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Sem 4 > Repro 6: Infections Of The Genital Tract > Flashcards

Repro 6: Infections Of The Genital Tract Flashcards

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1
Q

What organism is chlamydia caused by?

A

Chlamydia trachomatis, an obligate intracellular bacterium

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2
Q

Can chlamydia be detected with gram staining?

A

No

Instead use antigen detection/ enzyme immunoassays/ PCR

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3
Q

What can be the affects of a chlamydial infection in men and women and neonates?

A

Women: asymptomatic, urethritis, cervicitis, and if it ascends: salpingitis, PID, perihepatitis

Men: urethritis, epidymitis, prostatitis, proctitis

  • can cause conjunctivitis in eyes
  • neonates: can cause conjunctivitis and pneumonia if untreated
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4
Q

How can chlamydia be diagnosed?

A

Urethral or endocervical swab (or swab conjunctiva in neonates)
Can do 1st catch urine which is less sensitive but more efficient as patient can do themselves

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5
Q

How can chlamydia be treated?

A
  • macrolides eg erythromycin, clarithromycin, azithromycin
  • tetracyclines eg doxycycline

dont use beta lactams as chlamydia trachomatis contains little peptidoglucan in its cell wall

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6
Q

What is gonorrhoea caused by?

A

Neisseria gonorrhoeae

A gram negative intracellular diplococcus

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7
Q

What can the affects of a gonorrhoea infection be in men and women?

A

Men: urethritis, epidymitis, prostatitis, proctitis, pharyngitis

Women: asymptomatic, urethritis, endocervicitis, PID

Disseminated gonorrhoea infections cause cause bacteriaemia, skin rash, joint lesions

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8
Q

How can gonorrhoea be diagnosed?

A

Swab from urethra/rectum/endocervix/pharynx or urine

Then gram stain, or culture (more sensitive)

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9
Q

How can gonorrhoea be treated?

A

IM ceftriaxone (due to increasing penicillin resistance)

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10
Q

What is HPV?

A

Human papilloma virus
>100 types
Some can cause genital warts, main concern is association of some types with cervical and anogenital carcinoma

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11
Q

Which types of HPV are vaccinated against?

A

6 & 11 (known to cause genital warts)

16 & 18 (known to be oncogenic)

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12
Q

How can HPV infection be diagnosed?

A

Biopsy at cervical smears or cervical swab

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13
Q

How is HPV treated and prevented?

A

Tx is often spontaneous resolution, or can give topical podophyllin or cryotherapy (freeze the wart)

Prevent via HPV vaccine, 2 doses offered to girls aged 12-13

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14
Q

What are some causes of genital ulcers?

A

HSV (herpes simplex virus)
Syphilis
Chanchroid

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15
Q

What is bacterial vaginosis?

A

Disturbance of normal vaginal flora, usually due to change in pH
Usually overgrowth of Gardnerella vaginalis or anaerobes

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16
Q

How does bacterial vaginosis commonly present?

A

Fishy odour, discharge and irritation

17
Q

How can bacterial vaginosis be diagnosed?

A

Vaginal pH >4.5
KOH whiff test
Gram stained HSV

18
Q

How can bacterial vaginosis be treated?

A

Metronidazole

19
Q

What is vulvovaginal candidiasis?

A

Aka yeast infection/ thrush

Due to excessive growth of Candida albicans and other candida species

Not classed as an STI as the agent is typically part of the normal vaginal flora

20
Q

What are some risk factors for vulvovaginal candidiasis?p

A

Antibiotics (kills off the healthy vaginal bacterial eg lactobacillus)
Oral contraceptives
Pregnancy (increase in oestrogen favours yeast overgrowth)
Diabetes (high glucose favours bacteria environment)
Obesity
Steroids

21
Q

What are symptoms of vulvovaginal candidiasis?

A

Profuse, white, itchy, curd-like discharge

22
Q

How can vulvovaginal candidiasis be treated?

A

Antifungals, topical azoles or nystatin or oral fluconazole

23
Q

What is trachomonas vaginalis?

A

Flagellated Protozoa

Can be asymptomatic or cause thin, frothy, offensive discharge

24
Q

How can a trachomonas vaginalis infection be treated?

A

Metronidazole

25
Q

What is the difference between endometriosis and endmetrisis?

A

Endometrisis is infection and inflammation of the endometrium lining of the uterus

Endometriosis is a chronic condition where endometrial tissue grows outside of the uterine cavity, mostly on peritoneal cavity or within ovaries

26
Q

What is salpingitis and what is it commonly caused by?

A

Infection and inflammation of the Fallopian tube/s
Commonly caused by chlamydial trachomatis and Neisseria gonorrhoea
Often leads to infertility as ovum can’t pass through tube

27
Q

What is PID?

A

Pelvic inflammatory disease
When infections ascends up from the endocervix, and can cause salpingitis, endometritis, parametritis, oophoritis, tubo-ovarian abscesses or pelvic peritonitis

28
Q

What are tubo ovarian abscesses?

A

Formation of an inflammatory mass involving Fallopian tube/ ovary/ other adjacent pelvic organs
Very serious and can cause sepsis if it ruptures

29
Q

What are some complications of PID?

A

Infertility
Ectopic pregnancy
Chronic pelvic pain
Fitz-Hugh-Curtis syndrome

30
Q

What is Fitz-Hugh-Curtis syndrome?

A

Type of perihepatitis due to spread of infection from PID

Causes RUQ pain and ‘violin string’ adhesions of partial peritoneum to liver

31
Q

What organsims caused pelvic inflammatory disease?

A

Chlamydia trachomatis
Neisseria gonorrhoea
Bacterial vaginosis organisms eg gardnerella vaginalis, mycoplasma, anaerobes

32
Q

What are some risk factors for PID?

A 
Young age
Multiple sexual partners
Lack of barrier contraception
Low socioeconomic class
IUCD (coil itself doesn't increase risk, but it's insertion and removal makes entry of organisms possible)
33
Q

How can PID present clinically?

A 
Pyrexia
Lower abdominal pain
Painful sex
Abnormal discharge
Abnormal bleeding
34
Q

Which examinations can be used when assessing if a patient has PID?

A

Bimanual examination (2 fingers in vagina, one hand on abdomen)

Speculum examination (to look at lower genital tract for signs of inflammations, redness etc)

Also do urine test, blood test (WBC, CRP), endocervical swab, HVS, USS

35
Q

How is PID treated?

A

Antibiotics for 14 days!!!

Ceftriaxone + doxycycline + metronidazole

Also give analgesia, can do laparoscopy if severe/ presence of tubo-ovarian abscesses

Sem 4 (25 decks)

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