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SA reproductive > S9) Infections of the Reproductive Tract > Flashcards

S9) Infections of the Reproductive Tract Flashcards

1
Q

What are the main public health messages required to limit STI’s?

A
  • Practice safe sexual behaviour
  • Reduce total number of partners
  • Seek better sexual health education
  • Seek early treatment for suspected STI
  • Avoid alcohol/illicit drug abuse
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2
Q

Identify 6 factors which affect the transmission of genital tract infections

A
  • Age
  • Condom use
  • Sexual orientation
  • Socioeconomic status
  • Number of partners
  • Ethnicity
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3
Q

Identify 5 of the most commonly occuring STI’s

A
  • Chlamydia
  • Gonorrhea
  • Genital herpes
  • Genital warts
  • Syphillis
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4
Q

What is the causative organism in chlamydia?

A

Chlamydia trachomatis

  • typically asymptomatic
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5
Q

What is the causative organism in gonorrhea?

A

Neisseria gonorrhea

  • gram negative diplococci
  • yellow discharge
  • intermenstrural bleeding
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6
Q

What is the causative organism in genital warts?

A

Human papilloma virus

  • DNA virus
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7
Q

What is the causative organism in genital herpes?

A

Herpes simplex virus (1&2)

  • lifelong infection
  • ulcers and blisters
  • mouth-anus
  • antivirals
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8
Q

Briefly, describe the incidence of different STI diagnoses in men

A
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9
Q

Briefly, describe the incidence of different STI diagnoses in women

A
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10
Q

Briefly, describe the incidence of different STI diagnoses in men by ethnic group

A
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11
Q

Briefly, describe the incidence of different STI diagnoses in women by ethnic group

A
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12
Q

How does chlamydia present in males?

A
  • Urethritis
  • Dysuria
  • Epididymitis
  • Prostatitis

- Conjunctivitis

- Asymptomatic pharyngeal infection

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13
Q

How does chlamydia present in females?

A
  • Increased discharge
  • Dyspareunia (painful sex)
  • Post coital bleeds
  • Intermenstrual bleeds
  • Conjunctivitis
  • Asymptomatic pharyngeal infection
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14
Q

How is chlamydia diagnosed in men?

A
  • First catch urine NAAT (nucleic acid amplification testing)
  • Rectal NAAT
  • Pharyngeal NAAT
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15
Q

How is chlamydia diagnosed in women?

A
  • Vulvovaginal & endocervical swabs for NAAT
  • Rectal NAAT
  • Pharyngeal NAAT
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16
Q

Describe the treatment of chlamydia in men and women

A
  • Doxycycline / Azithromycin (1st line)
  • Erythromycin / Ofloxacin (2nd line)
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17
Q

How does gonorrhea present in men?

A
  • Urethral discharge
  • Dysuria
  • Anal discharge

- Asymptomatic pharyngeal infection

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18
Q

How does gonorrhea present in women?

A
  • Altered discharge
  • Lower abdominal pain

- Asymptomatic pharyngeal infection

  • Asymptomatic rectal infection
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19
Q

How is gonorrhea diagnosed?

A
  • Microscopy of gram stained genital specimen
  • NAATs
  • Cultures / swabs
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20
Q

Describe the treatment of gonorrhea

A
  • Ceftriaxone & azithromycin
  • Spectinomycin (alternative for penicillin allergy)
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21
Q

Why are both azithromycin and ceftriaxone given as treatment for gonorrhea?

A

Azithromycin prevents antibiotic resistance to ceftriaxone and also treats the possible co-infection of chlamydia

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22
Q

How does genital herpes present?

A
  • Painful ulceration
  • Dysuria
  • Vagina discharge
  • Fever
  • Myalgia
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23
Q

How is genital herpes diagnosed?

A
  • Type specific serology
  • Virus detection of vesical fluid/ulcer base
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24
Q

Describe the treatment of HSV

A
  • General advice
  • Suppressive treatment for recurrent HSV
  • Aciclovir, valciclovir/famciclovir
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25
Q

How do anogenital warts present?

A

Benign, painless outgrowths on penis / vulva, vagina, urethra and cervix

26
Q

How are genital warts diagnosed?

A

Biopsy in atypical lesions

27
Q

Describe the treatment of anogenital warts

A
  • No treatment (spontaneous resolution)
  • Topical application (podophyllotoxin)
  • Physical ablation (excision, cryotherapy, electrosurgery)
28
Q

What is a preventative measure for anogenital warts?

A

HPV vaccination

29
Q

What is the causative organism in syphilus?

A

Treponema pallidum

  • direct contant - vertical transmission (mother to child)
30
Q

How does syphilis present?

A
  • 1o – painless ulcer
  • 2o – rash, mucosal lesions, multi-system involvement
  • Latent – symptom-free years
  • 3o – neurosyphilis, CV syphilis, parenchymous (40 years later)
31
Q

What is the causative organism in trichomoniasis?

