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Transition block 1 > Microbiology - genital tract infection > Flashcards

Microbiology - genital tract infection Flashcards

1
Q

What vaccinations are available for STIs?

A

Hepatitis B, hep A and HPV all available for MSM

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2
Q

What is pre exposure prophylaxis and what are some examples?

A

Medicine taken before exposure to STI to reduce risk of infection
Tenofovir disoproxil/ emtricitabine
Reduces HIV incidence by 86%

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3
Q

What is post exposure prophylaxis and in what STIs can it be used?

A

Medicine taken after exposure to reduce risk of infection
Hep B - HPV vaccine up to 7 days
HIV - 3 anti-retrovirals, start within 72 hours for 28 days in total

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4
Q

What are the most common bacterial STIs?

A

Chlamydia trachomatis, neisseria gonorrhoea and treponema pallidum (syphilis)

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5
Q

What are the most common viral STIs?

A

HPV (genital warts), HSV (genial herpes), hepatitis and HIV

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6
Q

What are the most common parasitic STIs?

A

Trichomonas vaginalis, phthirus pubis (pubic lice/crabs), scabies

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7
Q

What are some predisposing factors for candida infection?

A

Recent antibiotic therapy, high oestrogen levels, poorly controlled diabetes, immunocompromised patients

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8
Q

How does candida present?

A

Intensely itchy white vaginal discharge

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9
Q

How is candida diagnosed?

A

Clinical diagnosis

High vaginal swab for culture - majority of cases are caused by C.albicans

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10
Q

How is candida treated?

A

Topical clotrimazole

Oral fluconazole

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11
Q

What are the symptoms of acute bacterial prostatitis?

A

Symptoms of UTI but may have lower abdominal pain/back/perineal/penile pain and tender prostate on examination

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12
Q

What causes acute bacterial prostatitis?

A

Rare complication of UTI

Same organisms as UTI (chlamydia, gonorrhoea, E.coli, enterococcus)

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13
Q

How is acute bacterial prostatitis diagnosed?

A

Clinical signs + MSSU for C&S (mid stream sample of urine for culture and sensitivity)

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14
Q

How is acute bacterial prostatitis treated?

A

Ciprofloxacin for 28 days, trimethoprim if high C.diff risk

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15
Q

What organisms are present in the normal vaginal flora?

A

Lactobacillus species predominates and produces lactic acid which suppresses the growth of other bacteria
+/- strep viridans, GBBHS, candida

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16
Q

What causes bacterial vaginosis?

A

Replacement of normal flora with gardnerella vaginalis causing the pH to elevate and become more basic (from the normal 4-4.5)

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17
Q

How is BV diagnosed?

A

Discharge may contain bubbles
Adding 10% KOH to the discharge elicits a fishy odour - positive whiff test
A wet mount reveals the absence of bacilli and their replacement with clumps of coccobacilli (clue cells)

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18
Q

How is BV treated?

A

Directed against the anaerobic flora - metronidazole for 7 days
BV relapse rate is about 30%

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19
Q

Where can chlamydia trachomatis infect?

A

Urethra, rectum, throat and eyes + endocervix in women

20
Q

What kind of bacteria is chlamydia trachomatis?

A

Obligate intracellular bacteria with biphasic life cycle

Does NOT stain with gram stain - no peptidoglycan wall

21
Q

What serological group of chlamydia causes a genital infection?

A

Serovars D-K

22
Q

What serological group of chlamydia causes lymphogranuloma venereum?

A

Serovars L1-L3

23
Q

How is chlamydia trachomatis treated?

A

Azithromycin PO 1g for uncomplicated chlamydia

Doxycycline 100mg BD for 7 days for complicated chlamydia

24
Q

How are chlamydia and gonorrhoea diagnosed?

A

Combined NAATs or PCR - tests for both organisms
Highly sensitive and specific
Men - first pass urine sample
Women - HVS or VVS

25
Q

Where can neisseria gonorrhoea infect?

A

Urethra, rectum, throat and eyes + endocervix in women

26
Q

What kind of bacteria is neisseria gonorrohoea?

A

Gram negative diplococcus (2 kidney beans)

Much less common than chlamydia infection

27
Q

Other than NAAT and PCR how can N.gonorrhoea be tested for?

A

Microscopy of urethral/endocervical swabs

Culture on selective agar plates

28
Q

What is the treatment for N.gonorrhoea?

A

IM ceftriaxone

Test of cure is recommended for all patients

29
Q

What causes syphilis?

A

Treponema pallidum - does NOT stain with gram stain

30
Q

How is syphilis diagnosed?

A

PCR or serological test to detect antibodies

31
Q

Syphilis is a 4 stage illness, describe the first and last stage?

A

First stage = primary lesion - chancre

Last stage = late stage syphilis - CVS + CNS complications many years later

32
Q

What are some non-specific serological tests for syphilis?

A

VDRL (venereal diseases research lab)
RPR (rapid plasma reagin)
Indicate tissue inflammation, useful for monitoring response to therapy

33
Q

What are some specific serological tests for syphilis?

A

TPPA + TPHA

IgM + IgG ELISA - screening test for syphilis

34
Q

How is syphilis treated?

A

Very sensitive to penicillin

Injectable long acting preparations of penicillin

35
Q

What causes genital herpes?

A

HSV 1 + 2

36
Q

What kind of virus is HSV?

A

Enveloped virus containing double stranded DNA

37
Q

Describe the pathogenesis of genital herpes

A

Primary infection may be asymptomatic
Virus replicates in dermis and epidermis, gets into nerve endings and causes inflammation -> exquisitely painful multiple small vesicles
Virus can reactivate from the sacral root ganglion causing recurrent herpes attacks

38
Q

How is genital herpes diagnosed?

A

Swab in virus transport medium of deroofed blister for PCR test

39
Q

How is genital herpes treated?

A

Aciclovir helpful if taken early enough

40
Q

What kind of organism is trichomonas vaginalis?

A

Single celled protozoal parasite transmitted via sexual contact

41
Q

What does infection with trichomonas vaginalis cause?

A

Vaginal discharge and irritation

42
Q

How is trichomonas vaginalis diagnosed?

A

HVS for microscopy

43
Q

How is trichomonas vaginalis treated?

A

PO metronidazole

44
Q

Describe the pathogenesis of pubic lice infection

A

Acquired from close genital contact
Lice bite skin and feed on blood, which causes itching
Female lice lay eggs on hair next to skin

45
Q

How are pubic lice treated?

A

Malathion lotion

Transition block 1 (11 decks)

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