Non STI and other?

Question 1

Sx of BV?

Answer 1

Painless
malodour less thin grey fishy DC

Question 1

what causes Bacterial Vaginosis?
Physiology?

Answer 1

excessive PV cleaning + new sex partner

loss of normal bacteria flora; lactobacilli (maintains Acidic pH) replaced with (high anaerobes) Gardnerella vaginalis

Question 2

Dx of BV?
Criteria?

Answer 2

Amsel criteria
need at least 3 out of 4

Question 3

what does amsel criteria contain?

Answer 3

pH>4.5
+ve Whiff test with KOH
White/grey DC
Clue cells on histology (gram -ve infiltration of epithelium)

Question 4

what other criteria can be used when analysing microscopy and why?

Answer 4

Hay ison criteria
depending on level of gardnerella present

Question 5

Tx for BV?

Answer 5

PO 400mg BD Metronidazole for 7 days

Question 6

Tx for BV in pregnancy?

Answer 6

Oral/topical metronidazole for 7 days

Question 7

why is BV bad in pregnancy/general?

Answer 7

Increased risk of Preterm labour, PROM, Miscarriage, High STI risk

Question 8

What is candida?

Answer 8

genital thrush

Question 9

causes of candida/genital thrush?

Answer 9

T2DM
Pregnant
recent Abx use
new sex partner

Question 10

Sx of candida?

Answer 10

Painless, malodourless, cottage cheese DC, LOTS, satellite lesions

Question 11

Dx of candida?

Answer 11

clinical but do need high vaginal swab of DC

Question 12

Tx of candida?

Answer 12

stat dose 150mg PO Fluconazole

Question 13

Tx of candida in pregnancy?

Answer 13

300mg Clotrimazole pessary

Question 14

Tx for oral thrush?

Answer 14

Fluconazole

Question 15

What is Pelvic inflammatory disease (PID)?

Answer 15

Ascending STI pelvic infection
(bacteria spread from vagina to rest of upper genital tract - ovaries, uterus, Fallopian tubes)

Question 16

What is the MC STI causing PID?

Answer 16

CT (or NG, M.G (mycoplasma genitalium))

Question 17

Sx of PID?

Answer 17

deep dysparaunia, discharge, cervicitis (PC/PMB), chronic pelvic pain, salpingitis + oopheritis (low fertility), vaginitis

Question 18

Dx of PID?

Answer 18

Triple swab
adnexal motion tenderness on bimanual
TV USS with contrast
HIV serology
bhCG - ectopic rule out

Question 19

Tx of PID?

Answer 19

100mg BD Doxycycline for 7 days + 1g IM Ceftriaxone + PO 400mg Metronidazole

Question 20

Complications of PID?

Answer 20

Infertility
High ectopic pregnancy
Fitz Hugh curtis (violin string diaphragmatic - hepatic adhesions) - peripheral abscess
Tx = laparoscopic adhesionolysis

Question 21

What is Lymphogranuloma venereum (LGV)?

Answer 21

CT induced (L2 Serovar) lymphadenopathy

Question 22

Sx and Tx of LGV?

Answer 22

Sx = ulcerating papule + proctocolitis + inguinal LNadenopathy

Dx and Tx = same as chlamydia

Question 23

What is balanitis?

Answer 23

inflammation of the glans penis

Question 24

what are the 2 causes of balanitis?

Answer 24

Candida - MC Lichen sclerosis (BXO)

Question 25

Sx of balanitis caused by candida?

Answer 25

white itchy lesions, gunky white thick discharge

Question 26

Tx of balanitis caused by candida?

Answer 26

Topical clotrimazole

Question 27

Sx of balanitis xerotica obliterans?

Answer 27

White plaques +/- tip of urethral meatus +/- phimosis (narrowing of foreskin - can't be retracted)

Question 28

Typical Patient with Lichen sclerosis? age, gender, what is it?

Answer 28

40-60 y/o M+F Fibrosis of superficial dermis leading to scar tissue and plaques

Question 29

Sx of lichen sclerosis?

Answer 29

white shiny plaques Koebner phenomena (worse with friction)

Question 30

What is lichen sclerosis called in M and F?

Answer 30

M = Balanitis xerotica obliterans (BXO) F = Kraurosis vulvae (>menopause)

Question 31

Dx of lichen sclerosis?

Answer 31

clinical, can do biopsy if uncertain

Question 32

Tx of lichen sclerosis?

Answer 32

high potency steroid 0.05 clobetasol proprionate

Question 33

What is pubic lice?

Answer 33

phthirus pubis (crab louse)

Question 34

Sx of pubic lice?

Answer 34

severe itchy pubic region +/- visible movement Maculae cerulae (blue small regions of feeding)

Question 35

Tx of pubic lice?

Answer 35

permethrin topical insecticide

Question 36

What is a chancroid? Sx?

Answer 36

painful genital ulceration discharge inguinal LNadenopathy due to Hemophilus Ducreyl (-ve stretobacillus)

Question 37

Tx of a chancroid?

Answer 37

stat PO azithromycin