Gynae Conditions Flashcards
(39 cards)
Young women presents with discharge and itchy vagina. She has type 1 diabetes and on examination there is a cottage cheese look on the labia. What is the likely diagnosis?
Candida albicans
How do you treat candida albicans of the vagina
Confirm with a high vaginal swab for culture
Then clotrimazole pessary or cream
If doesnt settle then oral fluconazole
Man presents with lots of pus of the urethra described as a greenish yellow, and also of the rectum. He has pain when peeing. Has occurred for the last 3 days. Mentions he had unprotected sex around a week ago now. What is the likely diagnosis? What investigation should be offered?
Neisseria gonorrhoea
PCR of first pass urine sample or swab of discharge but can only do after 14days since contact
What is the type of bacteria of neisseria gonorrhoea
Gram negative intracellular diplococci
What is the treatment for neisseria gonorrhoea?
Ceftriaxone 1g IM first line
Cefixime 400mg and azithromycin 2g IM 2nd line
Then NAAT test of cure
Do you need partner notification for neisseria gonorrhoea
YES
Anyone had sexual contact with in the last 2 weeks of symptoms
Women 22yrs presents with irregular bleeding, and lower abdominal pain and has noticed discharge in her underwear recently. She has been sleeping around. But her last partner was over 2 weeks ago and she’s been having these symptoms a few days now. What is the likely diagnosis?
Chlamydia
What is the treatment for chlamydia?
Doxycycline twice a day for 7 days
If allergic then erythromycin or ofloxacin
Do patients with chlamydia need partner notification?
Yes in last 2 weeks
What are some of the complications associated with chlaymydia infection?
Pelvic inflammatory disease
Tubal infertility
Reactive arthritis
Which serovars of chlamydia causes genital infection?
Serovars D-K
Which serovars of chlamydia causes lymphogranuloma venerum?
L1-L3
What is amsels criteria used to diagnose?
Bacterial vaginosis
What are the points of amsels criteria? What does 3/4 suggest?
Thin white homogenous discharge
Clue cells (outlined cells)
Vaginal PH >4.5
Positive whiff test (adding potassium hydroxide
Bacterial vaginosis
Who is most likely to get bacterial vaginosis?
Women who have sex with women
What is the treatment for bacterial vaginosis?
Not sexually transmitted but an overgrowth of anaerobic organisms like garnella vaginallis HENCE
Oral metronidazole 400mg for 5-7days cant drink alcohol during this time
Women presents with vaginal discharge, of a yellow/greenish colour appearing with bubbles. On examination there is vulvovaginitis, and a strawberry cervix. What is the likely diagnosis?
Trichomonas vaginalis
Does bacterial vaginosis require partner notificiation?
NO dont treat partners as no benefit
Does trichomonas vaginalis require partner notification?
No dont treat partners as procides no benefit
What is the treatment for trichomonas vaginosis?
Oral metronidazole for 5-7days
Caused by sexual contact a flagellated protozoan parasite
What is the incubation period for syphilis?
9-90 days with an average of 21days
what is the investigation for syphilis infection? Can only do after chancre healed
PCR with viral medium
VDRL and RPR are non specific antibodies that react to syphilis infection both become negative after treatment
TPHA is treponema specific antibody that remains positive even after treatment
Left lower abdo pain for 7 months, pain during sex, regular cycle, on ultrasound ovary has a fluid filled cyst of ground glass echogenicity. Diagnosis?
Endometriosis of ovary
What is the transformational zone in the cervix cell type change?
Squamous to columnar
