STIs (general) + vaginal discharge

Question 1

STis - general facts

Answer 1

1. Impact disproportional on adolescents and young adults
2. Partner notification and treatment vital
3. Confidentiality paramount
4. Notifiable conditions = hepatitis (B-E), chlamydia, donovanosis, gonoccocal infection, syphilis
5. Assessment of competency for minors (?)

Question 2

STIs - risk factors

Answer 2

1. Multiple partners (two or more in the last year), concurrent partners, or recent partner change (in past 3mo)
2. Non-use of barrier protection
3. STI in partner, or other STI
4. Younger age (esp =/

Question 3

Increased vaginal discharge - causes

Answer 3

Physiological

1. Estrogen-related = puberty, pregnancy, COCP
2. Cycle related = maximal mid-cycle and premenstrual
3. Sexual excitement and intercourse

Pathological - infection

4. Non-sexually transmitted (BV, chlamydia)
5. Sexually transmitted (TV, chlamydia, gonorrhoea)

Pathological - non-infective

6. Foreign body (retained tampon, condom or post-partum swab)
7. Malignancy (any part of the genital tract)
8. Atrophic vaginitis (often blood-stained)
9. Cervical ectropion or endocervical polyp
10. Fistulae (urinary or faecal)

Question 4

Characteristics of common causes for vaginal discharge

Answer 4

1. Physiological = clear/white, mucoid, no odour
2. Candida infection = white, curd-like, no odour
3. Trichomonal infection = green/grey, frothy, offensive odour
4. Gonococcal infection = greenish, watery, no odour
5. Chlamydial infection = not specified (?)
6. Bacterial vaginosis (BV) = white/grey, watery, offensive odour
7. Malignancy = bloody, watery, offensive odour
8. Foreign body = grey or bloody, purulent, offensive odour
9. Atrophic vaginitis = clear/blood-stained, watery, no odour
10. Cervical ectropion = clear, watery, no-odour