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Repro > Genital Disorders (Non-STI) > Flashcards

Genital Disorders (Non-STI) Flashcards

1
Q

Genital symptoms can be largely split into three categories:

A
  • STIs - Non-STI MIcrobial problems - Non-microbial problems
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2
Q

What are the major Microbial problems (not STIs)

A

Vulvovaginal Candidiasis Bacterial Vaginosis Balanoposthitis Tinea Cruris Erythrasma Other things that affect skin elsewhere can also affect skin around the genitals e.g. Staph aureus impetigo or Cellulitis

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3
Q

What causes Candidiasis?

A

-90% of cases are Due to Candida Albicans -Candida GLABRATA also common

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4
Q

Its common to asymptomatically carry Candida albicans, whats it commonly called when it becomes symptomatic?

A

Thrush

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5
Q

How does a case of Vulvovaginal Candidiasis present?

A

With itching and a thick “cottage cheese” type discharge

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6
Q

Risk factors for candidiasis?

A

Diabetes

Oral Steroids

Immunosuppression

Pregnancy

Simply being in the reproductive age group

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7
Q

So how do we diagnose a case of Candidiasis?

A

-The classic h/o itching and cottage cheese discharge -Do an exam looking for fissuring, erythema with satellite lesions and discharge Can also gram stain and culture

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8
Q

How do we treat Vulvovaginal candidiasis?

A

With Azole antifungals: - Either Clotrimazole PV or -Fluconazole PO If they’re resistant do cultures and sensitivity tests Also avoid irritants and treat dermatitis to protect the skin

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9
Q

Bacterial Vaginosis is the other major microbial problem women face, how common is it?

A

The commonest cause of abnormal discharge. It affects anything from 10-40% of women at once

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10
Q

How does Bacterial Vaginosis present?

A

Watery Grey or yellow “fishy smelling” discharge Look for complaints of the smell worsening after sex May be soreness/itching but more due to dampness than directly the microbes

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11
Q

How do you diagnose Bacterial Vaginosis?

A

history Exam - Thin homogenous discharge (smell) Ph>4.5 Gram Staining

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12
Q

How do we treat bacterial vaginosis?

A

Antibiotics: Metronidazole (either oral or vaginal gel) Clindamycin (Vaginal) Probiotics Vaginal acidification

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13
Q

What is balanoposthitis?

A

Inflammation of the head of penis (Balantitis) and Shaft (Posthitis) Common forms are Candida infection and Plasma Cell Balantitis

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14
Q

What is Plasma Cell Balantitis?

A

Chronic inflammation of the head of the penis due to overgrowth of commensal microbes. Also leads to foreskin dysfunction

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15
Q

What microbial problem might be refer to as athletes groin?

A

Tinea Cruris, its the same dermatophyte as causes atheletes foot and is often related

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16
Q

How does Tinea Cruris look?

A

A red area that spreads out from the groin, often with a flaky edge.

17
Q

What is Erythrasma?

A

Simila to Tinea Cruris its a dark area spreading out from the groin. Caused by Corynebacterium Minutissimum

18
Q

List some none-microbial causes of genital symptoms?

A
  • Dermatoses - Structural Abnormalities e.g. a cyst - Pain syndromes - Trauma - Neoplastic - Systemic Diseases - Perceived problems
19
Q

What are some common traumatic injuries to the genitals?

A

Torn Frenulum or ruptured vessels in the penis

20
Q

What systemic diseases commonly affect the genitals?

A

Some autoimmune conditions can cause Lichen Sclerosis; Lichen Planus, itchy white patches on the skin around the genitals. In lichen sclerosis they commonly appear around the opening to the vagina, anus and penis and can obstruct the openings

21
Q

Many people present with a complaint but on history and exam they actually have no pathology, what might be the reason for this?

A
  • Regretted sexual encounters including assault - Other problems in life - Mental health including anxiety - Media story, family member or friend recently diagnosed
22
Q

How do we manage a perceived problem?

A

Acknowledge it, they must know your not dismissing them Properly test for anything they’re worried about e.g. HIV or cancer or they won’t stop worrying Provide a benign explanation where possible instead of just saying “its normal dwai”

23
Q

What are some benign things that can result in people coming to the doctor?

A
  • Fox-Fordyce spots - Vulval Papillomatosis - Coronal Papillae (pearly papules on the penis) - Tyson’s Glands
24
Q

What are Fox-Fordyce spots?

A

Visible sebaceous glands under the skin of the penis/scrotum They’re totally normal, its just cos the glands of that area are very big

25
Q

What are common symptoms of a Non-STI genital symptom

A

• Discharge from an orifice • Pain from somewhere • Rashes • Lumps and swellings • Cuts, sores, ulcers • Itching • Change in appearance • Vague sense of things not being right…

26
Q

How do bacterial vaginosis come about??

A

Misunderstood- due to an imbalance of bacteria rather than a specific bacteria. -Reduction of lactobacilli- reduction of H202 production -Overgrowth of BV associated bacteria -Raised Ph

27
Q

What are complications of BV?

A

•Associated with endometritis if uterine instrumentation / delivery •Associated with premature labour •Increases risk of HIV acquisition

28
Q

What is this?

A

Candida Balantitis

29
Q

What is this?

A

Zoon’s Balantis

30
Q

What are candida Balantitis and Zoon’s Balantis due to?

A

Commensal pathogens

In the case of Zoon’s balantis due to choronic inflammation and/or foreskin malfunction

31
Q

What can staph pyogens lead to

A

Impetigo

Erysipelas

32
Q

What can Dermatophyte infection lead to?

A

Tinea cruris

33
Q

What is erythrasma?

A

Bacterial skin rash in groin area which is similar to tinea cruris.

34
Q

Treatment of tinea cruris and erythrasma?

A

steroids + bacterial/fungal treatment

35
Q

What is this?

A

Erythrasma

36
Q

what is this?

A

Tinea cruris

37
Q
A
38
Q

What are some examples of pain syndromes?

A

-Vestibulodynia

Provoked introital tenderness

-Vulvodynia

Persistent burning or aching

-Chronic Pelvic Pain Syndrome

Sometimes labelled as prostatitis, but usually no ‘itis’.

Cause unclear buy muscular dysfunction implicated

Repro (40 decks)

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