W02: STIs; Genetic Conditions in Pregnancy Flashcards
Describe presenting symptoms and signs of common sexually transmitted infections in the UK
- discharge
- pain
- rashes
- lumps and swellings
- cutes, sores, ulceration
- itching
- change in appearance
- feeling abn.
- systemic symptoms
Describe how STIs are diagnosed and managed, including follow-up
- Nucleic Acid Amplification Tests
- Enzyme immunoassays for chlamydia
Describe the potential sequelae if STI are left untreated
- syndromes
- psychological distress
- infertility; cancer; adverse pregnancy outcomes
Pelvic inflammatory disease with associated ectopic pregnancy and infertility leads the list. Male infertility as a result of sexually transmitted diseases appears uncommon
List the differential diagnosis of people presenting with genital symptoms
uti
prolapse
atrophic vaginistis
incontinence: sx, stress, urge
cystisis
BPH
stricture
stones
obstruction
Outline sexual history taking and how common sexual problems may present
- effective hx taking: +gynae hx
- direct qs regarding symptoms
- partner notification
- HIV testing
- health promotion
- detecting high-risk behaviour and advise risk reduction
Describe some anatomic variants and how to distinguish them from STDs
- pathology to anatomy: cysts, torn frenulum + infection
- commensal overgrowth, dysbiosis, acidity etc.
Vulvovaginal candidosis
Microbial condition not STD/STI - trivial; candida albicans; acquired from bowel; asymptomatic
symptomatic =>thrush: itch, + discharge
* DM, steroid use, imm suppr.
> Clotrimazole
Fluconazole
Bacterial vaginosis: commonest pres, complications, dx, mgmt
*commonest causee of abn vaginal discharge; 50/50 symptom/asympt.
- thin homogenous grey/yellow fishy discharge
- maybe worse after period/sex
- biofilm problem
=> endometritis, premature labour, ⇧risk of HIV acquisition
Dx: clinical, gram stain
> Metronidazole
Clindamycin
Probiotics
Vaginal acidification
Aetiology of BV
Lactobacilli dysbiosis = ⇩H2O2 prod
&
Bacterioa overgrowth = BV associated
&
Raised pH
Balanitis & Posthitis
candidal balanitis
- zoon’s balanitis aka plasma cell balanitis
- chronic inflamm 2º to overgrowth of commensal organisms
- impetigo
- s. aureus or strep pyogenes
Causes of genital symptoms
- pain syndromes
Causes of genital symptoms
- pain syndromes: -dynias
- vestibulodynia
- vulvodynia
- chronic pelvic pain syndrome
- dermatoses
- congenital
- traumatic
- neoplastic
- systemic disease
Causes of genital symptoms
- pain syndromes
R0=BcD
equation looking at reproductive number = avg number of infections produced
B = likelihood of transmission per encounter
c = rate of acquiring new partners
D = duration of infectivity
- If R0 >1 then epidemic is sustained
If R0 <1 then epidemic reduces
Assortative mixing
Some people have sex with people like them (similar lifestyle – eg IDU, same ethnicity)
leads to high prevalence within a subpopulation (core) but limited spread through the wider community.