Semester 2: STIs, UTIs, Obstetric/Perinatal Infections Flashcards
What are the anatomical barriers of the reproductive tract?
Skin
Access to mucosal sites/primary sites of infection
What are the mucosal barriers of the reproductive tract?
pH does not favour growth of pathogens
Flushing action of fluids
Circulating immune cells
What factors influence susceptibility to STIs?
Age (child bearing age for women)
Immune status
Gender (anatomical, transmission, in men circumcision, hormonal)
Concominant STIs
Social behaviour: sexual education, unprotected sex
Asymptomatic infections
What are the sources of STIs
Mucosal
Breaches in skin - oral, anal
Shared blood/blood products
Where do STIs most commonly effect?
Most STIs affect reproductive tract, oral, anal cavities
What are bacterial sources of STIs
Neisseria gonorrhea Chlamydia trachomatis Treponema pallidum Mycoplasma sp Ureaplasma sp
What are the viral sources of STIs
Herpes simplex virus (HSV) Human papillomavirus (HPV) Hep B Hep C (low risk) HIV
What are the fungal sources of STIs
Candida albicans
Trichomonas vaginalis
What are the ectoparasite sources of STIs?
Phthirus pubis - pubic lice
Sarcoptes scabiei - scabies
What are some complications of STIs?
Pelvic Inflammatory Disease Bacterial Vaginosis Cancer Neurological events (HIV, syphilis) Sterility (chronic/untreated infections)
What are some signs and symptoms of PID?
Range, many asymptomatic
Lower abdominal pain, fever, cervical motion tenderness, cervical inflammation
Inflammation of uterus, fallopian tubes, ovaries
What are some complications of untreated PID?
May lead to infertility, ectopic pregnancy
What is PID a common sequelae of?
Gonorrhea and chlamydia infection in women
What are the causes of bacterial vaginosis?
Unknown but linked to STI, antibiotic usage, douching, imbalance in flora composiiton
What are some signs and symptoms of bacterial vaginosis?
Abnormal vaginal discharge, foul-smelling, white or grey in colour
Burning sensations while urnating, vaginal itching
What are some complications of bacterial vaginosis?
Increased risk of PID and associated complications, preterm labour and low birth weight. Increased risk of STI transmission
What cancers are complications of STIs?
HPV cervical cancer
HIV Kaposi’s sarcoma
What are anatomical factors influencing susceptibility to UTI?
Length of urethra
Disruption of urine flow, bladder voiding
Congential
Surgery/catheterization
Disease-related (neurological, mechanical)
What are some factors in men influencing susceptibility to UTIs?
Circumcision
Enlarged prostate
What are some factors in women influencing susceptibility to UTIs?
Sexual intercourse
pH changes, hormonal changes, pregnancy
What are some pathogenic sources of UTIs?
E. coli (80%)
Coagulase negative staphylococci (10%)
S. aureus, enterococcus faecalis, pseudomonas aeruginosa, Klebsiella sp, Enterobacter sp.
C. albicans
Viral causes rare (CMV, adenovirus, mumps, rubella); associated with hemorrhagic cystitis
“SEEK PP”
What are some sources of UTIs?
Colonization of the urinary tract (sexual intercourse, hygiene, ascending infection) Hematogenous spread of another infection (kidneys, descending infection) Device related (urinary catheter)
What are the clinical features of UTIs
Urethritis - blood in urine, painful urination/ejaculation, vaginal d/c
Cystitis - cloudy/bloody urine, abdominal pain, fever
Pyelonephritis - fever, vomiting, abdominal pain, long term kd dysfunction, kd failure, high BP
Prostatitis - fever, chills, urinary dysfunction
Epididymitis - low grade fever/chills, testicular inflammation and pain
How are UTIs diagnosed?
Urinalysis - culture, microscopy, dipstick test, nitrite test for enterobacteriaceae
Ultrasound - obstruction, kidney stones
X-ray - structural
What are the complications of UTIs?
Long term pyelonephritis may lead to kd dysfunction/failure
Sepsis
In men - epididymitis may lead to sterlitiy
What is the treatment for UTIs?
Antimicrobial sparing strategies important due to emerging antibiotic resistance (20-30% self-resolving) but untreated can lead to renal complications
What infections may be reactivated during pregnancy?
CMV, EBV, HSV
What infections may cause serious effects during pregnancy?
Malaria
UTI, Candidiasis
Influenza
Viral hepatitis
What infections may cross the placental barrier?
Torch Toxoplasmosis, Treponema Other (Parvo, varicella, TB) Rubella CMV HSV, HIV
What are the potential fetal complications with toxoplasmosis?
fetal malformation
What are the potential fetal complications with Treponema?
musocal, skin lesions, lymphadenopathy, hepatosplenomegaly
What are potential fetal complications of CMV?
Deafness, mental retardation
What are potential fetal complications of HSV?
Disseminated neonatal infection
What infections may be passed on to the newborn during childbirth?
N. gonorrheae: neonatal conjunctivitis C. trachomatis: neonatal conjunctivits/pneumonia HSV: infection skin/eye/mouth Genital HPV: laryngeal warts GBS: septicemia, death C. albicans: neonatal oral thrush HIV: childhood AIDS
What infections may be passed to newborns via breast milk?
HIV
HTLV
CMV
Rubella
