D&M Genito Infections

Question 1

UTI diagnosis, women under 65 - 7

Answer 1

1. Discomfort, pain or stinging during urination
2. Waking at night one or more times to pass urine.
3. Urine appears cloudy to the naked eye
4. Passing urine more often than usual.
5. Urgency — strong desire to empty bladder
6. Pain or tenderness
7. Visible blood in the urine

Question 2

UTI Referral symptoms – 10

Answer 2

1. Severity – consider cloudiness, smell, systemic symptoms, pain, age
2. Duration & recurrent cases
3. Abnormal vaginal discharge or other signs of an STI
4. Red flagssuch as haematuria, loin pain, rigors, nausea, vomiting, and altered mental state — consider the possibility of serious illness such as sepsis (vital signs temperature, blood pressure, heart rate and respiratory rate)
5. Under 12 or >65
6. Diabetic
7. Immuno-compromised patients
8. Men
9. Pregnancy
10. Indwelling catheter
11. First case referral

Question 3

UTI Advice - 6

Answer 3

1. Drink plenty of water, avoid alcohol
2. Avoid intercourse till symptoms resolve
3. Avoid perfumed cosmetics/bubble bath etc
4. Avoid ignoring call to urinate
5. Hygiene
6. Cotton underwear and avoid tight fitting clothes

Question 4

Vaginal Candidiasis Referral symptoms – 8

Answer 4

1. First case
2. Diabetes (hyperglycaemia enhances production of protein receptors on C albicans)
3. Discharge with abnormal smell/consistency/colour
4. OTC Medicine line failure
5. Recurrent cases (many possible causes)
6. Women under 16 & over 60
7. STIs
8. Men (Balanitis is only fungal)

Question 5

Vaginal Candidiasis Advice – 4

Answer 5

1. Probiotic yoghurt can be effective, either topically or orally
2. Avoid tight clothing, perfumed soaps
3. Treat partner if appropriate (Balanitis or asymptomatic with recurrent cases for ♀)
4. Avoid douching

Question 6

Vaginal Candidiasis Treatment - 4

Answer 6

1. Triazole (Fluconazole) oral capsule 150mg. Can disturb GI, possible Drug-drug interactions. Maybe combined with an external cream.
2. Treatment OTC should not be used in pregnancy or possibly pregnant
   Various cream/cream & pessary cream combination products
3. Imidazole (clotrimazole) products e.g. Pessaries – for internal symptoms. 500mg pessary as a stat dose
4. Creams:
   2% cream – for external symptoms – apply 2-3 x daily for up to 7 days
   10% cream – internal symptoms – insert a stat dose via applicator

Question 7

Vaginal candidasis

Answer 7

White discharge
Pain during sex
Itching
Soreness & stinging
Red cracked or damaged skin