Repro: Infections Of The Genital Tract

Question 1

What is the difference between an STI and a STD?

Answer 1

STI: symptomatic and asymptomatic cases

STD: symptomatic cases only

Question 2

What are some implications of STIs?

Answer 2

• pelvic inflammatory disease
• infertility
• reproductive tract cancers (eg papilloma virus)
• transmission to fetus / neonate

Question 3

What is the management for STIs?

Answer 3

Important to test for other STIs - if they have the risk factors for one they have risk for all

Contact tracing - patients and public health

Treatment preferable a single dose or short

Advise on safe sex

Question 4

What are the 2 classes of human papilloma virus?

Answer 4

Low risk types (HPV 6&11):
Benign, painless epithelial or mucosal growths
Usually resolve spontaneously

High risk types (HPV16):
Oncogenic - associated with cervical and anal cancer

Question 5

What is the treatment for HPV?

Answer 5

None - 70% of cases resolve in 1yr, 90% in 2yrs

Question 6

What are the symptoms of chlamydia trachomatis in males, females and neonates?

Answer 6

Males: urethritis, epididymitis, prostatitis, inflammation of anal area

Females: urethritis, cervicitis, salpingitis, perihepatitis (mostly asymptomatic)

Neonates: conjunctivitis, pneumonia

Question 7

How is chlamydia trachomatis diagnosed?

Answer 7

Endocervical and urethra swab: then do NAAT (nucleic acid amplification test)

Or 1st void urine (an also detect gonorrhoea from the same specimen)

Question 8

What is the treatment for chlamydia trachomatis?

Answer 8

Adults:
Doxycycline or azithromycin (can be given as one large dose)

Children:
Erthyromycin (to preserve bone density)

Question 9

What are the symptoms of herpes simplex virus?

Answer 9

Extensively painful genital ulceration, dysuria, inguinal lymphadenopathy , fever

Question 10

How is herpes simplex virus diagnosed?

Answer 10

PCR of the vesicle fluid or the ulcer base

Question 11

How is herpes simplex virus treated?

Answer 11

Aciclovir (can be given orally or IV)

Can be used for prophylaxis for frequent recurrence - the virus can lie latent in the dorsal root ganglia

Question 12

What is the classification of neisseria gonorrhoea?

Answer 12

Its a gram negative intracelular diplococcus - looks exactly the same as neisseria meningitis

Question 13

What are the symptoms of gonorrhoea in males and females?

Answer 13

Males: purulent discharge, urethritis, epididymitis, prostatitis, proctitis, pharyngitis, testis pain

Females: asymptomatic, endocervicitis, urethritis, PID

Question 14

How is neisseria gonorrhoea diagnosed?

Answer 14

Swab from urethra, cervix, throat or rectum - gram stain

Can do NAAT on the urine

Question 15

What is the treatment for neisseria gonorrhea?

Answer 15

Im ceftriaxone, as it has increasing resistance to other agents

Question 16

Which STI does treponema pallidum cause?

Answer 16

Syphilis

Question 17

Who is at higher risk of syphilis?

Answer 17

Men and MSM

Question 18

What are the different stages of syphilis?

Answer 18

1: painless ulcer called a chancre
2: 6-8 weeks later, fever rash, mucosal lesions in the mouth, lymphadenopathy

Then there are some latent years

3: Neurosyphilis, cardiovascular syphilis
(These are severe complications)

Question 19

How is treponema pallidum detected?

Answer 19

It cannot be grown

Therefore have to undergo serology - initial screening with EIA antibody

Question 20

How is treponema pallidum treated?

Answer 20

Treated with penicillin then followed up

Question 21

What can cause inguinal lymphadenopathy?

Answer 21

LGV (lymphogranuloma venereum) - clamydia serotypes 1 2 3

Get a raised bump and access in the groin area

Question 22

What does trichomonas vaginalis cause?

Answer 22

Irritation, dysuria, vaginal inflammation

Alongside a thin, froth, offensive discharge

Question 23

How is trichomonas vaginalis diagnosed and treated =?

Answer 23

Diagnosed with a vaginal wet preparation and culture enhancement

Treated with metronidazole

Question 24

What are some risk factors for vaginal candida infection?

Answer 24

• antibiotics
• oral contraceptives
• pregnancy
• obesity
• steroids
• diabetes

Question 25

How is candida detected and treated?

Answer 25

A high vaginal smear with possible untrue

Treated with topical azoles, oral fluconaxzole or nystatin

Question 26

What are the symptoms of bacterial vaginosis?

Answer 26

An offensive fishy discharge

Question 27

How is bacterial vaginosis diagnosed clinically?

Answer 27

A vaginal pH >5 and the ‘whiff test’

Question 28

How is bacterial vaginosis treated?

Answer 28

Metronidazole