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3a sexual health > Vaginal Infections > Flashcards

Vaginal Infections Flashcards

1
Q

What is the most common STI in the developing world?

A

chlamydia

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2
Q

What organism causes thrush?

A

thrush = candidiasis

candida albicans - yeast like fungus

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3
Q

What are the risk factors for candidiasis (thrush)?

A

pregnancy
diabetes
antibiotic use
immunosuppression

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4
Q

How is thrush presented?

A

“cottage cheese” discharge
vulval irritation
itching
superficial dyspareunia

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5
Q

How is candidiasis diagnosed?

A

clinical diagnosis *

microscopic detection of mycelia spores on wet slides

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6
Q

How is thrush treated?

A

1st line = topical imidazole (canestan), clotrimazole pessary
2nd line= oral fluconazole (contraindicated in pregnancy)

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7
Q

Which organism causes chlamydia?

A

chlamydia trachomatis= small bacterium

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8
Q

What organism causes gonorrhoea?

A

neisseria gonorrhoea = gram -ve diplococcus

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9
Q

What are the risk factors for chlamydia and gonorrhoea?

A

sexually transmitted so previous STI, multiple partners, early sexual experience

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10
Q

How does chlamydia present?

A

asymptomatic in 70% females
dysuria
irregular bleeding
vaginal discharge

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11
Q

How does gonorrhoea present?

A 
asymptomatic
vaginal discharge 
urethritis 
cervicitis 
bartholinitis
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12
Q

What are the possible complications of chlamydia?

A 
pelvic inflammatory disease
Reiters syndrome 
infertility 
risk of ectopic pregnancy 
epididymitis
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13
Q

What are the possible complications of gonorrhoea?

A 
pelvic inflammatory disease
tubal infertility 
risk of ectopic pregnancy 
Bartholins abscess 
disseminated gonorrhoea - fever, pustular rash, septic arthritis
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14
Q

How is chlamydia and gonorrhoea diagnosed?

A

Nucleic Acid Amplification Test (NAAT) on 1st void urine

incubation period of 2 weeks

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15
Q

How is chlamydia treated?

A

azithromycin bd for 7 days

partner notification!

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16
Q

How is gonorrhoea treated?

A

IM ceftriaxzone

partner notification!

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17
Q

Which organism causes trichomoniasis?

A

trichomonas vaginalis = flagellate protozoa

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18
Q

How does trichomoniasis present?

A 
grey-green frothy discharge 
strawberry cervix
irritation 
dysuria 
ph>4.5
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19
Q

How is trichomoniasis diagnosed?

A

wet film microscopy

culture of vaginal swabs

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20
Q

How is trichomoniasis treated?

A

metronidazole oral

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21
Q

How does a herpes simplex virus present?

A

primary infection = most severe, acute
can have recurrent attacks from reactivation of latent virus

  1. prodrome - itching
  2. flu like illness
  3. vulvitis and pain
  4. small vesicles on vulva
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22
Q

What are some of the triggers that could cause a reactivation of the herpes simplex virus?

A

stress, sex, menstruation

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23
Q

how is herpes simplex virus diagnosed?

A

PCR testing on vesicular fluid

24
Q

How is herpes simplex virus managed?

A
  1. no cure
  2. symptomatic relief - analgesia, saline bathing
  3. oral acyclovir
  4. condoms when infected as contagious
25
Q

Which symptoms are HSV 1 or 2 associated with?

A

HSV 1= lesions around mouth and lips

HSV 2= genital lesions

26
Q

What are the symptoms for bacterial vaginosis?

A

white fishy smelling discharge

27
Q

How is bacterial vaginosis diagnosed?

A

USING AMSTELS CRITERIA (3/4):

  1. white thin layer
  2. positive whiff test
  3. ph >4.5
  4. CLUE cells
28
Q

How is bacterial vaginosis treated?

A

oral metronidazole 5-7 days

29
Q

How long is the incubation period for gonorrhoea/chlamydia?

