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Gynaecology > Vaginal infections > Flashcards

Vaginal infections Flashcards

1
Q

What are the causes of vaginal discharge? give the types of discharge they can cause

A
  1. Physiological - pregnancy, sexual arousal, puberty, COCP
  2. Infection - itchy and smelly
  3. Foreign body
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2
Q

What is the 2nd commonest cause of discharge?

A

Thrush

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3
Q

What is the organism causing thrush

A

95% Candida albicans

5% Candida glabrata

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4
Q

What are the sx of thrush

A

→ Sore, red, fissured vagina

→ White curd discharge

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5
Q

What are the RF of thrush

A 
−	Pregnancy 
−	Contraceptives
−	Steroids
−	Immunodeficiency’s
−	Diabetes
−	Abx
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6
Q

What are the Ix for thrush

A

microscopy and culture

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7
Q

What is Rx of thrush

A

topical treatment clotrimazole

Fluconazole single dose

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8
Q

What is the cause of trichomoniasis?

A

Trichomonas vaginalis

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9
Q

What are the sx of trichomoniasis?

A

vaginitis and a bubbly, thin, fish-smelling appearance. Strawberry appearance of the cervix

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10
Q

What are the ix for trichomoniasis?

A
  • Exclude gonorrhoea

* Motile flagellates are seen on wet films or cultured

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11
Q

What is the treatment of trichomoniasis?

A

metronidazole

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12
Q

What are the sx of bacterial vaginosis?

A

Fishy, thin, grey/white discharge

Vagina not inflamed or itchy

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13
Q

What is the cause of BV?

A

overgrowth of bacterial flora e.g. of ‘Gardnerella vaginalis’ and too few lactobacillae

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14
Q

What is seen on wet microscopy in BV?

A

clue cells

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15
Q

What are complications of BV

A
  • Increased risk of preterm labour
  • Intra-amniotic infection in pregnancy
  • Susceptibility to HIV
  • Post-termination sepsis
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16
Q

how is a diagnosis of BV made/

A

culture

17
Q

What is treatment of BV

A

metronidazole or clindamycin

18
Q

What are the causes of discharge in children?

A

→ Infection from faecal flora
→ Staphs and streps causing pus
→ Threadworms - also cause pruritus
→ Rectal foreign body

19
Q

What are the ix for discharge in children?

A

vulval/vaginal swab

MSU (look for glycosuria)

20
Q

What is the treatment of discharge in children?

A

erythromycin

oestrogen cream

21
Q

What is the most common bacterial STI in the UK?

A

Chlamydia

22
Q

What % of women are asymptomatic w chlamydia?

A

70

23
Q

What are the sx of chlamydia?

A
  • Dysuria
  • Vaginal discharge
  • IMB/PCB
24
Q

What are the complications of chlamydia?

A 
→	PID
→	Perihepatitis
→	Reiter’s syndrome - arthritis, conjunctivitis and urethritis
→	Tubal infertility 
→	 risk of ectopic pregnancy
25
Q

How is the diagnosis of chlamydia made?

A

vulvo-vaginal or endocervical swab for nucleic acid amplification test (NAAT)
Self-swabs

26
Q

What is the treatment of chlamydia in non-pregnant women?

A

azithromycin single dose OR doxycycline BD for 7 days

Abstain from sex until both partners treated

27
Q

What is the treatment of chlamydia in pregnant women?

A

erythromycin BD for 10-14 days

28
Q

what are the risks of having chlamydia during pregnancy?

A

preterm ROM
prematurity
neonatal conjunctivitis and pneumonia

29
Q

What is the causative organism of gonorrhoea?

A

Neisseria gonorrhoeae - gram -ve diplococcus

30
Q

What are sx of gonorrhoea in women

A 
Increased or altered vaginal discharge
Lower abdo pain 
Dysuria
IMB
Dyspareunia
31
Q

What are the sx of gonorrhoea in men?

A

Purulent urethral discharge
Dysuria
Anal discharge

32
Q

What are the complications of gonorrhoea in men?

A

prostatitis
epididymitis
orchitis

33
Q

What are the complications of gonorrhoea in women?

A
  • PID
  • Bartholin’s or skene’s abscess
  • Tubal infertility
  • risk of ectopic pregnancy
  • Can become disseminated in which there is: fever, pustular rash, migratory polyarthralgia and septic arthritis
34
Q

How is a diagnosis of gonorrhoea made?

A

vulvovaginal/endocervical swab for NAAT using special medium
May need urethral, pharyngeal and rectal swabs

35
Q

What is the rx of gonorrhoea?

A

ceftriaxone IM stat and azithromycin PO stat

36
Q

What is rx of gonorrhoea in penicillin allergic women?

A

spectinomycin IM in place of ceftriaxone

Gynaecology (34 decks)

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