Brainscape's Knowledge GenomeTM

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


See full index

Women's Health > Infectious Disorders of the Female Genital Tract > Flashcards

Infectious Disorders of the Female Genital Tract Flashcards

1
Q

Vaginitis

Definition and types of

A

Inflammation of the vaginal canal

Often with vulvar irritation

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

Normal vaginal conditions

A

Normal flora:

  • staph, strep, anaerobic bacteria
  • Group B Strep (bad if pg)
  • Lactobacillus

Lactobacillus predominate and maintain pH at 3.5-4.5, they are supported by glycogen and estrogen

Normal amount of discharge = 1.5g/day

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

Infectious causes of vaginitis

A
  • candidiasis
  • bacterial vaginosis
  • trichomoniasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Noninfectious causes of vaginitis

A

atrophic (less estrogen ==> less discharge)
chemical (dyes, perfumes, etc.)
allergic
foreign body

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

General sxs of vaginitis

A

inflammation
change in discharge - leukorrhea

asymptomatic to significant discomfort

  • pruritis, burning, irritation
  • vulvovaginitis common when contact with d/c
fishy odor (amines are broken down by anaerobes)
color/consistency/volume of discharge changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Candidiasis Risk Factors

A 
DM
recent antibiotic use
OCPs
pregnancy (change in estrogen)
corticosteroid therapy 
occlusive clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Candidiasis Sxs and Signs

A

White, thick discharge
Intense pruritis
dysuria (as flow touches labia)

Vulvar/labial erythema, excoriation, edema
white d/c, often without odor

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

Candidiasis Etiology

A

Candida albicans MC

Candida glabrata at increasing rates; harder to tx

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

Candidiasis Dx

A

Characteristics signs and sxs
Normal pH
Hyphae/spores on wet prep or culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Candidiasis Tx

A

Antifungal Therapy

  • topicals (miconazole, butoconazole, etc.) qhs x 7days
  • fluconazole 150mg PO x 1 dose

OTC therapies are the same, but only topicals are available

Vaginal hygiene

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

Vaginal hygiene

A

cotton/no underwear to improve airflow
wipe front to back
avoid occlusive/wet clothing, douching or any vaginal FB’s, baths, or perfumes/dyes, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bacterial Vaginosis Etiology

A

Overgrowth of normal anaerobic bacteria:

  • decrease of lactobacillus
  • increase gardnerella, mobiluncus, mycoplasma, bacteroides

Overgrowth may be caused by douching and vaginal irritants

Common cause of vaginal discharge in women of childbearing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bacterial vaginosis d/c

A

Non-irritating d/c that is thin, grey-white/yellow with a foul/fishy odor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bacterial Vaginosis Dx

A

Amsel Criteria: (must have 3)

  • abnormal d/c with foul odor
  • abnormal pH (>4.5)
  • positive “whiff” test with KOH
  • wet prep shows clue cells

in the future can use DNA probe to determine high gardenerella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clue cells

A

squamous cells are surrounded by anaerobic bacteria

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

Bacterial Vaginosis Tx

A

Vaginal hygeine
pelvic rest x 1 week after tx

Topical or PO metronidazole or clindamycin x 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

STI’s

A 
Trichomoniasis 
Human Papilloma Virus 
Herpes Simplex Virus 
Chlamydia 
Gonorrhea 
Trichomonas vaginalis 
Syphilis

Always screen for comorbid STIs!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Trichomoniasis Etiology

A

unicellular, flagellate protozoan: trichomonas vaginalis

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

Trichomoniasis Risk Factors

A

Multiple sexual partners
Hx of STIs
Lack of condom use
Lower SES

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

Trichomoniasis S&S

A

Persistent, profuse frothy d/c
Vulvar pruritis/foul odor
Dysuria

Inflamed labia, perineum, vagina
Small petechiae on cervix/vaginal wall
(STRAWBERRY SPOTS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Trichomoniasis Dx

A

Wet mount shows increased PMNs and motile flagellate
pH >5
KOH wiff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Trichomoniasis Tx

A

Metronidazole PO 2gm x1 for pt and partner

23
Q

HPV Etiology and Transmission

A

Warts, condyloma acuminata, types 6 and 11

Transmission - skin to skin contact, but spreads more quickly over mucous membranes
Incubation 1-6 months
Viral shedding can occur even when warts are not present

24
Q

HPV S&S

A

Signs - numerous, discrete, fleshy lumps with a smooth, velvety surface; can be hidden in anus or vaginal canal

Symptoms - mass (MC); pruritis, bleeding, burning, tender, discharge, pain

25
Q

HPV Dx

A

Visual inspection

Sometimes requires acetic acid wash to visual skin

26
Q

HPV Tx

A

Often difficult, requiring multiple visits

Tx like any other wart - destruction with cryotherapy, electrocautery/curettage, TCA acid, etc.

