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Reproductive System Brian > Genital Symptoms > Flashcards

Genital Symptoms Flashcards

1
Q

What are examples of genital symptoms?

A
  • Discharge from an orifice
  • Pain
  • Rashes
  • Lumps and swellings
  • Cuts, sores, ulcers
  • Itching
  • Change in appearance
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2
Q

What are the different categories of causes for genital symptoms?

A
  • STD
  • Other microbial problem not regarded as STD
  • Non-microbial
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3
Q

What are some examples of microbial infections not regarded as STIs in the UK?

A
  • Vulvovaginal candidosis
  • Bacterial vaginosis
  • Balanoposthitis – anaerobic/candida
  • Impetigo
  • Erisipelas
  • Dermatophyte infections
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4
Q

What is the aetiology of vulvovaginal candidosis?

A
  • 70% candida albicans
  • 30% other species such as C. Glabrate
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5
Q

What are risk factors for vulvovaginal candidosis?

A
  • Diabetes
  • Oral steroids
  • Immune suppression
  • Pregnancy
  • Reproductive age group
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6
Q

Describe the epidemiology of vulvovaginal candidosis (common/rare)?

A

Very common

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7
Q

What is the presentation of vulvovaginal candidosis?

A
  • Often asymptomatic
  • If symptomatic
    • Thrush
      • Itch
      • Discharge – classically thick, ‘cottage cheese’
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8
Q

What is the discharge due to vulvovaginal candidosis usually decribed as?

A
  • Discharge – classically thick, ‘cottage cheese’
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9
Q

How is vulvovaginal candidosis diagnosed (including investigations)?

A
  • Characteristic history
  • Vaginal pH
  • Examination findings
    • Fissuring
    • Erythema with satellite lesions
    • Characteristic discharge
  • Investigations
    • Gram stained
      • Low sensitivity
    • Culture
      • Higher sensitivity, low specificity
    • PCR
      • Highest sensitivity, lowest specificity
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10
Q

What are some possible examination findings for vulvovaginal candidosis?

A
  • Fissuring
  • Erythema with satellite lesions
  • Characteristic discharge
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11
Q

Which of gram staining, culture and PCR has greatest sensitivity and specificity?

A
  • Gram stained
    • Low sensitivity
  • Culture
    • Higher sensitivity, low specificity
  • PCR
    • Highest sensitivity, lowest specificity
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12
Q

What is the treatment for vulvovaginal candidosis?

A
  • Often does not require any
  • Azole antifungals
    • Clotrimazole 500mg PV once
    • Fluconazole 150mg PO once
  • If resistant case
    • Determine species and sensitivities and treat accordingly
  • Other management
    • Maintain skin – avoid irritants, treat dermatitis
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13
Q

What does BV stand for?

A

Bacterial vaginosis

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14
Q

What is the aetiology of bacterial vaginosis?

A
  • Increased gardnerella vaginalis, enterococcus faecalis and actinomyces neuii
  • Reduced lactobacalli
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15
Q

Describe the epidemiology of bacterial vaginosis (common/rare)?

A
  • Commonest cause of vaginal discharge
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16
Q

Describe the pathophysiology of bacterial vaginosis?

A
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17
Q

What is the presentation of bacterial vaginosis?

A
  • Asymptomatic in 50%
  • Watery grey/yellow ‘fishy’ discharge
  • May be worse after period/sex
  • Sometimes sore/itch from dampness
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18
Q

Describe the diagnosis of bacterial vaginosis?

A
  • Characteristic history
  • Examination findings
    • Thin, homogeneous discharge
  • Investigations
    • pH
    • Gram stained smear of vaginal discharge
19
Q

What are possible complications of bacterial vaginosis?

A
  • Associated with endometritis if uterine instrumentation/delivery
  • Associated with premature labour
  • Increases risk of HIV acquisition
20
Q

What is the treatment of bacterial vaginosis?

A
  • Antibiotics
    • Metronidazole
    • Clindamycin
  • Probiotics
  • Vaginal acidification
21
Q

What is balanitis?

A

Balanitis = inflammation of the head of the penis

22
Q

What is postitis?

A

Postitis = inflammation of the foreskin

23
Q

What is the aetiology of balanitis and posthitis?

A
  • Usually candida lanitis
24
Q

What is impetigo?

A

Is a common and highly contagious skin infection

25
Q

What is the aetiology of impetigo?

A
  • Usually staph aureus or strep pyogenes
26
Q

What is erysipelas?

A

Superficial form of cellulitis

27
Q

What is the aetiology of erysipelas?

A
  • Usually strep pyogenes
28
Q

What are examples of yeast (dermatophyte) infections?

A
  • Trichophyton rubrum
    • Known as athletes penis
    • Treated with antifungal
  • Tinea cruris
    • Known as athletes groin
  • Erythrasma
29
Q

What is trichophyton rubrum known as?

A

Athletes penis

30
Q

What is tinea cruris known as?

A

Athletes groin

31
Q

What can non-microbial conditions that cause ‘genital symptoms’ be categorised into?

A
  • Perceived problems only (normal findings)
    • No clinical findings
    • Only findings are physiological
  • ‘Real problems’
    • Structural abnormalities
    • Dermatoses
32
Q

What are possible perceived problems?

A
  • Vaginal discharge
  • Urethral discharge
  • Dysuria
  • Genital/pelvic discomfort
  • Rashes
  • Skin lumps
  • Penis size, scrotum lumps, labial shape
33
Q

What are some examples of things that are normal but can be perceived as an STI?

A
  • Fox-Fordyce spots
  • Vulval papillomatosis
  • Coronal papillae
    • Also known as penile pearly papules
  • Tyson’s glands
34
Q

Describe the management approach to ‘perceived problems’?

A

Questions to understand why this is occurring:

  • Regretted sexual encounter
  • Problems in life
  • Mental health problems such as anxiety

Management approach:

  • Acknowledge their perception
  • Ask what they think is going on to rule out worries
  • Reassurance
    • Provide explanation of symptoms
  • Discuss limitations of medical approach
35
Q

What are some non-microbial causes of genital symptoms?

A
  • Pain syndromes
  • Dermatoses
  • Congenital
  • Traumatic/iatrogenic
  • Neoplastic
  • Neuromuscular
  • Manifestations of systemic disease
  • Idiopathic
36
Q

What are some different pain syndromes that can cause genital symptoms?

A
  • Vestibulodynia
    • Provoked introital tenderness
  • Vulvodynia
    • Persistent burning or aching
  • Chronic pelvic pain syndrome
    • Cause unclear but muscular dysfunction implicated
37
Q

What are some causes of non-microbial genital symptoms?

A

Pain syndromes

Lymphocoele

Congenital cyst

Torn frenulum and ecchymosis

Lichen sclerosus

Lichen planux

Penile carcinoma

38
Q

What is lymphocoele?

A

Blocked lymph duct

39
Q

What is a congenital cyst?

A

Cyst forms in-utero

Can be left or removed

40
Q

What is the most common aetiology of torn frenulum and ecchymosis?

A

Torn during sex

41
Q

What is lichen sclerosus?

A

Autoimmune disease causing scarring and thinning of the skin

42
Q

What kind of condition is lichen planus?

A

Autoimmune condition

43
Q

What is penile carcinoma?

A

Cancer of the penis

Reproductive System Brian (34 decks)

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