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FINALS - OBS, GYNAE, BREAST > gynae infection - bacterial > Flashcards

gynae infection - bacterial Flashcards

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1
Q

natural pH of vagina

A

acidic

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2
Q

which bacteria keeps vaginal pH

A

lactobacillus –> acidic pH

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3
Q

most common organism thrush

A

candida albicans (yeast infection)

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4
Q

RF thrush

A

DM // antibiotics, steroids // pregnant // immunosuppressed eg HIV

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5
Q

symptoms thrush

A

cottage cheese discharge // not smelling // itch!! // superficial dyspareunia, dysuria // vulva redness, fissures

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6
Q

invx thrush

A

usually clinical (can do high vaginal swab)

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7
Q

1st line mx thrush

A

oral fluclonazole 150mg +/- topical imidazole

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8
Q

2nd line mx thrush

A

pessary clotrimazole 500mg +/- topical imidazole

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9
Q

mx thrush in pregnancy

A

pessary (oral contraindicated)

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10
Q

what defines recurrent thrush

A

4 in a year

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11
Q

invx recurrent thrush

A

high vaginal swab // consider glucose for diabetes

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12
Q

mx recurrent thrush

A

induction maintenance regime // oral fluconazole every 3 days –> 0ral fluclonazole weekly for 6 months

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13
Q

organism VB

A

gardnerella vaginalis (anaerobe)

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14
Q

who gets BV

A

sexually active women (not an STI)

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15
Q

amstel criteria for BV

A

3/4: smelly, thin discharge // clue cells on microsocpy // pH >4.5 // whiff test

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16
Q

mx BV

A

oral metronidazle 5-7 days // (topical metro or clinda if oral CI)

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17
Q

mx BV in pregnancy

A

oral metro at all stages

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18
Q

complications of BV in pregnancy

A

preterm, low birth weight, chorioamnionitis

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19
Q

what organism causes trichomonas

A

protozoan (STI)

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20
Q

features trichomonas (F)

A

smelling, yellow discharge // strawberry cervix!!! // pH >4,5

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21
Q

features trichomonas (M)

A

asymptomatic, maybe urethritis

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22
Q

invx trichomonas

A

microscopy –> wet mounds + motile trophozoite

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23
Q

mx trichomonas

A

oral metro 5-7 days

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24
Q

symptoms chlamydia

A

asymptomatic // F: cervicitis, bleeding, dysuria // M: discharge, dysuria

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25
complications chlamydia
epidiymitis // PID // endometritis // ectopic pregnancy // reactive arthritis // Fitz hugh curtis (hepatitis)
26
invx + swab chlamydia
M: first void urine // F: vulvovaginal swab // NAAT // 2 weeks after exposure if known contact
27
screening for chlamydia
all sexually active people aged 15-24
28
1st line mx chlamydia
doxy 7 days // (or azithro 1 day --> 500mg OD for 2 days)
29
chlamydia mx if pregnant
azithro, erythro, amoxicillin
30
contact timeline chlamydia for symptomatic men
4 weeks prior to symptoms and all after
31
contact timeline chlamydia for women and asymptomatic men
6 months prior
32
mx for chlamydia contacts
offer treatment before test comes back
33
what type of bactiera is chlamydia
gram -ive + intracellular
34
what does chlamydia serovaris A-C cause
ocular infection in africa (not an STI) // endemic trachoma
35
what does chlamydia serovaris D-k cause
STI // neonatal disease
36
what does chlamydia serovaris L1-L3 cause
Lymphogranuloma venereum
37
RF Lymphogranuloma venereum
MSM // HIV // tropics and developing countries
38
symptoms Lymphogranuloma venereum
1 = painless pustules to ulcers --> 2 painful inguinal lymph (rarely fistula) --> 3 protocolitis + rectal bleeding
39
mx Lymphogranuloma venereum
doxycycline
40
what is PID
infection and inflammation of pelvic organs
41
common causes PID
chlamydia most common // gonorrhoea, mycoplasma
42
symptoms PID
lower abdo pain // fever // deep dyspareunia // dyruria // menstrual changes // discharge
43
o/e PID
cervical excitation
44
invx PID
pregnancy // high vagial swab (often negative)
45
complications PID
Fitz-Hugh Curtis (perihepatitis) // infertility // ectopic
46
mx PID
oral ofloxacin + oral metro // IM ceftriaxone + oral doxy + oral metro
47
what type of bacteria is gonorrhoea
gram -ive dipplococcus
48
symptoms gonorrhoea
M: urethral discharge, dysuria // F: cervicitis, vaginal discharge // pharyngeal or rectal asymptomatic
49
complications gonorrhoea
urethral strictures // epididymitis + PID --> infertility // disseminated gonorrhoea --> septic arthritis
50
symptoms disseminated gonorrhoea
tenosynovitis, polyarthritis, dermatitis --> septic arthritis, endocarditis, perihepatits
51
invx gonorrhoea
NAATS screening // urethral in males, endocervical in women
52
1st line mx gonorrhoea
single IM dose
53
2nd line mx gonorrhoea
oral ceftriazone 400mg (single dose) + oral azithro 2g (single dose)
54
causes urethritis (men only)
chlamydia , gonorrhoea, ureaplasma or mycoplasma
55
invx urethritis
swab
56
mx urethritis
oral doxy 7 days OR single dose oral azithro
57
what causes genital chancroids
Haemophilus ducreyi
58
symptoms chancroid
painful genital ulcer (sharply defined) + unilateral, painful lymph nodes
59
incubation syphilis
trep pallidum 9-90 days
60
primary symptoms syphilis
painless chancre (ulcer) - may be on cervix // non-tender lymph
61
symptoms secondary Syphilis
(6-10 weeks later) // fever, lymph // rash on trunk, palms, soles // buccal ulcers // condylomata lata (painless warts on genitals)
62
tertiary symtpoms Syphilis
gummas (granuloma on skin and bone) // aortic aneurysm // paralysis of insane // argyll roberston pupil
63
symptoms congenital syphillis
blunted inciesors // rhagades (linear scar at mouth) // keratitis // deaf
64
non-trep serological sesting
non-specific // shows number of antibodies // negative after treatment // uses cardiolipin to test
65
trep speceific serological sesting
TP-EIA // shows reactivity
66
what causes false negative non-trep serology
pregnancy // SLE, APS // TB // leprosy // malaria // HIV
67
1st line mx syphilis
IM penicillin (doxy alternative)
68
what needs to be tested after treatment of syphillis
non-trep serology (RPR or VDLR) should DECREASE
69
what reaction is sometimes seen after syphillis testing
Jarisch-Herxheimer reaction // fever, rash, tachycardia after 1st dose // conservative mx

FINALS - OBS, GYNAE, BREAST (27 decks)

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