A

Trichomonas vaginalis (flagellated protozoa)

32
Q

How does trichomoniasis present?

A
  • Urethral discharge
  • Dysuria
33
Q

What is scabies?

A

Scabies is a skin condition caused by an infestation of the human itch mite called Sarcoptes scabiei

34
Q

What are pubic lice?

A

Pubic lice are small parasites (crab louse – Phthirus pubis) affecting the genital area

35
Q

What is bacterial vaginosis?

A
  • Bacterial vaginosis is a female genital tract infection which is not sexually transmitted
  • It is the most common cause of abnormal discharge, odour and irritation in women of childbearing age
36
Q

What are the causative organisms in bacterial vaginosis?

A
  • Gadnerella vaginalis
  • Prevotella spp
  • Mobiluncus spp
37
Q

How is bacterial vaginosis diagnosed?

A
  • High vagina gram stained smear
  • Vaginal pH > 4.5
  • Pungent odour with the KOH ‘whiff test’
  • Presence of clue cells on a wet mount
38
Q

How is bacterial vaginosis treated?

A

Metronidazole

39
Q

What is vulvovaginal candidiasis? non STI

A

Vulvovaginal candidiasis is a genital tract infection referring to vaginal and vulval symptoms caused by a yeast

40
Q

What are the causative organisms of vulvovaginal candidiasis?

A
  • Candida albicans
  • Other non-albicans candida species
41
Q

How does vulvovaginal candidiasis present?

A
  • Vaginal discharge
  • Vulval itch
  • Soreness
  • Dyspareunia
42
Q

State 5 risk factors for vulvovaginal candidiasis

A
  • Pregnancy
  • Antibiotics
  • Oestrogen oral contraceptives
  • Diabetes
  • Immunosupression
43
Q

How is vulvovaginal candidiasis diagnosed?

A

High vaginal smear (± culture)

44
Q

Describe the treatment of vulvovaginal candidiasis

A
  • Topical azoles
  • Oral azoles
45
Q

What is LGV?

A

Lymphogranuloma venereum is an STI caused by C. trachomatis serotypes L1-3 and presents with a rapidly healing papule then inguinal bubo

46
Q

What is chancroid?

A

Chancroid is a bacterial STD presenting as painful genital ulcers which are caused by infection with Haemophilus ducreyi

47
Q

What is Donovanosis?

A

Donovanosis is a tropical sexually transmitted infection presenting as genital nodules which progress to ulcers, caused by Klebsiella granulomatis

48
Q

Provide a differential diagnosis for a patient presenting with genital skin and mucous membrane lesions

A
  • Genital ulcers – HSV, syphilis, chanchroid
  • Vesicles of Bullae – HSV
  • Genital papules – anogenital warts
49
Q

Provide a differential diagnosis for a patient presenting with urethritis

A
  • Gonococcal urethritis
  • Non-gonococcal urethritis – C.trachomatis, ureaplasma, mycoplasma, HSV
  • Post-gonococcal urethritis
50
Q

Provide a differential diagnosis for a female patient presenting with a pelvic infection

A
  • Pregnancy related – chorioamnionitis, post-partum endometriosis
  • Pelvic Inflammatory Disease
51
Q

Provide a differential diagnosis for a patient presenting with vulvo-vaginitis and cervicitis

A
  • Vulvovaginitis – candiasis, trichomoniasis, HSV
  • Cervicitis – C. trachomatis, N. gonorrhea, HSV, HPV
  • Bartholinitis
  • Bacterial vaginosis
52
Q

Provide a differential diagnosis for a patient presenting with prostatitis

A
  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Chronic pelvic pain syndrome
53
Q

Provide a differential diagnosis for a patient presenting with epididymitis

A
  • Non-specific bacterial epididymitis
  • Sexually transmitted epididymitis
54
Q

Provide a differential diagnosis for a patient presenting with orchitis

A
  • Viral orchitis (mumps, coxsackie B)
  • Pyogenic bacterial orchitis
55
Q

What is the illness iceberg and how does this concept apply in the case of STI’s?

A
  • The illness iceberg states that patients presenting to the GP are a small representative of a larger population of people with a specific condition
  • In terms of an STI, most are asymptomatic so patients presenting to the GP are a small minority of those with STI’s as they have symptoms
56
Q

what is non-gonococcal urethritis

A
  • inflammation of the urethra associated with discharge
  • can be sexually transmitted
  • chlamiydia trichomatis
  • mycoplasma genitalium
57
Q

what is trichomonads vaginalis?

A
  • protozoa
  • increases alkaliity
  • causes frothy green/yellow discharge
  • vulval itching
58
Q

bacterial vaginosis

A

non-sti

  • via oral-sex
  • smoking
  • fishy smelling, thin, grey homogenous discharge
59
Q

differences in discharge

A
60
Q

what are the two common medications given

A

common antibiotics:

azithromycin

ceftriaxone

SA reproductive (22 decks)

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