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Semester 4 - Reproductive System > Session 6 - Genitalfections > Flashcards

Session 6 - Genitalfections Flashcards

1
Q

Name two sources of epidemiological date for assesing rates of infection of the genital tract

A

Genitourinary medicine clinics

Communicable disease surveillance centres

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2
Q

What is the issue with data from a GUM clinic?

A

Data is an underestimate, as does not take into account people presenting through their GPs

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3
Q

Give five groups at particular risk of STI

A

o Young people
o Minority ethnic groups
o Those affected by poverty and social exclusion
o Low socio-economic status groups
o Those with poor educational opportunities
o Unemployed people
o Individuals born to teenage mothers

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4
Q

What five conditions are associated with STI?

A

o Pelvic Inflammatory Disease (PID)
o Impaired fertility
o Reproductive tract cancers
o Risk of infection with blood-borne viruses – HBV, HIV
o Risk of congenital or peripartum infection of neonate

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5
Q

Give four differential diagnosis for genital skin and mucous membane lesions

A

o Genital ulcers
o Vesicles or bullae
o Genital papules
o Anogenital warts

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6
Q

Give five differential diagnosis for urethritis

A 
o	Gonococcal urethritis
o	Chlamydial urethritis
o	Non-specific urethritis
o	Post-gonococcal urethritis
o	Non-infectious urethritis
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7
Q

Give one main differential for vulvo-vaginitis

A

o Bartholinitis

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8
Q 
How much has the following increased since '95?
o	Uncomplicated Gonorrhoea 
o	Genital Chlamydia – 
o	Infectious Syphilis – 
o	GUM clinic workload
A

o Uncomplicated Gonorrhoea – 102% Increase
o Genital Chlamydia – 107% Increase
o Infectious Syphilis – 57% Increase
o GUM clinic workload – 34% Increase

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9
Q

What organism causes chalmydia?

A

Chlamydia trachomatis

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10
Q

Describe chlamydia trachomatis

A

Gram -‘ve obligate intracellular bacterium

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11
Q

How does chalmydia present in males?

A

o Urethritis, epididymitis, prostatitis, proctitis

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12
Q

How does chlamydia present in females?

A

o Urethritis, cervicitis, salpingitis, perihepatitis

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13
Q

How is chlamydia diagnosed?

A

o Doxycycline or Azithromycin

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14
Q

What causes gonorrhoeae?

A

Neisseria Gonorrhoeae is a Gram –‘ve intracellular diplococcus

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15
Q

What is the clinical presentation of gonnorohoea in men?

A

o Urethritis, epididymitis, prostatitis, proctitis, pharyngitis

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16
Q

What is the clinical presentation of gonnorohoea in women?

A

o Asymptomatic, endocervicitis, urethritis, PID

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17
Q

What does disseminated gonococcal infection present as?

A

o Bacteraemia, skin and joint lesions

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18
Q

How is gonnorohoea diagnosed?

A

o Smear and culture

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19
Q

What is the treatment of gonorrhoeae?

A

Ceftriaxone

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20
Q

What causes herpes?

A

Herpes Simplex Virus, an encapsulated, double stranded DNA virus.

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21
Q

What is the clinical presentation of primary genital herpes

A

o Extensive, painful genital ulceration, dysuria, inguinal lymphadenopathy, fever

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22
Q

What is the clinical presentation of recurrent genital herpes?

A

o Asymptomatic  Moderate

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23
Q

How is genital herpes diagnosed?

A

o Smear and swab of vesicle fluid and/or ulcer base

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24
Q

How is genital herpes treated?

