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Repro > Lecture 10 - Infections Of The Repro Tract > Flashcards

Lecture 10 - Infections Of The Repro Tract Flashcards

1
Q

What are some important STIs?

A

Chlamydia
Gonorrhoea
Trichomoniasis
Genital Herpes
Genital Warts
Syphilis
HIV

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2
Q

What are 2 non STI reproductive tract infections?

A

Thrush (candidia albicans)
Bacterial Vaginosis

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3
Q

Who are more likely to get STIs, young or old people?

A

Young

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4
Q

What ethnic group has a risk of STIs?

A

Black afrocarribean

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5
Q

What are some risk factors for developing an STI?

A

Not using protection
Multiple sexual partners
Certain sexual practices
Sex workers
Early age first intercourse
Lack of immunisation
Being young

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6
Q

What is the main symptom of STIs?

A

Discharge

Men = urethral
Women = vaginal

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7
Q

Can vaginal discharge be normal?

Can urethral discharge be normal?

A

Vaginal discharge be normal

Urethral discharge in men never normal

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8
Q

What does physiological vaginal discharge look like?

A

White or clear non offensive discharge

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9
Q

What is the causative organism for Vaginal Thrush?

A

Candida albicans

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10
Q

How does vaginal thrush infect a patient?

A

Candida albicans is normal vaginal flora but it gets “activated/overgrows” in immunocompromised states, diabetes or after antibiotics
High oestrogen favours it

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11
Q

What increases the risk of developing of Vaginal Thrush/Candida albicans infection?

A

Immunocompromised
Diabetes (High sugar)
Post antibiotics (dec normal flora)
High oestrogen (combined oral contraceptive pill)

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12
Q

What are the symptoms of Candida albicans?

A

Vulval/vaginal itching
White NON SMELLY cheese like vaginal discharge

Painful intercourse
Pain on urination

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13
Q

What is the term for painful intercourse?

A

Dyspareunia

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14
Q

What is the term for painful urination?

A

Dysuria

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15
Q

How would you treat candidia albicans?

A

Antifungals:
Fluconazole
Clotrimazole

Given straight into vagina (Pessary)

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16
Q

What is the main causative organism for bacterial vaginosis?

A

Gardnerella vaginalis

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17
Q

What are the main risk factors for developing Bacterial Vaginosis?

A

Vaginal washes/douching
Receiving oral sex
Smoking

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18
Q

What is the basic reason bacterial vaginosis develops?

A

Normal flora is overgrown by the anerobic orgaisms like Gardnerella vaginalis

Lactobacilli no longer around maintaining low pH

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19
Q

What type of cells are seen on a gram stain for bacterial vaginosis?

A

Clue cells

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20
Q

What are the symptoms of bacterial vaginosis?

A

Fishy smelling thin white discharge

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21
Q

What is the treatment for bacterial vaginosis?

A

Oral metronidazole
Clindamycin gel

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22
Q

What is the most common discharge causing STI?

A

Chlamydia trachomatis

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23
Q

What type of organism is chlamydia trachomatis?

A

Obligate Intracellular bacterium with a unique cell WALL

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24
Q

Why cant chlamydia trachomatis be gram stained?

A

Has a unique cell wall
It also prevents phagolysosome fusion

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25
Q

What are the symptoms of Chlamydia in women?

A

70% asymptomatic
Inc/smelly discharge
Postcoital or intermentstrual bleeding
Deep dyspareunia
Dysuria

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26
Q

What are the symptoms of chlamydia in men?

A

50% asymptomatic
Urethral discharge + urethritis
Dysuria
Epididymitis

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27
Q

What type of organism is Neisseria Gonorrhoeae?

A

Gram negative diplococci

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28
Q

what colour do gram negative bacteria stain?

A

Red

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29
Q

What are the symptoms of Neisseria Gonorrhoeae infection in men?

A

90% men symptomatic

Thick yellow discharge
Often dysuria

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30
Q

What are the symptoms of Neisseria Gonorrhoeae infection in women?

A

50% asymptomatic
Dysuria
Inc/altered discharge
Dyspareunia
Lower abdominal pain
Intermenstrual bleeding

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31
Q

What do you treat if you suspect Chlamydia Trachomatis or Neisseria Gonorrhoeae?

A

Treat for both even if you only suspect 1

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32
Q

What 2 antibiotics are given to treat bacterial STIs (Neisseria Gonorrhoeae or Chlamydia Trachomatis)?

A

Azithromycin
Ceftriaxone

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33
Q

What organism causes Trichomoniasis?

A

Trichomonas vaginalis
(Protozoa)

34
Q

How does Trichomoniasis present in women?

A

Thick very smell frothy discharge and lots of it

Itching (way you can differentiate this from bacterial vaginosis is that BV doesn’t have itching)

35
Q

What conditions does Trichomoniasis best develop in?

A

Alkaline conditions in vagina

36
Q

How does trichomoniasis present in men?

A

Urethritis which then has discharge

37
Q

What is the treatment for Trichomoniasis?

A

Metronidazole

38
Q

What is non-gonococcal urethritis in men?

A

Inflammation of the urethra with associated discharge that’s not caused by gonorrhoea

39
Q

What are the common causes of non-gonococcal urethritis in men?

A

Chlamydia trichomatis
Trichomonas vaginalis
Mycoplasma gentialium

But can also be pathogen negative

40
Q

What investigations are done in men when theres a disease causing discharge?

