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Infection > Lecture 7.1: Infections of the Genital Tract > Flashcards

Lecture 7.1: Infections of the Genital Tract Flashcards

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1
Q

Where are microorganisms commonly found in the male genitals?

A

Microorganisms commonly found at foreskin at the hood of the penis

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2
Q

Why is the female genitourinary tract so susceptible to infections?

A
  • Many openings in one place (3)
  • Short urinary tract (4 times shorter than males)
  • No particular cleansing mechanisms
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3
Q

What does Venereal mean?

A

Relating to sexual desire or sexual intercourse

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4
Q

Infections of the Reproductive Tract​: Non-Venereal

A
  • Bacterial Vaginosis
  • TSS
  • Bartholin Gland Infections
  • Vulvo-Vaginal Candidiasis (Thrush)
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5
Q

Infections of the Reproductive Tract​: Venereal Types

A
  • Bacterial
  • Viral
  • Parasitic
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6
Q

Infections of the Reproductive Tract​: Venereal [Bacterial]

A
  • Syphills
  • Gonorrhoea
  • Chlamydia
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7
Q

Infections of the Reproductive Tract​: Venereal [Viral]

A
  • HPV
  • HIV
  • Herpes
  • Hep B
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8
Q

Infections of the Reproductive Tract​: Venereal [Parasitic]

A
  • Trichomoniasis
  • Public Lice
  • Scabies
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9
Q

What are some Vaginal Defences​? (7)

A
  • High oestrogen states cause proliferation of vaginal epithelium​
  • Increased glycogen encourages Lactobacilli to produce lactic acid.
  • Normal vaginal pH 3.8-4.5
  • Epithelial mucosal barrier​
  • Produces hydrogen peroxide ​
  • Produces bacteriocins ​
  • Normal vaginal discharge: Contains IgA and IgG, mucins
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10
Q

Risk Factors for Dysbiosis: Individual (6)

A
  • Genetic
  • Sexual Practices
  • Diet
  • Smoking
  • Hygiene
  • Race
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11
Q

Risk Factors for Dysbiosis: Relational (4)

A
  • Sexual Network
  • Social Network
  • Housing Arrangement
  • Behavioural Norms (polygamy…etc)
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12
Q

Risk Factors for Dysbiosis: Community (4)

A
  • Built Environment
  • Poverty
  • Food Alert
  • Stress
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13
Q

Risk Factors for Dysbiosis: Societal (3)

A
  • Racism
  • Politics
  • Segregation
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14
Q

What is Bacterial Vaginosis?

A
  • Vaginal inflammation caused by dysbiosis
  • Most common cause is Gardnerella vaginalis
  • Most prevalent cause of vaginal discharge or malodor
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15
Q

Bacterial Vaginosis: Signs and Symptoms (3)

A
  • Fishy smell​
  • Thin grey/white discharge​
  • 50% asymptomatic
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16
Q

Bacterial Vaginosis: Investigation (4)

A
  • History of new vaginal products​
  • Test the pH of the discharge​
  • Whiff test (add KOH to sample)​
  • High vaginal swab: Clue cells
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17
Q

Bacterial Vaginosis: Treatment and Management (4)

A
  • Stop using products on vagina​
  • Oral metronidazole ​
  • Intravaginal metronidazole gel​
  • STI screen – higher risk
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18
Q

What is Vulvo-Vaginal Candidiasis (Thrush)?

A
  • A symptomatic inflammation of the vagina and/or vulva
  • Caused by a superficial fungal infection, usually with Candida albicans
  • Candida is opportunistic and competes with lactobacilli within the vagina
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19
Q

Vulvo-Vaginal Candidiasis (Thrush): Signs and Symptoms (5)

A
  • Vulval/vaginal itching​
  • Vaginal soreness​
  • White ‘cheese-like’ discharge​
  • Dysuria​
  • Superficial dyspareunia
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20
Q

Vulvo-Vaginal Candidiasis (Thrush): Investigations (2)

A
  • Diagnosis by examination​

* Swabs done to EXCLUDE alternate diagnosis

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21
Q

Vulvo-Vaginal Candidiasis (Thrush): Treatment and Management (5)

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A
  • Avoid irritants on the vagina ​
  • Loose fitting undergarments ​
  • Topical antifungals: Clotrimazole Cream​
  • Oral Fluconazole ​
  • Control underlying conditions? T2DM
22
Q

What are Bartholin’s Glands?

