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Year 4 Gynae > Genital discharge > Flashcards

Genital discharge Flashcards

(46 cards)

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1
Q

Questions to ask regarding genital discharge

A 
Consistency
Volume 
Colour 
Blood
Smell 
Duration 
Washing 
Abx use
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2
Q

Differentials for abnormal genital discharge

A 
Chlamydia 
Gonorrhoea 
Trichomoniasis 
Bacterial vaginosis 
Mycoplasma genitalium

Cervical ectropion
Cervical neoplasm
Post menopausal vagintis

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3
Q

Associated female symptoms

A 
Pelvic pain 
PCB 
IMB 
Itchiness 
Dyspareunia 
Rashes
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4
Q

Examination for female genital discharge

A

Inspect genitalia
Speculum
+/- Bimanual exam

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5
Q

When to do a bimanual exam

A

If there is lower abdominal pain or deep dyspareunia

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6
Q

Investigations for abnormal genital discharge

A

High vaginal swab - wet mount and garm stain for microscopy

Vulvovaginal swab - NAAT

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7
Q

What does a high vaginal swab detect

A

Trichomonas vaginalis
Gardenerella vaginalis
Candida

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8
Q

What does a vulvovaginal swab detect

A

Chlamydia trachomatis

Neisseria gonorrhoea

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9
Q

Candidiasis presenting complaint

A

Thick, white, cheese-like discharge

Itching and soreness

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10
Q

Candidiasis history

A 
Antibiotic use 
Washing 
Steroid use 
Chemotherapy 
HIV 
Pregnancy 
DM 
Atopy
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11
Q

Investigations for candidiasis

A

high vaginal swabs - microscopy and culture

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12
Q

Microscopy of candida albicans

A

Spores
Psuedohyphae
Neutrophils

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13
Q

Treatment of candida albicans

A

Fluconazole orally stat

+ clotrimazole cream BDS for 2 weeks

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14
Q

Contrainidcations for fluconazole

A

Pregnancy and breastfeeding

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15
Q

Treatment for recurrent candida albicans

A

Fluconazole every 72 hours for 3 doses

then

Fluconazole once per week for 6 months

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16
Q

Advice for candidiasis

A

Good diabetes control
Avoid perfumed products
Do not over wash
May swap to POP

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17
Q

Bacterial vaginosis presenting complaint

A

Copious discharge
Fishy odour
White

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18
Q

Amsel criteria for bacterial vaginosis

A
  1. Discharge
  2. Clue cells on wet mount
  3. Raised pH
  4. KOH whiff test +ve
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19
Q

Microscopy for Gardenerella vaginalis

Study These Flashcards
A

Gram positive cocci

20
Q

Hay Ison criteria for bacterial vaginalis

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A

Gram stain of posterior fornix

21
Q

Bacterial vaginalis history

Study These Flashcards
A 
Antibiotic use 
Washing 
Steroid use 
Chemotherapy 
HIV 
Pregnancy
22
Q

Treatment of bacterial vaginalis

Study These Flashcards
A

Metronidazole BDS 5 days

23
Q

Bacterial vaginalis

Study These Flashcards
A

Treat even if asymptomatic

Avoid high dose metronidazole

24
Q

Trichomonas vaginalis presenting complaint in females

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A

Frothy discharge
Dysuria
Vulval soreness
Itching

25
Sign of trichomoniasis
Strawberry cervix
26
Trichomonas vaginalis presenting complaint in males
Non-specific urethritis
27
Complications of trichomoniasis
Pre term Low birth weight Enhanced HIV transmission
28
Investigations for trichomoniasis
High vaginal swab - wet mount, gram stain microscopy and culture Speculum NAAT from first void urine sample
29
Treatment of trichomoniasis
Metronidazole BD 5 - 7 days - first line | Metronidazole 2g PO stat - 2nd line
30
Associated male symptoms
``` Testicular pain Anal pain Swellings Lumps Dysuria Urinary symptoms ```
31
What does polymorphonuclear leucocytes indicate
Urethritis
32
How to treat non-specific urethritis
Doxycycline bds oral - 7 days
33
Non specific urethritis
Inflammation of the urethra that is not due to chlamydia or Neisseria gonorrhoea
34
Presenting complaint for chlamydia
``` Urethritis - dysuria Cervicitis - clear, thin discharge PMB IMB Lower abdominal pain ```
35
Complications of chlamydia
``` PID Epididymo - orchitis SARA - arthritis Tubal infertility Increased risk of ectopics ```
36
Extra-genital symptoms of chlamydia
Conjunctivitis Pharyngitis SARA Proctitis
37
Treatment for chlamydia
Doxycycline PO BDS 7 days Azithromycin if allergic
38
Contraindications of doxycycline
Pregnancy
39
When to retest for chlamydia
12 weeks
40
Neisseria gonorrhoea on microscopy
Gram negative diplococci
41
Presenting complaint of gonorrhoea
Purulent discharge | IMB or PCB
42
Complications of gonorrhoea
PID epididymo-orchitis Proctitis
43
Disseminated gonorrhoea
Rash Joint pain Erythema
44
Investigations for gonorrhoea
Vulvovaginal swab - gram stain and microscopy and culture and sensitivity First void urine - NAAT
45
Treatment for gonorrhoea
Ceftriaxone IM single dose
46
Mycoplasma genitalium treatment
1 week doxycycline + 3 days azithromycin

Year 4 Gynae (35 decks)

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