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3rd year > Repro - Infections > Flashcards

Repro - Infections Flashcards

1
Q

what predominately makes up the normal vaginal flora

A

Lactobacillus

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2
Q

what is NOT part of normal vaginal flora

A

Lactobacillus acidophilus

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3
Q

what pH is the vagina? why?

A

acidic (pH 4-4.5) due to production of lactic acid +/- hydrogen peroxide

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4
Q

what causes candida infection

A

usually candida albicans

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5
Q

what are the risk factors for candida infection

A

recent antibiotics or steroids
high oestrogen levels (pregnancy, combined pill)
poorly controlled diabetes
immunocompromised

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6
Q

what are the symptoms of a candida infection

A

intensely itchy white vaginal discharge

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7
Q

what is the investigations of a candida infection

A

high vaginal swab for culture

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8
Q

what is the treatment of a candida infection

A

topical clotrimazole pessary

oral fluconazole

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9
Q

what is the symptoms of Bacterial vaginosis (BV)

A

white/grey discharge with strong smell (may contain bubbles)

alkali pH

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10
Q

what is the treatment of Bacterial vaginosis

A

metronidazole for 7 days

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11
Q

would you treat the male sexual partners of someone who has Bacterial vaginosis

A

no

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12
Q

what type of bacteria is gonorrhoea

A

gram -ve, diplococcus

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13
Q

what are the symptoms of gonorrhoea

A

unusual purulent discharge
pain/burning when passing urine
bleeding after sex/between periods
inflammation of foreskin

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14
Q

what are the investigations of gonorrhoea

A

females = urethral or endocervical swab for NAATs

male = first pass urine for NAATs

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15
Q

what is the treatment of gonorrhoea

A

ceftriaxone IM

if unable to be given IM = cefixime + azithromycin Oral

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16
Q

would you retest after treating gonorrhoea

A

yes

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17
Q

what is the most common STI in the UK

A

Chlamydia

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18
Q

what are the types of Chlamydia? what do they cause?

A 
A-C = trachoma (eye infection not STI)
D-K = urogenital infection 
L1-L3 = Lymphogranuloma venereum (LGV)
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19
Q

what are the symptoms of Lymphogranuloma venereum (LGV)? who is affected by it?

A

histologically identical to Crohns = rectal pain, discharge, bleeding

tropical climates, men who have sex with men

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20
Q

what are the symptoms of Chlamydia

A

asymptomatic

females = bleeding after sex/between periods, painful sex, purulent cervicitis

males = clear/milky discharge, pain peeing, urethritis

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21
Q

what is the investigation for Chlamydia? when should they be carried out?

A

test 14 days after exposure

female = vulvovaginal swab 
male = first pass urine
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22
Q

what is the treatment for Chlamydia

A

1st line = doxycycline

2nd line = azithromycin

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23
Q

would you retest after treating for Chlamydia

A

Yes, retest 3 weeks later

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24
Q

what is Trichomonas Vaginalis

A

single celled protozoal parasite

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25
Q

what are the symptoms of Trichomonas Vaginalis

A

females = frothy, purulent discharge & irritation

males = urethritis

26
Q

what is the investigation for Trichomonas Vaginalis

A

high vaginal swab

27
Q

what is the treatment of Trichomonas Vaginalis

A

oral metronidazole

28
Q

what causes Syphilis? what is it?

A

treponema pallidum = gram negative spirochete organism

29
Q

what are the 2 types of Syphilis

A 
congenital = caught from mother
acquired = caught via body fluids
30
Q

what are the 4 stages of Syphilis

A

primary lesion = organism multiples at inoculation site and enters bloodstream

secondary stage = large number of bacteria circulating in blood and manifesting at different sites

latent stage = low-level multiplication in intima of small blood vessels

tertiary = cardiovascular, neurovascular, etc complications

31
Q

what are the symptoms of Syphilis at each stage

A

primary lesion = painless chancre & non-tender lymphadenopathy

secondary = flu-like symptoms, generalised rash, “snail-track” mouth ulcers

latent = no symptoms

tertiary = heart/brain/etc issues

32
Q

what are the investigations of Syphilis at each stage

A

Bloods

primary = PCR, IgM
secondary & tertiary = VDRL, RPR

33
Q

what is the treatment for Syphilis

A

benzathine penicillin

if allergic desensitise first

34
Q

do you retest after treatment for Syphilis

A

yes, retest until RPR is negative

35
Q

what causes Genital Herpes

A

herpes simplex virus

36
Q

what are the types of Genital Herpes

A

primary infection = first exposure
non-primary first episode = first presentation symptoms
recurrent

