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3- Reproduction > Genitourinary > Flashcards

Genitourinary Flashcards

(48 cards)

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1
Q

Bacterial vaginosis

A

overgrowth of bacteria in the vagina, specifically anaerobic bacteria

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2
Q

BV anaerobic bacteria

A

Gardenella vaginali (most common)
Mycoplasma hominid
prevotella

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3
Q

BV presentation

A

fishy-smelling watery grey discharge

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4
Q

BV investigations

A

vaginal pH
- BV occurs with pH >4.5

Standard charcoal vaginal swab
-‘clue cells’ on microscopy

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5
Q

BV management

A

metronidazole

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6
Q

candidiasis

A

thrush

vaginal infection with yeast of candida family

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7
Q

candidiasis presentation

A

thick, white discharge

Vulval and vaginal itching, irritation or discomfort

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8
Q

Candidiasis management

A

Antifungal medications

  • clotrimazole (cream or pessary)
  • fluconazole (tablets)
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9
Q

Chlamydia aetiology

A

chlamydia trachomatis: gram-negative bacteria

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10
Q

Chlamydia screening swabs

A

Charcoal swab
- microscopy, culture and sensitivities

NAAT swabs
- check directly for DNA or RNA of organism

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11
Q

Chlamydia presentation

A

asymptomatic

women

  • abnormal vaginal discharge
  • pelvic pain
  • abnormal vaginal bleeding
  • painful sex
  • painful urination

men-urethral discharge/ discomfort

  • painful urination
  • epididymo-orchitis
  • reactive arthritis
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12
Q

Chlamydia exam findings

A

pelvic/ abdo tenderness
cervical motion tenderness
inflamed cervix
purulent discharge

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13
Q

chlamydi management

A

doxycycline 100mg twice a day for 7 days
(contraindicated in pregnancy and breastfeeding)

Alternative: Azithromycin

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14
Q

genital herpes

A

HSV type 1 and 2

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15
Q

HSV-1

A

associated with cold sores

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16
Q

HSV-2

A

associated with genital herpes

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17
Q

Management of genital herpers

A

Aciclovir

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18
Q

Pregnancy and genital herpes management

A

Primary contract before 28 weeks

  • acyclovir
  • regular prophylactic from 36 weeks
  • Asymptomatic: vaginal delivery
  • Symptoms: Caesarean section

primary contract after 28 weeks

  • acyclovir
  • immediate regular prophylactic acyclovir
  • recommend c-section

recurrent

  • low risk of neonatal infection
  • regular prophylactic acyclovir from 36 weeks
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19
Q

gonorrhoea aetiology

A

gram-negative diplococcus bacterium

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20
Q

gonorrhoea presentation

Study These Flashcards
A

Female

  • odourless purulent discharge
  • dysuria
  • pelvic pain

Male

  • odourless purulent discharge
  • dysuria
  • testicular pain/ swelling
21
Q

Gonorrhoea diagnosis

Study These Flashcards
A

NAAT

Genital infection

  • swabs
  • first catch urine sample in males

Standard charcoal Endocervical swab
- for antibiotic sensitivities

22
Q

gonorrhoea management

Study These Flashcards
A 
IM ceftriaxone  (sensitivities not known) 
Oral ciprofloxacin (known senitivities)

Follow up: Test of cure

23
Q

AIDS-Defining illness

Study These Flashcards
A

Occur where CD4 count has dropped to a level that allows for unusual opportunistic infection & malignancies

Kaposi's sacroma 
Pneumocystis Jirovecii Pneumonia 
Cytomegalovirus infection 
Candidiasis 
Lymphomas 
TB
24
Q

Monitoring HIV

Study These Flashcards
A

CD4 count

Virl lod

25
HIV treatment
Combination of antiretroviral therapy yearly cervical smears for women with HIV Vaccinations - avoid live vaccines - influenza, pneumococcal, hep A&B, tetanus, diphtheria, polio
26
HIV and pregnancy / breastfeeding
Mother's viral load will determine mode of delivery breastfeeding: Not recommended. HIV can be transmitted during breastfeeding, even if mother' viral load undetectable
27
mycoplasma genitalium
Bacteria that causes non-gonococcal urethritis
28
mycoplasma genitalium investigations
often asymptomatic. Urethritis key feature NAT - first urine sample men - vaginal swabs
29
mycoplasma genitalium management
Doxycycline followed by azithromycin Pregnancy & breastfeeding; Azithromycin alone
30
pelvic inflammatory disease
Inflammation and infection of the organs of the pelvis, caused by infection spreading up and through the cervix. Significant cause of tubular infertility and chronic pelvic pain
31
PID aetiology
Neisseria gonorrrhoea Chlamydia trachomatis Mycoplasma genitalium + less common by non-STIs - gardenella vaginalis - h.influenzae - e.coli
32
PID risk factors
``` no barrier contraception multiple sexual partners younger age existing STI Previous PID IUD ```
33
Presentation of PID
``` Pelvic or lower abdo pain Abnormal vaginal discharge Abnormal bleeding Pain during sex Fever Dysuria ```
34
PID exam findings
``` pelvic tenderness cervical motion tenderness inflamed cervix prulent discharge Possible fever ```
35
PID investigations
NAAT swabs: chlamydia & gonorrhoea NAAT: mycoplasma genitalium if available HIV test Syphilis test. Raised inflammatory markers (CRP & ESR)
36
PID management
Antibiotic regime IM ceftriaxone Doxycycline 100mg 2x day for 14 days metronidazole 400mg 2x daily for 14 days
37
Fitz-Hugh-Curtis Syndrome
Complication of PID Inflammation and infection of liver capsule, leading to adhesions between liver and peritoneum. RUQ pain - possibly referred to right shoulder tip if diaphragmatic irritation
38
Syphilis
bacteria: treponema pallidum (spirochete bacteria) Incubation period: 21 dys
39
Syphilis stages
``` primary Secondary latent tertiary neuro ```
40
Presentation of syphilis
Primary - painless genital ulcer - local lymphadenopathy Secondary - maculopapular rash - Condylomata lata (grey wart-like lesions) - Low-grade fever - lymphadenopathy - alopecia - oral lesions Tertiary - gummatous lesions - aortic aneurysm - neurosyphilis Neuroyphilis - headache - aletered behaviour - dementia - tabes dorsalis - ocular syphilis - paralysis - sensory impairment
41
Argyll-Robertson pupil
Specific finding in neurosyphilis Constricted pupil accommodates when focusing on a near object but does not react to light Often irregularly shaped
42
Syphilis diagnosis
Antibody test COnfirm presence of T.pallidum - dark field microscopy - PCR
43
Syphilis management
IM benzathine benzylpenicillin
44
trichomoniasis
trichomonad vaginalis- parasite | protozoan. Single-celled organism with flagella
45
Trichominiasis cervix exam
Strawberry cervix | - inflammation. tiny haemorrhages across surface of cervix
46
trichomoniasis presentation
``` asymptomatic vaginal discharge;frother & yellow-green itching dysuria dyspareunia balanitis ```
47
diagnosis of trichomoniasis
standard charcoal swab with microscopy - posterior fornix of vagina - urethral swab or first-catch urine in men
48
Trichomoniasis management
metronidazole

3- Reproduction (15 decks)

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