Microbiology of genital tract infection

Question 1

Predominate normal vaginal flora

Answer 1

Lactobacillus

Question 2

Presentation of vaginal candidiasis

Answer 2

Itchy white vaginal discharge

Question 3

Treatment of candidiasis

Answer 3

Clotrimazole cream/pessary

Oral fluconazole

Question 4

Manifestation of candida infection in males

Answer 4

Spotty rash on glans penis- balanitis

Question 5

Gardnerella/mobiluncus species cause…

Answer 5

Bacterial vaginosis

Question 6

Main symptom of bacterial vaginosis

Answer 6

Thin, watery, fishy-smelling discharge

Question 7

Diagnostic features of bacterial vaginosis (2)

Answer 7

Raised vaginal pH

High vaginal swab- “clue cells”

Question 8

Treatment of bacterial vaginosis

Answer 8

Oral metronidazole

Question 9

Test which should be carried out if prostatitis + less than 35 years old

Answer 9

First pass urine test for chlamydia and gonorrhoea

Question 10

Management of acute bacterial prostatits

Answer 10

Ciprofloxacin 28 days (trimethoprim if high C. diff risk)

Question 11

Infection sites of chlamydia (5)

Answer 11

Eyes, throat, rectum, urethra, cervix

Question 12

Causative agent in syphilis

Answer 12

Treponema pallidum

Question 13

Four stages of syphilis infection

Answer 13

Primary- chancre (painless ulcers at infection site)
Secondary- rash, ulcer, flu-like symptoms
Latent stage
Late stage- cardio/neuro symptoms

Question 14

Screening test for syphilis used in Tayside

Answer 14

IgM + IgG ELISA on clotted blood sample

Question 15

Treatment of syphilis

Answer 15

Long acting injectable penicillin

Question 16

Commonest viral STI

Answer 16

Genital warts (HPV)

Question 17

Causative agent of genital warts

Answer 17

Human papillomavirus, mainly serotypes 6 and 11

Question 18

Prevention of genital warts

Answer 18

HPV vaccine given to girls aged 11-13, against serotypes 6, 11, 16 and 18

Question 19

Management of genital warts (2)

Answer 19

Non keratinised- podophyllotoxin cream/lotion

Keratinised- cryotherapy

Question 20

Symptoms of genital herpes

Answer 20

Very painful small, easily ruptured vesicles

Question 21

Treatment of genital herpes (2)

Answer 21

Aciclovir and pain relief

Question 22

Single cell protozoa spread by sexual contact

Answer 22

Trichomonas vaginalis

Question 23

Treatment of trichomonas

Answer 23

Oral metronidazole

Question 24

Symptoms/signs of trichomonas (3)

Answer 24

Yellow/green offensive discharge
“Strawberry cervix”
Increased vaginal pH