Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

O&G > Gynaecological infections > Flashcards

Gynaecological infections Flashcards

1
Q

What is bacterial vaginosis

A

Where other bacteria overgrow (e.g. Gardnerella vaginalis) and reduce the lactobacilli in the vagina, bacterial vaginosis occurs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is lactobacilli

A
  • healthy vaginal bacteria, and produce lactic acid that keeps the pH low and prevents other bacteria overgrowing.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the presentation of bacterial vaginosis

A

Fishy smelling watery / grey discharge
Dysuria
High vaginal pH
“Clue cells” on microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management of bacterial vaginosis

A
  • Vaginal swabs to exclude other causes of symptoms (including chlamydia and gonorrhoea)
  • Avoid vaginal irrigation or cleaning with soaps that may disrupt the natural flora
  • Metronidazole is the first line antibiotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What risks are thought o be associated with bacterial vaginosis

A
  • Pre term delivery in pregnancy

- Increased susceptibility of picking up other STIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is candidiasis

A

Candidiasis is a common fungal infection. It is commonly called “thrush”. It is more common in immunosuppressed patients and those with diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the presentation of candidiasis

A

Itchy
Thick, white discharge, like “cottage cheese”
Vulval and vaginal irritation / pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of cadidiasis

A

Clotrimazole cream
One off clotrimazole pessary
One off oral fluconazole dose (150mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the presentation of Gonorrhoea

A 
More often symptomatic than chlamydia (90% men, 50% women)
Odourless, green, purulent discharge
Dysuria
Pelvic pain
Testicular pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of pathogen causes Gonorrhoea

A

Neisseria gonorrhoeae is a gram negative diplococcus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you diagnose gonorrhoea

A
  • Nucleic acid amplification testing (NATT) can detect the DNA of gonorrhoea on endocervical swabs or urine
  • An endocervical swab should be taken for culture and sensitivities prior to antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of Gonorrhoea

A
  • Single dose of ceftriaxone 500mg IM and azithromycin 1g oral
  • Test again to assess response to treatment (“test of cure”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What pathogen causes Chlamydia

A
  • Chlamydia trachomatis (gram negative bacteria) is an intracellular organism
  • most common STI in UK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the presentation of Chlamydia

A 
Asymptomatic in 50% men
Asymptomatic in 75% of women
PV discharge
Pelvic pain
Abnormal bleeding
Painful sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common cause of infertility in the UK

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may you find on examination of a patient with chlamydia

A 
Cervical excitation
Fever
Purulent discharge
Pelvic/abdominal tenderness
Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you diagnose chlamydia

A
  • Vulvovaginal swab in females
  • Urine sample in males (catching urine as it is first produced – “first catch”)
  • Tested using nucleic acid amplification tests (multiplying the DNA of the pathogen and testing by PCR to get an early results)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What must you do for all patients with an STI

A

Contact tracing for partners
Education to prevent future infection
Test and treat any other STDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the management of Chlamydia

A

Doxycycline for 7 days or
Single dose of 1g azithromycin (better for compliance)
No need to test for cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Lymphogranuloma Venereum

A

a condition affecting the lymphoid tissue around the site of infection in patients infected with chlamydia. Treatment is the same as for chlamydia.

21
Q

What is the first stage of Lymphogranuloma Venereum

A

Painless ulcer. This can occur on the penis in men, vaginal wall in women or rectum after anal sex.

22
Q

What is the second stage of Lymphogranuloma Venereum

A

Lymphadenitis. This is swelling, inflammation and pain in the lymph nodes infected with the bacteria. This could be the inguinal or femoral lymph nodes.

23
Q

What is the third stage of Lymphogranuloma Venereum

A

This is where there is inflammation of the rectum and anus. Proctocolitis leads to anal pain and discharge.

24
Q

What is PID

A

inflammation, most commonly caused by infection, of the organs of the pelvis, usually from infection spreading up through the cervix. It is a major cause of infertility and pelvic pain.

25
Q

What are the most common pathogens to cause PID

A

Chlamydia trachomatis

Neisseria gonorrhoeae

26
Q

What is the presentation of PID

A 
Pelvic pain / pain in lower abdomen
Fever
Dysuria
Deep dyspareunia
Vaginal discharge
Abnormal bleeding (intermenstrual / postcoital)
Menorrhagia
Cervical excitation
27
Q

What is the management of PID

A
  • Antibiotics as per local guidelines
    NICE suggest:
  • Oral ofloxacin 400mg twice daily with oral metronidazole 400mg twice daily for 14 days
    OR IM ceftriaxone 500mg single dose with oral doxycycline 100mg twice daily with oral metronidazole 400mg twice daily for 14 days
    Treat based on clinical diagnosis (no need to wait for microbiology)
    Consider removing intrauterine devices
28
Q

What is Fitz-Hugh-Curtis Syndrome

A

This is where pelvic inflammatory disease causes inflammation of the liver capsule, leading to adhesions between the liver and peritoneum.
It results in right upper quadrant pain that can be referred to the right shoulder tip if there is diaphragmatic irritation.

