What is the name of he HPV vaccine?

A

Gardasil

89
Q

Who is eligible for the HPV vaccine gardasil?

A

F 11-13yr

MSM <46yr

90
Q

Which type of HSV is most likely in oral and genital presentations?

A

HSV1 oral

HSV2 genital

91
Q

Which type of HSV has a higher recurrence rate and increased viral shedding?

A

HSV2

92
Q

What is the incubation period of HSV?

A

3-6day

93
Q

How long do S+S typically last in a genital herpes outbreak?

A

14-21day

94
Q

‘Where’ is the HSV during asymptomatic periods between outbreaks?

A

Latent in sacral root ganglion

95
Q

What is the method of HSV transmission?

A

Skin: skin

96
Q

Do HSV attacks increase or decrease in intensity with time?

A

Decrease

97
Q

How does the prodromal period of HSV infection present?

A

Fever, myalgia

98
Q

How does genital herpes primary infection present?

A

Painful small vesicles
Dysuria
Vag/urethral discharge
Lymphadenopathy

99
Q

How is genital herpes most commonly diagnosed?

A

Clinical Dx

100
Q

How is genital herpes definitively diagnosed?

A

PCR swab during outbreak

101
Q

What is the management of genital herpes?

A

PO acyclovir

102
Q

What is the management of pain in genital herpes?

A

TOP lidocaine

103
Q

When is prophylaxis indicated in genital herpes?

A

If >6 attacks / year

104
Q

What is phthirus pubis more commonly known as?

A

Pubic lice

105
Q

What is the management of pubic lice?

A

Malathoin lotion

106
Q

What type of organism is trichomonas vaginalis

A

single celled protozoa (parasite)

107
Q

How does trichomonas vaginalis present in males and females?

A

M - urethritis

F - discharge/irritation

108
Q

Trichomonas vaginalis Dx?

A

high vaginal swab microscopy

109
Q

What is the Tx of trichomonas vaginalis?

A

PO metronidazole

110
Q

What organism can cause a non-gonococcal urethritis or be asymptomatic? It is diagnosed by NAAT

A

mycoplasma genitalium

111
Q

What is the name of chlamydia serovars L1-3?

A

LGV lymphogranuloma

112
Q

67% of people with LGV infection also have what other STI?

A

HIV

113
Q

Condyloma acuminatum aka _____

A

Genital warts

114
Q

Koilocytosis indicates the presence of which organism

A

HPV

Y3 Reproductive (28 decks)

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