A

2 weeks

if present before, may need to re-test

30
Q

What should you NOT do with metronidazole?

A

drink alcohol!

31
Q

List the complications of herpes simplex virus

A

meningitis
sacral radiculopathy
transverse myelitis
disseminated infection

32
Q

What are the risk factors for genital warts?

A

multiple partners

smoking

33
Q

Which virus causes genital warts?

A

Human papillomavirus (type 6 and 11 especially)

34
Q

How do genital warts present?

A

growth/lesions
painless
itchy
dyspareunia

35
Q

How is genital warts managed?

A
  1. podophyllotoxin cream

2. cryotherapy

36
Q

List the risk factors for bacterial vaginosis

A

sexually active
IUCD
new partner

37
Q

How is bacterial vaginosis diagnosed?

A

high vaginal swabs

38
Q

What causes bacterial vaginosis?

A

anaerobes over growing in normal vaginal flora

NOT A STI

39
Q

List the risk factors for syphilis

A

multiple partners
MSM
HIV
unprotected sex

40
Q

Which organism causes syphilis?

A

spirochaete treponema pallidum

41
Q

Describe the primary infection of syphilis

A

in first few days- weeks

  1. chancre = painless ulcer at site of sexual contact
  2. local non tender lymphadenopathy
42
Q

Describe the secondary infection of syphilis

A

in 6-10 week

  1. systemic symptoms e.g. fever
  2. rash on trunk, palms and soles
  3. buccal snail track ulcers
  4. condulomata lata
43
Q

Describe the tertiary infection of syphilis

A

years after

  1. neurosyphilis
  2. gumma= granulomatous lesions of skin and bone
  3. argyll robertson pupil
  4. ascending aortic aneurysm
44
Q

How is syphilis diagnosed?

A

serology blood test

45
Q

How is syphilis treated?

A

IM benzylpenicillin

46
Q

Describe the adverse reaction you can get after treatment for syphilis

A

Jarish Herxheimer reaction!
seen after 1st dose
causes fever, rash, tachycardia

47
Q

List the risk factors for acquiring HIV

A

sexual transmission - vaginal secretions, semen or blood
needs sharing
infected blood products
needle stick injuries e.g. health care
mother to child e.g. birth, breastfeeding

48
Q

Describe how HIV initially present?

A

presents similar to glandular fever 3-12 weeks after infection…

malaise
lymphadenopathy 
sore throat
myalgia 
diarrhoea
mouth ulcers
maculopapular rash
49
Q

Outline the possible complications of HIV

A 
oral thrush
shingles
Kaposi sarcoma
HIV dementia
PML
aspergillosis 
oesophageal candiasis
50
Q

What is the management of HIV?

A

HAART
2 x NRTI e.g. zidovudine PLUS
1 x protease inhibitor OR 1 x non NRTI

51
Q

List the tests done in an asymptomatic screen in the GUM clinic

A
  1. first void urine NAAT for chlamydia and gonorrhoea
  2. HIV and syphilis blood tests

+ Hep B/C serology if high risk

52
Q

Who is at high risk of hepatitis B/C?

A

sex workers
IVDU
high risk areas
MSM

53
Q

Which tests are done for a symptomatic screen in GUM clinic?

A
  1. high vaginal swabs
  2. urethral swabs
  3. pharyngeal/ rectal swabs (depending on exposure)
  4. urinalysis
54
Q

Describe the primary, secondary and tertiary prevention regarding sexual health

A

PRIMARY PREVENTION
education, awareness, free condoms, Hep B vaccination

SECONDARY PREVENTION
targeted screening, partner notification/ contact tracing

TERTIARY PREVENTION
treat the disease!

55
Q

Why do we treat GUM?

A
  1. get rid of symptoms
  2. control spread of disease
  3. prevent long term complications e.g. PID, sub fertility, neurosyphilis

3a sexual health (3 decks)

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