Study These Flashcards
A
  • The Bartholin’s glands are a pair of pea-sized glands

* Located at entrance of the vagina at 5 o’clock and 7 o’clock

23
Q

Abscess of Bartholin’s Glands

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A

They are usually unilateral, tense, and nonpainful

24
Q

Abscess of Bartholin’s Glands: Signs and Symptoms (4)

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A
  • Erythema
  • Acute Tenderness
  • Oedema
  • Occassionally cellulitis of the surrounding subcutaneous tissue
25
Abscess of Bartholin's Glands: Treatment (4)
* Classical surgical treatment – Marsipulisation​ * Cut and drain abscess​ * Stitch skin edges to form ‘kangaroo pouch’​ * Allows for drainage
26
The Five P’s​ of Diagnosing STIs
1) Partners​ 2) Practices​ 3) Prevention of Pregnancy​ 4) Protection from STDs​ 5) Past history of STDs
27
What is Chlamydia? How does it cause Infection? (5)
* Chlamydia trachomatis * Gram-negative bacterium​ * Can only replicate WITHIN a host cell * No cell wall, just two cell membranes​ * Enters by breaks in mucous membranes​ * 2 forms in its life cycle:​ Elementary body (EB) & Reticulate body (RB)
28
Chlamydia in Women: Signs and Symptoms (7)
* Purulent vaginal or cervical discharge​ * Post-coital bleeding​ * Intermenstrual bleeding​ * Deep dyspareunia​ * Dysuria ​ * Pelvic pain and tenderness​ * Cervical motion tenderness
29
Chlamydia in Women: Investigations (4)
* Speculum – hypertrophic cervix ​ * Endocervical swab​ * First catch urine sample ​ * Self-taken vulvo-vaginal swab
30
Why is Chlamydia so hard to diagnose?
* 70% Asymptomatic in Women * 50% Asymptomatic in Men
31
Chlamydia in Men: Signs and Symptoms (5)
* Mucopurulent urethral discharge​ * Urethritis​ * Dysuria ​ * Epididymo-orchitis ​ * Reactive arthritis
32
Chlamydia in Men: Investigations (2)
* First catch urine sample ​ * Urethral swab
33
What is a Nucleic Acid Amplification Test (NAAT)?
A nucleic acid test is a technique used to detect a particular nucleic acid sequence and thus usually to detect and identify a particular species or subspecies of organism
34
Chlamydia: Treatment and Management (6)
* 7 days of oral doxycycline BD * Or a single dose of azithromycin) * Avoid intercourse and oral sex until treatment completed ​ * Treat patient AND partner(s)​ * Reinforce healthcare education ​ * Offer repeat testing 3-6 months after treatment
35
Complications of Chlamydia (7)
* Lymphogranuloma Venereum ​ * Conjunctivitis * Reactive Arthritis * Pelvic Inflammatory Disease * Infertility * Peri-Hepatitis (Fitz-Hugh-Curtis Syndrome)​ * Vertical Transmission in Pregnancy (Blindness, Pneumonia, Low Birth Weight)
36
What is Gonorrhoea?
* Gram- Negative Organism * Neisseria Gonorrhoea
37
Gonorrhoea in Women: Signs and Symptoms (7)
* Asymptomatic in 50%​ * Vaginal discharge ​ * Rarely dysuria​ * Dyspareunia​ * Rarely intermenstrual bleeding​ * Bartolin gland infection​ * PID – pain, infertility
38
Gonorrhoea in Men: Signs and Symptoms (3)
* Symptoms appear 2-5 days post-exposure​ * Muco-purulent urethral discharge​ * Dysuria
39
Gonorrhoea: Investigations
* Endocervical swab (women)​ * First catch urine (men)
40
Gonorrhoea: Treatment and Management (6)
* Await cultures and sensitivities before prescribing​ * Single dose Ciprofloxacin oral or IM Ceftriaxone​ * Abstain till 7 days post-treatment​ * Treat patient AND partner(s)​ * Reinforce healthcare education ​ * Offer follow-up 7 days post treatment
41
Complications of Gonorrhoea: Disseminated ​Gonococcal Infection (6)
* Bacteria multiply in neutrophils ​ * Travel via blood stream ​ * Endocarditis​ * Meningitis​ * Septic arthritis​ * Pustular/Petechial lesions
42
Complications of Gonorrhoea: During Pregnancy (6)
* 30% transmission rate​ * Conjunctivitis​ * Disseminated gonococcal infection ​ * Scalp abscess ​ * Vaginal and rectal infections​ * Pharyngeal infections
43
What is Syphilis?
* Caused by Treponema pallidum​ bacterium * Helical cell spirochete​ * Too small for gram-staining​ * Spread through contact with lesions​ * Mother-to-baby transmission
44
Stages of Syphilis: First Few Years (1)
• No signs and symptoms
45
Stages of Syphilis: Primary Stage (2)
* Sore/chancre found in genital area * Chancres do not result in pain and disappear without treatment
46
Stages of Syphilis: Secondary Stage (9)
* Skin Rash (reddish brown spots on back, palms and soles of feet) * Mucous membrane lesions throughout body but no itchiness * Fever * Sore Throat * Headache * Swollen Glands * Weight Loss * Myalgia * Fatigue
47
Stages of Syphilis: Tertiary Stage
* Blood Vessel Problems * Cardiac Problems * Nervous System Problems * Damaged Organs * Gummatous syphilis * Death
48
Stages of Syphilis: Latent Stage (2)
* Symptoms disappear for 1-20 years * Relapse Symptoms
49
Syphilis: Investigations (3)
* Lesion Swabs * Treponemal Enzyme Immunoassay (EIA) * Blood Test
50
Syphilis: Treatment and Management (3)
* Penicillin ​ * Contact tracing​ * Follow-up over 2 years

Infection (21 decks)

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