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3rd year > Repro - Infections > Flashcards

Repro - Infections Flashcards

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1
Q

what predominately makes up the normal vaginal flora

A

Lactobacillus

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2
Q

what is NOT part of normal vaginal flora

A

Lactobacillus acidophilus

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3
Q

what pH is the vagina? why?

A

acidic (pH 4-4.5) due to production of lactic acid +/- hydrogen peroxide

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4
Q

what causes candida infection

A

usually candida albicans

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5
Q

what are the risk factors for candida infection

A

recent antibiotics or steroids
high oestrogen levels (pregnancy, combined pill)
poorly controlled diabetes
immunocompromised

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6
Q

what are the symptoms of a candida infection

A

intensely itchy white vaginal discharge

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7
Q

what is the investigations of a candida infection

A

high vaginal swab for culture

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8
Q

what is the treatment of a candida infection

A

topical clotrimazole pessary

oral fluconazole

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9
Q

what is the symptoms of Bacterial vaginosis (BV)

A

white/grey discharge with strong smell (may contain bubbles)

alkali pH

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10
Q

what is the treatment of Bacterial vaginosis

A

metronidazole for 7 days

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11
Q

would you treat the male sexual partners of someone who has Bacterial vaginosis

A

no

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12
Q

what type of bacteria is gonorrhoea

A

gram -ve, diplococcus

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13
Q

what are the symptoms of gonorrhoea

A

unusual purulent discharge
pain/burning when passing urine
bleeding after sex/between periods
inflammation of foreskin

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14
Q

what are the investigations of gonorrhoea

A

females = urethral or endocervical swab for NAATs

male = first pass urine for NAATs

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15
Q

what is the treatment of gonorrhoea

A

ceftriaxone IM

if unable to be given IM = cefixime + azithromycin Oral

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16
Q

would you retest after treating gonorrhoea

A

yes

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17
Q

what is the most common STI in the UK

A

Chlamydia

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18
Q

what are the types of Chlamydia? what do they cause?

A 
A-C = trachoma (eye infection not STI)
D-K = urogenital infection 
L1-L3 = Lymphogranuloma venereum (LGV)
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19
Q

what are the symptoms of Lymphogranuloma venereum (LGV)? who is affected by it?

A

histologically identical to Crohns = rectal pain, discharge, bleeding

tropical climates, men who have sex with men

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20
Q

what are the symptoms of Chlamydia

A

asymptomatic

females = bleeding after sex/between periods, painful sex, purulent cervicitis

males = clear/milky discharge, pain peeing, urethritis

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21
Q

what is the investigation for Chlamydia? when should they be carried out?

A

test 14 days after exposure

female = vulvovaginal swab 
male = first pass urine
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22
Q

