Reproductive Tract Infecions Flashcards
What are 6 risk factors for getting a genital tract infections?
- Age between 15 and 24
- Ethnicity (Black)
- Low socio-economic status
- Multiple sexual partners
- Sexual orientation (Gay men)
- Lack of barrier contraception
What percentage of STIs are Asymptomatic?
Can you have more than 1 STI at once?
More than 50%
Yes
Describe the organism that causes the most common STI in the UK.
Why isn’t it seen on gram staining?
Chlamydia trachomatis- An obligate intracellular bacterium, has no cell wall
How does Chlamydia present in men and women
Men;
- Typically asymptomatic
- Mild urethritis, Testicular pain, Dysuria, Discharge
Women;
- Typically asymptomatic
- Discharge, Dyspareunia, Postcoital bleeding
What are 2 complications of Chlamydia
- PID
- Infections at sites outside of Genital tract (Conjunctivitis, Arthritis, Urethritis)
Chlamydia is investigated using Nucleic Acid Amplification tests
What is the treatment?
- Doxycycline/ Azithromycin
- Erythromycin in case of pregnancy/ allergy
Describe Neisseria gonorrhoeae
- Gram negative intracellular diplococcus
- Has Pili to adhere to epithelial cells
How does Gonorrhoea present in men and women?
Men (90% symptomatic);
- Thick yellow Discharge, Dysuria
Women;
- Typically asymptomatic
- Discharge and Lower Ab pain
What are 3 complications of Gonorrhoea?
- Disseminated gonorrhoea infection
- PID in women
- Epididymo-orchitis in men
What is non-gonococcal urethritis (NGU)?
How do you treat it?
Inflammation of the Urethra, not caused by Gonorrhoeal infection
Test for other organisms and give appropriate antibiotic
What is the treatment for Gonorrhoea?
Combined AB therapy;
- Ceftriaxone to treat gonorrhoea
- Azithromycin to ‘boost’ its effect and reduce risk of resistance
- Giving two antibiotics to treat Chlamydia as a common co-infection
List 4 investigations that can be carried out if Discharge is identified in men
- FBC, CRP
- Urine sample (To look for organisms and exclude UTI)
- NAAT to look for Chlamydia
- Urethral swab
Describe a physiological cause of vaginal discharge
Secretory Phase of Uterine cycle due to Progesterone;
- Thicker cervical mucus
- Cyclical
Describe the organism that causes Trichomoniasis
Trichomonas vaginalis;
- A protozoa
- Favours pH 6 (normal vaginal pH around 4)
How does Tricchomoniasis present in men and women?
Men;
- Often asymptomatic
- Dysuria, Discharge
Women;
- Yellow discharge
- Irritation of vulva and vagina
How is Trichomoniasis diagnosed and treated?
Diagnosed with swabs
Treated with Metronidazole
Name 2 Non-sexually transmitted infections in women that can cause vaginal discharge
- Bacterial vaginosis
- Candidiasis
What commonly causes Candidiasis?
What are 4 risk factors?
Candida albicans overgrowth
- Immunosuppression (HIV, Pregnancy)
- Diabtetes
- Antibiotics
- Oestrogen containing oral contraceptives (COCP)
How does Candidiasis present?
How is it investigated and treated?
- White vaginal discharge
- Itching, Pain and/or Dyspareunia
- High vaginal swabs
- Treated with oral and/ or topical Azoles
What is the general cause of bacterial vaginosis?
Suggest 1 risk factor and name an organism that commonly causes vaginosis
Growth of bacteria due to pH imbalance in vagina
- Vaginal douching
- Gardnerella vaginalis
How does bacterial vaginosis present?
How is it investigated and treated?
- Offensive white/ grey discharge
- No itching or pain
- High vaginal swabs, Cultures
- Metronidazole
List 3 genital tract infections that are investigated via High Vaginal swabs?
- Candidiasis
- Bacterial Vaginosis
- Trichomoniasis
Urine samples are ineffective at diagnosing STIs in women, what are they used for?
To rule out UTIs
Describe Swab taking in women to look for STIs
- High vaginal for Trichomoniasis, Candidiasis, BV
- Endocervical for Chlamydia/ gonorrhoea
- Vulvovaginal if asymptomatic for “ “