37
Q

what are the symptoms of Genital Herpes

A

small, painful blisters

  • no itching or tingling
  • can burst open to form ulcers
  • resolve within 5-7 days

painful urination
discharge
local lymphadenopathy
fever and tiredness

38
Q

what are the investigations for Genital Herpes

A

swab base of ulcer for PCR

serology is only used in pregnancy

39
Q

what is the treatment for Genital Herpes

A

aciclovir

pain relief = topical lidocaine, saline bathing, analgesia

40
Q

what are the symptoms of Mycoplasma Genitalium

A

asymptomatic

41
Q

what are the investigations for Mycoplasma Genitalium

A

NAATS

female = vulvovaginal swab 
male = first pass urine
42
Q

when would you test = for Mycoplasma Genitalium

A

if they have first line treatment for urogenital infection or PID has failed

43
Q

what are the types and symptoms of HPV

A

usually symptomatic

cauliflower warts

  • hands & feet = type 1 and 2
  • anogenital = type 6 and 11

cervical cancer = type 16 and 18

44
Q

what is the treatment of HPV

A

vaccine

warts:

- 1st line = podophyllotoxin
- 2nd line =  imiquiomod
- last line = electrocautery

anal warts = imiquiomod

45
Q

what causes pubic lice

A

phthirus pubis

46
Q

what are the symptoms of pubic lice

A

itching

47
Q

what is the treatment of pubic lice

A

malathion lotion

48
Q

what does HIV target?

A

CD4+ receptors

49
Q

what are the types of HIV

A

HIV-1 = group M is responsible for global pandemic

HIV-2 = simian immunodeficiency, limited to africa

50
Q

what are the symptoms of HIV

A 
primary = mimics flu/glandular fever 
asymptomatic 
opportunistic infections 
anemia 
HIV- associated wasting
51
Q

what are some examples of opportunistic infections associated with HIV

A 
pneumocystis jiroveci 
TB
cerebral toxoplasmosis
Cytomegalovirus (CMV)
progressive multifocal leukoencephalopathy
52
Q

give examples of AIDs related cancers and their cause

A

Kaposi’s sarcoma (vascular tumour) = herpes virus

Non-Hodgkin’s lymphoma = EBV

cervical cancer = HPV

53
Q

give examples of skin diseases in HIV

A

herpes zoster
herpes simplex
HPV

54
Q

what are the symptoms of o Cerebral toxoplasmosis

A

CD4+ <150
multiple cerebral abscess
headaches, fever, focal neurology, seizures, increased ICP

55
Q

what are the symptoms of Cytomegalovirus (CMV)

A

CD4+ <50

reduced visual acuity/floaters, abdo pain, diarrhoea, PR bleeding

56
Q

what are the symptoms of Pneumocystis jiroveci

A

SOB, dry cough, exercise desaturation

57
Q

who must ALWAYS be screened for HIV

A 
local prevalence >0.2%
MSM and their partners
drug users
partner who is HIV+
history of exposure
58
Q

what are the investigations of HIV

A

1st line = p24 capsule protein antibody

CD4+ Th cells <200

RNA = first marker to be seen, rarely used

antibody

rapid HIV test (POCT) = fingerprick blood or saliva specimen

59
Q

what is the treatment of HIV

A

HAART = combo of three drugs:

Nucleoside reverse-transcriptase inhibitors (NRTI)
Nucleotide reverse-transcriptase inhibitors (NtRTI)
Non-nucleoside reverse-transcriptase inhibitors (NNRTI)
Protease inhibitors

60
Q

who is offered PrEP?

A
  • Partner with HIV -detectable viral load OR men who has sex with men OR transwoman
  • >16
  • HIV negative
  • Commits to follow up every 3 months and will stop if no longer eligible
  • Resident in Scotland
61
Q

what is the treatment of a pregnancy women with HIV

A

HAART
vaginal delivery if viral load undetectable
caesarean if viral load detectable
exclusive formula feeding

3rd year (12 decks)

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