Genitourinary Medicine Flashcards
(76 cards)
What is bacterial vaginosis?
= bacterial imbalance of the vagina caused by overgrowth of anaerobic bacteria
(such as Gardnerella vaginalis)
Most common cause of abnormal vaginal discharge in women of childbearing age?
= bacterial vaginosis
What is the Amsel criteria used for?
= used to diagnose bacterial vaginosis
What features are involved in the Amsel criteria for BV?
- vaginal pH > 4.5
- homogenous grey or milky discharge
- positive whiff test (additional of 10% potassium hydroxide produces a fishy odour)
- clue cells present on wet mount
(3 out of the 4 features are needed to confer a diagnosis)
In what condition may clue cells be present on wet mount?
= bacterial vaginitis
Treatment of choice for bacterial vaginitis (2)
= Metronidazole or Clindamycin
What is chancroid?
= sexually transmitted infection (STI) of the genital skin primarily caused by the gram-negative bacillus Haemophilus ducreyi
infection typically manifests as a painful, potentially necrotic genital lesion. Commonly associated symptoms include painful lymphadenopathy and bleeding on contact
Patient presents with painful genital lesion which bleeds on contact. They have painful lymphadenopathy and have just come back from Greenland.
What is the diagnosis which comes to mind?
= Chancroid
Chancroid is usually diagnosed based on a clinical picture. However, what investigations can be used to help confirm diagnosis? (2)
- culture
- PCR (faster)
Treatment of chancroid?
= managed using antibiotics:
- Ceftriaxone
- Azithromycin
- Ciprofloxacin
What is Chlamydia caused by?
= Chlamydia trachomatis
(an obligate intracellular bacterium)
What are the risks to neonates if they are exposed to chlamydia during delivery? (2)
= can develop pneumonia or conjunctivitis
How is chlamydia tested for?
= nucleic acid amplification tests (NAATs) - swabs taken
Pharmacological treatment for chlamydia
(including dosage)
= orał doxycycline 100mg twice daily for 7 days
What inflammatory joint condition is a known chlamydia complication?
= reactive arthritis
What is AIDS?
(CD4 count less than?)
= terminal stage of HIV infection where combination antiretroviral therapy (cART) has not halted the spread of the virus
It is defined by presence of an AIDS-defining illness alongside a CD4 count of less than 200 cells/mm3
Causative agent of AIDs?
= HIV
How is HIV transmitted? (4)
- unprotected sexual contact
- sharing of infected needles
- mother-to-child transmission during birth or breastfeeding
- exposure to infected blood products
How are we able to determine the progression of AIDs in a patient?
= CD4 cell count
What are the different ways combined hormonal contraception (CHC) can be administered? (3)
- orally, pill form
- transdermally, via patch
- intravaginally, through use of vaginal ring
How does combined hormonal contraception function? (3)
- thickening cervical mucous, obstructing sperm
- thinning of endometrium, making transplantation difficult
- inhibits ovulation
What is the difference in hormone dosages with the 3 different types of oral combined contraceptive pills?
- monophasic
- phasic
- everyday pills
Monophasic: each pill has same dose of hormones
Phasic: pills contain different amounts of hormone and must be taken in correct order
Everyday pills: usually contain 21 hormone-containing pills, and 7 hormone-free pills
When starting on combined hormonal contraception, when will a patient be protected from day 1?
= if patient starts the pill on 1st day of natural period
For how long must a women use additional precautions when starting combined hormonal contraception, if unsure where abouts in her cycle she is?
= for 7 days