what is the treatment for Chlamydia

A

1st line = doxycycline

2nd line = azithromycin

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23
Q

would you retest after treating for Chlamydia

A

Yes, retest 3 weeks later

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24
Q

what is Trichomonas Vaginalis

A

single celled protozoal parasite

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25
what are the symptoms of Trichomonas Vaginalis
females = frothy, purulent discharge & irritation males = urethritis
26
what is the investigation for Trichomonas Vaginalis
high vaginal swab
27
what is the treatment of Trichomonas Vaginalis
oral metronidazole
28
what causes Syphilis? what is it?
treponema pallidum = gram negative spirochete organism
29
what are the 2 types of Syphilis
``` congenital = caught from mother acquired = caught via body fluids ```
30
what are the 4 stages of Syphilis
primary lesion = organism multiples at inoculation site and enters bloodstream secondary stage = large number of bacteria circulating in blood and manifesting at different sites latent stage = low-level multiplication in intima of small blood vessels tertiary = cardiovascular, neurovascular, etc complications
31
what are the symptoms of Syphilis at each stage
primary lesion = painless chancre & non-tender lymphadenopathy secondary = flu-like symptoms, generalised rash, "snail-track" mouth ulcers latent = no symptoms tertiary = heart/brain/etc issues
32
what are the investigations of Syphilis at each stage
Bloods primary = PCR, IgM secondary & tertiary = VDRL, RPR
33
what is the treatment for Syphilis
benzathine penicillin if allergic desensitise first
34
do you retest after treatment for Syphilis
yes, retest until RPR is negative
35
what causes Genital Herpes
herpes simplex virus
36
what are the types of Genital Herpes
primary infection = first exposure non-primary first episode = first presentation symptoms recurrent
37
what are the symptoms of Genital Herpes
small, painful blisters - no itching or tingling - can burst open to form ulcers - resolve within 5-7 days painful urination discharge local lymphadenopathy fever and tiredness
38
what are the investigations for Genital Herpes
swab base of ulcer for PCR | serology is only used in pregnancy
39
what is the treatment for Genital Herpes
aciclovir pain relief = topical lidocaine, saline bathing, analgesia
40
what are the symptoms of Mycoplasma Genitalium
asymptomatic
41
what are the investigations for Mycoplasma Genitalium
NAATS ``` female = vulvovaginal swab male = first pass urine ```
42
when would you test = for Mycoplasma Genitalium
if they have first line treatment for urogenital infection or PID has failed
43
what are the types and symptoms of HPV
usually symptomatic cauliflower warts - hands & feet = type 1 and 2 - anogenital = type 6 and 11 cervical cancer = type 16 and 18
44
what is the treatment of HPV
vaccine warts: - 1st line = podophyllotoxin - 2nd line = imiquiomod - last line = electrocautery anal warts = imiquiomod
45
what causes pubic lice
phthirus pubis
46
what are the symptoms of pubic lice
itching
47
what is the treatment of pubic lice
malathion lotion
48
what does HIV target?
CD4+ receptors
49
what are the types of HIV
HIV-1 = group M is responsible for global pandemic HIV-2 = simian immunodeficiency, limited to africa
50
what are the symptoms of HIV
``` primary = mimics flu/glandular fever asymptomatic opportunistic infections anemia HIV- associated wasting ```
51
what are some examples of opportunistic infections associated with HIV
``` pneumocystis jiroveci TB cerebral toxoplasmosis Cytomegalovirus (CMV) progressive multifocal leukoencephalopathy ```
52
give examples of AIDs related cancers and their cause
Kaposi’s sarcoma (vascular tumour) = herpes virus Non-Hodgkin’s lymphoma = EBV cervical cancer = HPV
53
give examples of skin diseases in HIV
herpes zoster herpes simplex HPV
54
what are the symptoms of o Cerebral toxoplasmosis
CD4+ <150 multiple cerebral abscess headaches, fever, focal neurology, seizures, increased ICP
55
what are the symptoms of Cytomegalovirus (CMV)
CD4+ <50 | reduced visual acuity/floaters, abdo pain, diarrhoea, PR bleeding
56
what are the symptoms of Pneumocystis jiroveci
SOB, dry cough, exercise desaturation
57
who must ALWAYS be screened for HIV
``` local prevalence >0.2% MSM and their partners drug users partner who is HIV+ history of exposure ```
58
what are the investigations of HIV
1st line = p24 capsule protein antibody CD4+ Th cells <200 RNA = first marker to be seen, rarely used antibody rapid HIV test (POCT) = fingerprick blood or saliva specimen
59
what is the treatment of HIV
HAART = combo of three drugs: Nucleoside reverse-transcriptase inhibitors (NRTI) Nucleotide reverse-transcriptase inhibitors (NtRTI) Non-nucleoside reverse-transcriptase inhibitors (NNRTI) Protease inhibitors
60
who is offered PrEP?
- Partner with HIV -detectable viral load OR men who has sex with men OR transwoman - >16  - HIV negative - Commits to follow up every 3 months and will stop if no longer eligible - Resident in Scotland
61
what is the treatment of a pregnancy women with HIV
HAART vaginal delivery if viral load undetectable caesarean if viral load detectable exclusive formula feeding

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