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Reproductive System > Reproductive Tract Infecions > Flashcards

Reproductive Tract Infecions Flashcards

1
Q

What are 6 risk factors for getting a genital tract infections?

A
  • Age between 15 and 24
  • Ethnicity (Black)
  • Low socio-economic status
  • Multiple sexual partners
  • Sexual orientation (Gay men)
  • Lack of barrier contraception
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2
Q

What percentage of STIs are Asymptomatic?

Can you have more than 1 STI at once?

A

More than 50%

Yes

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3
Q

Describe the organism that causes the most common STI in the UK.

Why isn’t it seen on gram staining?

A

Chlamydia trachomatis- An obligate intracellular bacterium, has no cell wall

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4
Q

How does Chlamydia present in men and women

A

Men;

  • Typically asymptomatic
  • Mild urethritis, Testicular pain, Dysuria, Discharge

Women;

  • Typically asymptomatic
  • Discharge, Dyspareunia, Postcoital bleeding
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5
Q

What are 2 complications of Chlamydia

A
  • PID

- Infections at sites outside of Genital tract (Conjunctivitis, Arthritis, Urethritis)

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6
Q

Chlamydia is investigated using Nucleic Acid Amplification tests

What is the treatment?

A
  • Doxycycline/ Azithromycin

- Erythromycin in case of pregnancy/ allergy

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7
Q

Describe Neisseria gonorrhoeae

A
  • Gram negative intracellular diplococcus

- Has Pili to adhere to epithelial cells

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8
Q

How does Gonorrhoea present in men and women?

A

Men (90% symptomatic);
- Thick yellow Discharge, Dysuria

Women;

  • Typically asymptomatic
  • Discharge and Lower Ab pain
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9
Q

What are 3 complications of Gonorrhoea?

A
  • Disseminated gonorrhoea infection
  • PID in women
  • Epididymo-orchitis in men
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10
Q

What is non-gonococcal urethritis (NGU)?

How do you treat it?

A

Inflammation of the Urethra, not caused by Gonorrhoeal infection

Test for other organisms and give appropriate antibiotic

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11
Q

What is the treatment for Gonorrhoea?

A

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
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12
Q

List 4 investigations that can be carried out if Discharge is identified in men

A
  • FBC, CRP
  • Urine sample (To look for organisms and exclude UTI)
  • NAAT to look for Chlamydia
  • Urethral swab
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13
Q

Describe a physiological cause of vaginal discharge

A

Secretory Phase of Uterine cycle due to Progesterone;

  • Thicker cervical mucus
  • Cyclical
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14
Q

Describe the organism that causes Trichomoniasis

A

Trichomonas vaginalis;

  • A protozoa
  • Favours pH 6 (normal vaginal pH around 4)
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15
Q

How does Tricchomoniasis present in men and women?

A

Men;

  • Often asymptomatic
  • Dysuria, Discharge

Women;

  • Yellow discharge
  • Irritation of vulva and vagina
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16
Q

How is Trichomoniasis diagnosed and treated?

A

Diagnosed with swabs

Treated with Metronidazole

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17
Q

Name 2 Non-sexually transmitted infections in women that can cause vaginal discharge

A
  • Bacterial vaginosis

- Candidiasis

18
Q

What commonly causes Candidiasis?

What are 4 risk factors?

A

Candida albicans overgrowth

  • Immunosuppression (HIV, Pregnancy)
  • Diabtetes
  • Antibiotics
  • Oestrogen containing oral contraceptives (COCP)
19
Q

How does Candidiasis present?

How is it investigated and treated?

A
  • White vaginal discharge
  • Itching, Pain and/or Dyspareunia
  • High vaginal swabs
  • Treated with oral and/ or topical Azoles
20
Q

What is the general cause of bacterial vaginosis?

Suggest 1 risk factor and name an organism that commonly causes vaginosis

A

Growth of bacteria due to pH imbalance in vagina

  • Vaginal douching
  • Gardnerella vaginalis
21
Q

How does bacterial vaginosis present?

How is it investigated and treated?

A
  • Offensive white/ grey discharge
  • No itching or pain
  • High vaginal swabs, Cultures
  • Metronidazole
22
Q

List 3 genital tract infections that are investigated via High Vaginal swabs?

A
  • Candidiasis
  • Bacterial Vaginosis
  • Trichomoniasis
23
Q

Urine samples are ineffective at diagnosing STIs in women, what are they used for?

A

To rule out UTIs

24
Q

Describe Swab taking in women to look for STIs

A
  • High vaginal for Trichomoniasis, Candidiasis, BV
  • Endocervical for Chlamydia/ gonorrhoea
  • Vulvovaginal if asymptomatic for “ “
25
Q

What is the most common viral STI?

What organism causes it?

A
  • Anogenital warts
  • Caused by HPV, commonly strains 6 and 11

(HPV- DNA virus, non enveloped)

26
Q

What is significant about strains 16 and 18 of HPV?

A
  • Have oncogenic properties, highly associated with cervical and anal cancer
  • Do not generally cause genital warts
27
Q

For which HPV strains does a vaccine exist?

A
  • 6 and 11 (Cause warts)

- 16 and 18 (Oncogenic)

28
Q

Describe the presentation of Anogenital warts

Describe their treatment

A
  • Painless genital warts
  • On Penis/ Vulva/ Vagina/ Cervix/ Perianal skin
  • Typically regress on their own, although topical treatments available
29
Q

What strands of HSV cause Herpes?

What’s common to both of them?

A

HSV-1 and HSV-2

Both multiply in epithelial cells of mucosal surfaces

30
Q

What infection is HSV-2 commonly associated with?

A

HIV

31
Q

Compare HSV-1 and HSV-2 in outcome

A

HSV-1: Can cause Oral and Genital herpes

HSV-2: Can cause Genital herpes and leads to recurrent, lifelong infection

32
Q

Why is infection with HSV-2 particularly dangerous in pregnancy?

A

In vaginal delivery, baby can develop complications of herpes

33
Q

How does Herpes present?

How can it be identified and treated?

A
  • Initially asymptomatic
  • Painful ulcers, Dysuria, Discharge
  • Swabs or serology
  • With antivirals such as Acyclovir (To reduce severity)
34
Q

Which spirochete bacterium is responsible for Syphilis?

Many who have this infection will also have what other infection?

A

Treponema pallidum

HIV (40%)

35
Q

Syphilis is more common in what 2 patient groups?

What are the 3 stages?

A
  • White gay men
  • Men aged 25-33

Primary, Secondary, Tertiary

36
Q

Describe Primary Syphilis

A
  • Painless ulcer in genitals/ sites involved in sexual contact
  • Very infectious, but lesion will usually disappear
37
Q

What proportion of people develop Secondary syphilis if left untreated?

After how long?

A

25%

4-10 weeks after initial infection

38
Q

Describe Secondary Syphilis

A
  • Affects other body systems (Glomerulonephritis, Hepatitis, Rash)
  • Symptoms disappear
39
Q

Describe the Tertiary Syphilis

A
  • Infection can remain latent

- Can reactivate in pregnancy-> Congenital syphilis

40
Q

How can we confirm and treat Syphilis?

A
  • Swabs
  • Blood tests
  • Penicillin based antibiotics

Reproductive System (21 decks)

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