25
What causes genital warts?
HPV
26
What HPV strains cause the highest risk?
16 and 18
27
What is the clinical presentation of HPV?
o Cutaneous, mucosal and anogenital (anus and genital) warts o Benign, painless, verrucous epithelial or mucosal outgrowths o Penis, vulva, vagina, urethra, cervix, perianal skin
28
How is HPV diagnosed?
Clinical, biopsy and genome analysis, hybrid capture
29
How is HPV treated?
o None – frequent spontaneous resolution | o Topical podophyllin, cryotherapy, intralesional interferon
30
What causes syphilis?
Treponema pallidum
31
What are the four stages of syphillis?
1. Indurated, painless ulcer (chancre) 2. 6 – 8 weeks later  Fever, rash, lymphadenopathy, mucosal lesions Latent – Symptom free years 3. Chronic Granulomatous lesions 4. Cardiovascular and CNS pathology
32
How is syphilis diagnosed?
Dark field microscopy, serology
33
How is syphilis treated?
Penicillin and test of cure follow up
34
What is trichomonas vaginitis caused by?
Flagellatd protozoan, trichomonas vaginalis
35
What are the key features of trichomonas vaginalis?
o Thin, frothy, offensive discharge | o Irritation, dysuria, vaginal inflammation
36
What is the treatment of trichomonas vaginitis?
Metronidazole
37
What are two types of parasites which cause genital infection?
Scabies mite | Pubic louse
38
Give two infections which occur post partum
Vulvovaginal Candidiasis | Bacterial Vaginosis
39
What causes vulvovaginal candidiasis?
Candida albicans
40
Give six risk factors for vulvovaginal candidiasis
 Antibiotics, oral contraceptives, pregnancy, obesity, steroids, diabetes
41
Give symptoms vulvovaginal candidiasis
o Profuse, white, curd-like discharge | o Vaginal itch, discomfort and erythema
42
How is vulvovaginal candidiasis diagnosed?
High vaginal smear and culture
43
How is vulvovaginal candidiasis treated?
Topic azoles or oral fluconazole
44
What distinguished bacterial vaginosis from vaginitis?
No inflammation of vaginal wall | - Caused by unsetlled normal flora
45
What is the main symptom of bacterial vaginosis?
Offensive fishy discharge
46
How does one diagnose bacterial vagnosis
 pH > 5, KOH whiff test |  High Vaginal Smear – Gram variable coccobacilli, reduced numbers of lactobacilli
47
How does one treat bacterial vaginosis
Metronidazole
48
Give five types of pelvic inflammatory disease
``` o Endometritis o Salpingitis o Oophoritis o Pelvic peritonitis o +/- tubo ovarian abscess ```
49
Give five PID risk factors
o Young age at first intercourse o Multiple sexual partners (polygyny) o High frequency of sexual intercourse o High rate of acquiring new partners within pervious 30 days o Alcohol/Drug use o Cigarette smoking (2x increased risk) o IUDs increase risk at point of insertion/removal for a few weeks
50
Give 5 bacteria that can cause PID
``` o Nesseria Gonorrhoea  Gram –‘ve intracellular diplococci o Chlamydia Trachomatis  Gram –‘ve extracellular (infective) organism o Bacterial Vaginosis  Anareobes, Enteric Gram –‘ve Bacteroides o Streptococci o Haemophillis Influenzae o Cytomegalovirus o Mycobacterium Tuberculosis ```
51
Give two immediate sequelae of PDI
 Tubo-ovarian abscess |  Pyo-salpinx
52
Give five long term sequlae of PID
 Ectopic Pregnancy (1 episode of PID  7x increased risk)  Infertility (1 episode of PID  12% increase, 2  25%, 3+  50-75%)  Dyspareunia (Painful sexual intercourse)  Chronic PID / Chronic pelvic pain  Pelvic adhesions
53
What is the pathogenesis of PID
Infection of the cervix (endocervicitis) spreads, either directly or via lymphatics to the endometrium, uterine tubes and the pelvic peritoneum
54
Give four factors associated with the ascent of bacteria in PID
o Instrumentation  Cervical dilation, coil insertion o Hormonal changes associated with menstruation  Lowers bacteriostatic effect of cervical secretion o Retrograde menstruation  Infection more common after a period o Virulence of the organisms in acute chlamydial and gonococcal PID
55
Give four laboratory tests for PID
Pregnancy test Triple and urethral swabs Midstream urine C-reactive protein
56
What is a triple swab?
 High vaginal swab – Bacteria vaginosis organisms  Endocervical swab – Neisseria gonorrhoea  Endocervical swab - Chlamydia trachomatis
57
Give six differential diagnoses for PID
o Ectopic pregnancy o Acute appendicitis o Irritable Bowel Syndrome (IBS) o Ovarian cyst accidents (torsion, rupture, haemorrhage) o Urinary Tract Infection (UTI) o Functional pelvic pain of unknown origin
58
What is chronic pelvic inflammatory disease?
``` Symptoms >6 months duration o Pelvic pain o Secondary dysmenorrhoea o Deep dyspareunia o Menstrual disturbance o Recurrent acute painful exacerbations ```
59
Give five clinical sequalae of chronic pelvic inflammatory disease
``` o Infertility o Ectopic pregnancy o Chronic pelvic pain o Pelvic adhesions/tubo-ovarian complex o Abnormal / painful periods ```

Semester 4 - Reproductive System (30 decks)

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