Non STI and other? Flashcards
Sx of BV?
Painless
malodour less thin grey fishy DC
what causes Bacterial Vaginosis?
Physiology?
excessive PV cleaning + new sex partner
loss of normal bacteria flora; lactobacilli (maintains Acidic pH) replaced with (high anaerobes) Gardnerella vaginalis
Dx of BV?
Criteria?
Amsel criteria
need at least 3 out of 4
what does amsel criteria contain?
pH>4.5
+ve Whiff test with KOH
White/grey DC
Clue cells on histology (gram -ve infiltration of epithelium)
what other criteria can be used when analysing microscopy and why?
Hay ison criteria
depending on level of gardnerella present
Tx for BV?
PO 400mg BD Metronidazole for 7 days
Tx for BV in pregnancy?
Oral/topical metronidazole for 7 days
why is BV bad in pregnancy/general?
Increased risk of Preterm labour, PROM, Miscarriage, High STI risk
What is candida?
genital thrush
causes of candida/genital thrush?
T2DM
Pregnant
recent Abx use
new sex partner
Sx of candida?
Painless, malodourless, cottage cheese DC, LOTS, satellite lesions
Dx of candida?
clinical but do need high vaginal swab of DC
Tx of candida?
stat dose 150mg PO Fluconazole
Tx of candida in pregnancy?
300mg Clotrimazole pessary
Tx for oral thrush?
Fluconazole
What is Pelvic inflammatory disease (PID)?
Ascending STI pelvic infection
(bacteria spread from vagina to rest of upper genital tract - ovaries, uterus, Fallopian tubes)
What is the MC STI causing PID?
CT (or NG, M.G (mycoplasma genitalium))
Sx of PID?
deep dysparaunia, discharge, cervicitis (PC/PMB), chronic pelvic pain, salpingitis + oopheritis (low fertility), vaginitis
Dx of PID?
Triple swab
adnexal motion tenderness on bimanual
TV USS with contrast
HIV serology
bhCG - ectopic rule out
Tx of PID?
100mg BD Doxycycline for 7 days + 1g IM Ceftriaxone + PO 400mg Metronidazole
Complications of PID?
Infertility
High ectopic pregnancy
Fitz Hugh curtis (violin string diaphragmatic - hepatic adhesions) - peripheral abscess
Tx = laparoscopic adhesionolysis
What is Lymphogranuloma venereum (LGV)?
CT induced (L2 Serovar) lymphadenopathy
Sx and Tx of LGV?
Sx = ulcerating papule + proctocolitis + inguinal LNadenopathy
Dx and Tx = same as chlamydia
What is balanitis?
inflammation of the glans penis
what are the 2 causes of balanitis?
Candida - MC
Lichen sclerosis (BXO)
Sx of balanitis caused by candida?
white itchy lesions, gunky white thick discharge
Tx of balanitis caused by candida?
Topical clotrimazole
Sx of balanitis xerotica obliterans?
White plaques +/- tip of urethral meatus +/- phimosis (narrowing of foreskin - can’t be retracted)
Typical Patient with Lichen sclerosis?
age, gender, what is it?
40-60 y/o
M+F
Fibrosis of superficial dermis leading to scar tissue and plaques
Sx of lichen sclerosis?
white shiny plaques
Koebner phenomena (worse with friction)
What is lichen sclerosis called in M and F?
M = Balanitis xerotica obliterans (BXO)
F = Kraurosis vulvae (>menopause)
Dx of lichen sclerosis?
clinical, can do biopsy if uncertain
Tx of lichen sclerosis?
high potency steroid 0.05 clobetasol proprionate
What is pubic lice?
phthirus pubis (crab louse)
Sx of pubic lice?
severe itchy pubic region +/- visible movement
Maculae cerulae (blue small regions of feeding)
Tx of pubic lice?
permethrin topical insecticide
What is a chancroid?
Sx?
painful genital ulceration
discharge
inguinal LNadenopathy
due to Hemophilus Ducreyl (-ve stretobacillus)
Tx of a chancroid?
stat PO azithromycin