A

Urine sample or swab of discharge

41
Q

Once a urine sample has been obtained from a man, what tests are usually done?

A

NAATs (Nucleic Acid Amplification Test) basically a PCR

42
Q

What are the 3 types of vaginal swab that can be done to investigate diseases causing discharge?

A

High vaginal swab
Endocervical swab
Vulvovaginal swab (self swab)

43
Q

What infections is a high vaginal swab testing for?

A

Trichomonas
Candida
Bacterial Vaginosis

44
Q

What do both endocervical and vulvovaginal swabs test for?

A

Chlamydia
Gonorrhoea

45
Q

Why is a vulvovaginal swab more favourable to an endocervical swab?

A

Vulvovaginal swab is done by the patient so more likely to actually have the swab done

46
Q

What are the infections that can cause discharge?

A

Chlamydia (trichomatis)
(Neisseria) Gonorrhoeae
Trichomoniasis vaginalis

Bacterial vaginosis
Candidia albicans (thrush)

47
Q

What are the 3 STIs causing discharge in women?

A

Chlamydia
Gonorrhoea
Trichomoniasis

48
Q

What are the 2 non STI infections causing discharge in women?

A

Bacterial vaginosis
Candidia albicans

49
Q

What are the 3 conditions causing genital lesions?

A

HPV
Herpes simplex virus 1 and 2
Syphilis

50
Q

What causes Genital warts?

A

HPV (Human Papillomavirus)

51
Q

Which 2 HPV viruses cause most genital infections?

A

HPV 6
HPV 11

52
Q

Which 2 HPV viruses cause the most cervical cancer?

A

HPV 16
HPV 18

53
Q

What HPV viruses does the Gardasil vaccine protect against?

A

HPV 6,11,16,18

54
Q

What virus causes genital lesions?

A

Herpes Simplex Virus 1 and 2

55
Q

Which Herpes simplex virus causes cold sores an genital lesions?

A

HSV 1

56
Q

What herpes simplex virus only causes genital lesions?

A

HSV 2

57
Q

What is a HSV infection like?

A

Lifelong infection, get initial then recurrent (first infection is worst)

58
Q

What are the symptoms or HSV infection?

A

Can be aymptomatic initially
Ulcers and blisters (genital, mouth and anus)
Systemic symptoms

59
Q

How do you test for HSV?

A

PCR/NAAT following a swab

60
Q

How is HSV treated?

A

Acyclovir (antiviral)

Doesn’t eradicate infection just reduces severity

61
Q

What is the causative organism of syphilis?

A

Treponema pallidum

62
Q

What type of organism is treponema pallidum (cause of syphilis)?

A

Coiled shaped bacteria (spirochete)

63
Q

What are the types of syphilis?

A

Primary syphilis
Secondary syphilis
Tertiary syphilis

64
Q

How does primary syphilis present?

A

Typically a single painless ulcer

65
Q

Why is syphilis often dangerous?

A

Normally goes undiagnosed for a while so progresses to secondary and tertiary syphilis leading to neurological and cardiovascular damage

66
Q

How is syphilis treated?

A

Penicillin

67
Q

Why are coinefctions common with STIs?

A

All transmitted the same way
Some often asymptomatic

68
Q

How are patients educated when treating STIs?

A

Use protection
Reduce number of sexual partners
Avoid sex until course of treatment is complete

69
Q

How are non STI infections managed?

A

Appropriate drugs (metronidazole)

Remove precipitating features
Patient education (vaginal hygiene)

70
Q

What is pelvic inflammatory disease?

A

Infection of the upper genital tract

71
Q

What are some of the pelvic inflammatory diseases?

(Infections seceding from the endocervix)

A

Endometritis
Salpingitis
Parametritis
Oophoritis
Tubo-ovarian abscess
Pelvic peritonitis

72
Q

What is salpingitis?

A

Inflammation of the fallopian tubes

73
Q

What is parametritis?

A

Inflammation of pelvic floor fascia

74
Q

What is oophoritis?

A

Infection of ovaries

75
Q

What is a tubo-ovarian abscess?

A

Collection of infection around the tubes

76
Q

What is the main cause of Pelvic Inflammatory Disease?

A

STIs

Chlamydia trichomatis
Neisseria Gonorrhoeae
Mycoplasma gentialium

77
Q

What are the symptoms of Pelvic Inflammatory disease?

A

Pelvic/lower abdominal pain
Discharge
Post goital/Intermenstrual bleeding
Fever
Dyspareunia
RUQ pain due to peri hepatitis (Fitz-Hugh-Curtis syndrome)
2ndary dysmenorrhoea

78
Q

What are the signs of PID?

A

Lower abdominal tenderness
Adnexal (low down in pelvis) tenderness
Pain when moooved uterus on bimanual vaginal exam
Discharge on speculum exam
Fever

79
Q

What are some complications of PID?

A

Sepsis
Peritonitis
Chronic pelvic pain
Infertility (adhesions blocking tubes)
Ectopic pregnancy
Fitz-Hugh-Curtis syndrome caused by peri-hepatitis

80
Q

How is PID managed?

A

Admit if unwell since risk of sepsis (peritonitis , fever etc…)

Antibiotics

81
Q

What antibiotics are used to treat pelvic inflammatory disease?

What dose and time period?

A

Ofloxacin 400mg twice per day
Metronidazole 400mg twice per day

Both for 14 days

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