Non-STIs Flashcards
What is the cause of candidiasis?
what are the associated risk factors?
- candida proliferation occurs when vaginal pH is more alkaline
- immunocompromised
- pregnancy
- sexually active
- Diabetes mellitus
- broad spectrum antibiotics
how common is it?
- very common, experienced by 90% of women at some point
- 2nd most common type of vaginal infection
what kind of history might they give?
- pruritus vulvae
- soreness/ itch
- superficial dyspareunia
- change in discharge (cottage cheese, non-offensive)
- dysuria
what investigation would you do? and what is the management?
- HVS for microscopy and culture
- 500mg single dose co-trimazole vaginal pessary
- topical 10% cotrimazole (canisten)
- fluconazole 150mg PO (if not pregnant)
- 85% are cured with this
what happens to vaginal flora in BV?
- excessive anaerobic bacteria
- decreased number of lactobacilli
- increase in gardnerella vaginalis
- pH becomes more alkaline
what are the risk factors for BV?
- smoking
- multiple sexual partners
- low SES
- pregnancy (15% prevalence in antenatal clinics)
what kind of signs and symptoms are there in BV?
- can be asymptomatic
- non purulent, homogenous discharge
- grey malodorous discharge
- fishy odour exacerbated during menstruation/ intercourse
what investigations should be done, what criteria should be fulfilled?
- HVS for microscopy and culture
Amsel criteria (3 of 4):
- thick grey/white discharge with offensive odour adhering to vaginal wall
- litmus pH (>4.5)
- fish amine test positive
- microscopy >20% clue cells (vaginal epithelia cells) reduced lactobacilli
how should it be managed?
- treatment unnecessary unless symptomatic/ pregnant/ undergoing gynae procedure
- oral metronidazole or topical clindamycin
what are the complications of BV?
- can cause PROM/ pre-term labour/ chorioamnionitis
- increased transmission of HIV
what are the infective causes of itching?
the non infective causes?
- candidiasis
- trichomoniasis
- scabies
- pthirus pubis (crabs)
- irritant vulvitis/ balanitis
- lichen planus/ simplex/ sclerosis
what are the treatments for lichen simplex?
symptoms and treatment of lichen planus?
- plaques, with lichenification: emollients and moisturisers, mild steroids
- itchy papular eruption, found on flexor surfaces and genitalia, treat with emollients and steroids
what is the signs and symptoms of lichen sclerosis?
treatment?
chronic inflammatory condition, causes narrowing of labia in women and glans in men
- causes pale atrophic skin with loss of architecture and erosions
- treatment is topical steroids and skin moisturisers
what is the main risk factor for candida balanitis?
how does it present?
- diabetes
- presentation: sore inflamed glans, no retractable foreskin, discharge, dysuria. obstruction of meatus
what is retires syndrome?
what do the lesions in circinate balanitis look like?
- conjunctivitis
- urethritis
- arthritis
- indistinguishable from psoriasis
