Inflammation of the Female Genital Tract Flashcards

1
Q

Describe the 2 categories of inflammatory conditions of the female genital tract?

A
  1. Specific - ones are due to infection usually sexually transmitted
  2. Non specific - An inflammatory reaction, but negative for a microbiological agent
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2
Q

Give examples of sequelae of infections of the female genital tract?

A

infertility, miscarriages and cancer

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3
Q

Which structures are considered to be part of the lower genital tract?

A

vulva, vagina and cervix

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4
Q

What is the term for inflammation of the vulva?

A

vulvitis

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5
Q

What is the term for inflammation of the vagina?

A

vaginitis

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6
Q

What is the term for inflammation of the vulva + vagina?

A

vulvovaginitis

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7
Q

What is the term for inflammation of the cervix?

A

cervicitis

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8
Q

What is the term for inflammation of the endometrium?

A

endometritis

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9
Q

What is the term for the inflammation of the fallopian tubes?

A

salpingitis

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10
Q

What is the term for the inflammation of the ovaries?

A

oophritis

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11
Q

What is the term for the inflammation of the fallopian tubes + ovaries?

A

salpingoophritis

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12
Q

List common infections of the female genital tract?

A
  1. viruses - Herpes simplex, Human papilloma virus (HPV).
  2. bacteria - Gonorrhoea, chancroid, granuloma inguinale, lymphogranuloma venereum, gardnerella vaginalis
  3. syphilis
  4. Mycoplasmal infection
  5. Chlamydial infection
  6. Trichomoniasis (protozoa)
  7. Candidiasis
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13
Q

Name the microbial infections that are confined to the lower genital tract?

A
  1. Herpes simplex
  2. Chanchroid
  3. Lymphogranuloma venereum,
  4. Granuloma inguinale
  5. Candidiasis
  6. Trichomonas vaginalis
  7. Gardnerella vaginalis
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14
Q

Describe the epidemiology of candidiasis?

A

Common infection in women

- 10% of women thought to be carriers

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15
Q

In which physiological conditions is candidiasis considered to be enhanced?

A
  1. diabetics
  2. oral contraception use
  3. pregnancy
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16
Q

What is the clinical presentation of candidiasis?

A
  1. Causes leukorrhoea - white discharge
  2. pruritus - itching
  3. Lesions can be small to large white patches
17
Q

How can candida organisms be visualized?

A
  1. wet mounts - a sample of vaginal discharge is observed by wet mount microscopy by placing the specimen on a glass slide and mixing with salt solution
  2. cervical pap smears
18
Q

What is Trichomoniasis?

A

infection caused by Trichomonas vaginalis

- a large flagellated ovoid protozoan

19
Q

What is the clinical presentation of Trichomoniasis?

A
  1. a purulent vaginal discharge and discomfort with pruritus

2. Vaginal or cervical mucosa is inflamed with a red appearance termed strawberry cervix

20
Q

Organisms of Trichomoniasis can be visualised by?

A

wet mounts or cervical Pap smears

21
Q

What is Gardnerella vaginitis?

A

infection caused by G. vaginalis

- gram negative coccobacillus

22
Q

What is the clinical presentation of Gardnerella vaginitis?

A

Presents as thin milky discharge with a fish like smell

23
Q

Gardnerella vaginitis is associated with?

A

shift in vaginal flora

- Replacement of normal lactobacilli by G. vaginalis

24
Q

What do cervical smears + wet mounts of Gardnerella vaginitis show?

A

clue cells = coccobacilli adhere to squamous cells completely covering them

25
Q

What is the clinical term for infections involving upper + lower genital tract?

A

pelvic inflammatory disease (PID)

26
Q

Common causative pathogens of PID include?

A

gonococci, chlamydia and enteric bacteria

- Gonococci is the common cause of PID

27
Q

Name situations in which PID can arise?

A
  1. as a complication of miscarriage or abnormal deliveries

2. sexually transmitted

28
Q

What is the clinical presentation of PID?

A
  1. Pelvic pain
  2. Adnexual tenderness on bimanual palpation
  3. Cervical excitation tenderness
  4. Fever
  5. Vaginal discharge
  6. Septic shock - Severe cases
29
Q

Describe the course of infection for Gonoccocal PID?

A
  • Begins in Bartholin gland and other vestibular glands , or periurethral glands
  • Cervix involvement is common but asymptomatic
  • Organisms then spread upward through mucosal surface to involve tubes and tubo- ovarian regions
  • For obscure reasons, the endometrium is usually spared
30
Q

What is the clinical presentation of Gonoccocal PID?

A

an acute suppurative inflammation with abscess formation in severe cases

  • Acute suppurative salpingitis
  • salpingo-oophritis
  • Tubo-ovarian abscesses can form
  • Tubes can from a pyosalpinx
31
Q

Non Gonoccocal bacterial PID results as a complication of?

A
  1. Induced miscarriage
  2. Dilatation and curettage
  3. Complicated deliveries
  4. Surgical procedures on the female genital tract
32
Q

Organisms that cause non gonoccocal bacterial PID include?

A
  1. Streptococci
  2. staphylococcus
  3. coliform bacteria
  4. Clostridium perfringes
33
Q

How does non gonoccocal bacterial PID spread?

A

lymphatics + veins

34
Q

What are the complications of PID?

A
  1. Peritonitis
  2. Intestinal adhesions between bowel and pelvic organs
  3. Bacteremia which can produce endocarditis, meningitis
  4. Infertility with blockage of fallopian tubes