27
Q

HPV Vaccines

A

Gardasil

  • quadrivalent for strains 6 and 11 (CA), 16 and 18 (warts)
  • boys and girls 6-26

Cervarix

  • bivalent: 6,11
  • girls only
28
Q

HSV Transmission and Incubation

A

Transmitted through viral shedding through sex (oral, anal, vaginal) and skin to skin contact

Incubation 2-20 days

29
Q

HSV S&S

A

Primary Outbreak:

  • most severe
  • small, painful, grouped vesicles develop at the site of contact -> pustules -> ulcers/erosions-> crust over and heal in 2-4 weeks
  • dysuria, regional lymphadenopathy, flu like sxs

Secondary Outbreak

  • less severe with fewer lesions
  • prodrome likely with tingling/pain
  • heal faster (1-2 weeks)

Recurrence can happen with any trigger

30
Q

HSV Dx

A

Clinical presentation
Tzanck smear
Serology - PCR (takes a long time)

31
Q

HSV Tx

A

PO acyclovir, valacyclovir within 24-72 hours of onset

32
Q

Chlamydia Characteristics

A

Chalmydia trachomatis
Transmission: sexual contact
Incubation 7-14 days

Risks: women <20yrs, multiple partners, lower SES

33
Q

Chlamydia S&S

A 
Often asymptomatic 
With active infections: 
- clear, mucopurulent d/c with cervicitis 
- dysuria
- postcoital bleeding
- pelvic pain
- fever
34
Q

Chlamydia Dx

A

DNA Assay - (urine test) MC

Cervical culture

35
Q

Chlamydia Tx

A

REPORT TO MDH
PO azithro x 1 or doxy x 7 days
Tx partner
Rescreen in 3-4 mos for reinfection

36
Q

Chlamydia Complications

A

PID

  • tubal occlusion/damage
  • infertility
  • ectopic pg risk
  • increases with each infection
37
Q

Gonorrhea Characteristics

A

Neisseria gonorrheae

transmitted through sexual contact

38
Q

Gonorrhea S&S

A 
Can be asymptomatic in early disease
With active disease: 
- copious mucopurulent d/c 
- dysuria/frequency
- pelvic pain 
- fever
39
Q

Gonorrhea Dx

A

DNA assay

culture

40
Q

Gonorrhea Tx

A

PO ceftriaxone 250mg IM x 1 + azithromycin 1gm or doxy 100mg po bid x 7 days

41
Q

Gonorrhea complications

A

PID

Disseminated - tenosynovitis, arthritis

42
Q

Syphilis etiology

A

treponema pallidum
transmitted through sex
incubation 1-12 weeks

43
Q

Syphilis RF

A

AA
the South
Urban areas

44
Q

Primary Syphillis

A

Painless, hard indurated ulcer forms at site of inoculation - chancre
- Usually solitary, but can go unnoticed; heals in 306 weeks without scar
Lymphadenopathy develops within 1-2 weeks
Bacteria remain in blood stream
Cha

45
Q

Secondary and Tertiary Syphilis

A

Rash affecting palms and soles
Flu like illness
Condyloma lata
Systemic, hepatitis, GI, MS, renal, neuro
Resolves in 2-6 weeks to latent infection

Tertiary
- CNS, CV (aortic aneurysms), derm

Congenital -> birth defects, still births

46
Q

Syphilis Dx and Screening

A

Dx- Spirochete seen on dark field microscopy

Screening - RPR/VDRL serology, then confirm with serology (fluorescent treponemal antibody absorption test (FTA))

47
Q

Syphilis Tx

A

Report to MDH
Pen G IM
Repeat titers at 3, 6, 12 and 24 months to ensure eradication

48
Q

PID Definition

A

acute ascending pelvic infection involving the upper genital tract with potential serious sequelae

49
Q

PID etiology

A

Gonorrhea MC
Chlamydia

10-20% of women who get GC/CT get PID

Can also result from procedures/surgery

50
Q

PID RF

A 
Adolescents 
Non-whites
Multiple partners
Previous  PID/STI 
Recent IUD insertion 
Smoking
Sex during menses
51
Q

PID S&S

A

Often asymptomatic
Crampy, bilateral low abdominal pain MC
Others: vaginal d/c, dysuria, dyspareunia, N/V, irregular bleeding

52
Q

PID Dx

A 
**Cervical motion tenderness**
adnexal tenderness, abdominal tenderness +/- rebound, discharge, fever
WBC >10,000
US 
Tx with any suspicion
53
Q

PID tx

A

Outpt if low/no fever, minimal abd findings and not toxic appearing
Ceftriaxone IM + doxy PO +/- metro PO x 14 days

54
Q

PID complications

A

permanent reproductive damage - infertility, ectopic pg risk
Chronic pelvic pain1`
abscess formation
intestinal adhesions/obstructions

Women's Health (9 decks)

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