29
Q

What is Herpes Simplex

A
  • Herpes simplex virus (HSV) causes both coldsores and genital herpes.
  • HSV-1 causes coldsores
  • HSV-2 causes genital herpes (some overlap)
  • Painful ulcers called stomatitis herpetiformis.
30
Q

What is presentation of genital herpes

A

Labial ulceration / vesicular lesions
Pain
No discharge
Ask about sexual contacts (including those with coldsores)

31
Q

How do you diagnose genital herpes

A

Diagnosis can be made clinically

A swab can be taken for a viral PCR to identify the cause

32
Q

How do you manage genital herpes

A
  • aciclovir (oral in stomatitis and genital herpes and topical with cold sores).
  • Treatment can be slow and require long term aciclovir.
33
Q

How do you treat genital herpes in pregnancy

A
  • first presentation >28 weeks gestation then elective caesarean at term is advised (it takes 6 weeks for the fetus to develop passive immunity).
  • recurrent genital herpes: start aciclovir and it is thought that the risk of transmission in vaginal delivery is low.
34
Q

What are the risks of genital herpes during pregnancy

A
  • Neonatal herpes simplex infection has high morbidity and mortality.
  • It should be avoided as much as possible and treated early if identified.
35
Q

What is Bartholin’s Cyst

A
  • The ducts of the Bartholins gland become blocked leading them to swell and become tender
  • 1-5cm fluid filled cyst
36
Q

What are the Bartholin glands

A

pair glands either side of the posterior part of the vaginal introitus (the vaginal opening). Normally they are responsible for vaginal lubrication.

37
Q

What is the management of a Bartholins cyst

A

usually resolve with simple treatment such as good hygiene, analgesia and warm compresses.

38
Q

What is Bartholins Abscess

A
  • Bartholins Cyst which becomes infected

- hot, tender, red and may be draining pus.

39
Q

What bacteria typically cause a Bartholins Abscess

A
  • staph and strep.

- E. Coli and gonorrhoea can also cause an abscess.

40
Q

What is the management of a Bartholins Abscess

A
  • Swab of pus or fluid
  • antibiotics: flucloxicillan or erythromycin if pen alllergy
  • May require surgical drainage
41
Q

What is Lichen Sclerosus

A
  • Thought to be an autoimmune condition.

- Symptoms and signs are made worse by friction to the skin – “Koebner phenomenon”.

42
Q

What are the symptoms of Lichen Sclerosus

A

Itching
Soreness and pain
Tight skin
Painful sex (superficial dyspareunia)

43
Q

What is the appearance of Lichen Sclerosus

A
  • labia, perianal and perineal skin.
  • associated fissures, cracks, erosions or haemorrhages under the skin.
  • “Porcelain-white”
  • Shiny
  • Papules / plaques
  • Tight
  • Thin
  • Slightly raised
44
Q

What are the complications of Lichen Sclerosus

A

Pain and discomfort
Bleeding
Narrowing of the vaginal or urethral openings
There is a 5% risk of developing vulval cancer. This is usually squamous cell carcinoma.

45
Q

What is the management of Lichen Sclerosus

A
  • It can’t be cured.
  • Followed up in secondary care.
  • Vulval biopsy can be performed if any lesions are suspicious or the diagnosis is in doubt.
  • Strong topic steroids are the mainstay of treatment (reduce risk of Ca too)
  • Emollients should be used regularly
46
Q

What topical steroid should be used in Lichen Sclerosus

A
  • Often clobetasol propionate 0.05% (dermovate).
  • initially once a day for 4 weeks then reduce the frequency down (e.g. to three times weekly then once weekly).
  • When the condition flares they can go back to using it daily until it is under control.
  • A 30g tube should last at least 3 months
47
Q

What are Nabothian Cysts

A
  • fluid filled cysts that are often seen on the surface of the cervix.
  • also called nabothian follicles.
  • up to 1cm in size, but rarely can be larger.
  • harmless.
  • May occasionally by biopsied to exclude other pathology
48
Q

What is Meig’s Syndrome

A
  • Occurs in older women.
  • Benign ovarian fibroma that generates the associated pleural effusion and ascites.
  • Once the tumour is removed, the effusion and ascites resolve and the prognosis is excellent.
49
Q

What is the triad of Meig’s Syndrome

A

Pleural Effusion
Ascites
Benign ovarian tumour

O&G (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions