What is the pathogenesis of Pelvic Inflammatory Disorder?
A pathogen moves up from the vagina and cervix and infects the pelvic organs.
What are the possible causes of PID?
Bacterial (common), viral, fungal, parasites.
How is PID diagnosed?
Pelvic exam, USS, Endometrial biopsy, laparoscopy.
What is the treatment for PID?
Bed rest, avoid sex, combined AB treatment
Symptoms of PID.
- Abdo pain
- Abnormal bleeding
- Abnormal vaginal discharge
- Painful sex
- Fever, N&V
What is endometriosis?
A disorder where the endometrial tissue grows outside of your uterus.
What is the pathogenesis of endometriosis?
Endometrial cells are transported from the uterine cavity during menstruation and become implanted onto the pelvic and abdominal cavities. This leads to ectopic hormonal fluctuations which alter the menstrual cycle. Each period leads to more scar tissue formation.
What are the symptoms of endometriosis?
- painful periods
- painful ovulation
- pain during or after sex
- Heavy or irregular bleeding
- painful bowel movements or urination
What are the symptoms of Cervicitis?
- Painful sex
- Vaginal discharge
- Painful urination
- Vaginal bleeding
What is the cause of Bartholinitis?
Infection (STD) and inflammation
What are the symptoms of Bartholinitis?
- Cyst that is red and painful
- pus visible at duct opening
- infection, fever, malaise
What is the cause of Varicocele?
Faulty or absent valves in the spermatic veins which causes blood to pool in the vein, the veins become swollen. This decreases blood flow to the testes.
What is orchitis?
Inflammation of the testes.
Causes of orchitis.
- prostate or epididymis infection
Symptoms of orchitis.
High fever, redness, swelling and tenderness.
What is balanitis?
Inflammation of the glans penis.
What is the cause of balanitis?
- Poor hygiene in uncircumcised men and Phimosis.
- Mainly in men with DM and candidiasis
What is Phimosis?
Tight foreskin that is unable to retract.
Symptoms of phimosis.
- Forceful or difficult urination
- urinary retention
- painful erection
What are the symptoms of prostatis?
- Same as UTI
- pain when standing, lower back pain, painful ejaculation, rectal pain
- Systemic - fever, chills, malaise
- Nocturia, dysuria, urinary retention
What are the complications of prostatitis?
- abscess and rupture into the urethra or rectum
- bacteraemia and septic shock
What is the bacteria that causes Gonorrhoea?
Neisseria gonorrhoeae bacteria
Pathogenesis of gonorrhoea.
Bacteria invades the mucosa of genitals and other areas of the body.
Pili attaches to epithelial cells which increases virulence.
Mucosal cells are damaged and inactivate IgA AB.
Strong inflammatory response.
Pyogenic infection (puss)
True/false: Gonorrhoea can lead to PID, arthritis, meningitis and endocarditis.
Burning sensation when urinating, pussy discharge from penis and painful/swollen testicles are signs of ______.
Painful, burning urination, increased vaginal discharge and bleeding between periods are signs of ________.
What is the most common STI in Australia?
What STI has the same pathogenesis as gonorrhoea with added signs?
Urethritis, cervicitis, bartholinitis are all signs of ____
In males, urethritis and proctitis are signs of ______
What is the systemic effect of chlamydia?
Treponema pallidum bacteria is the cause of what STI?
How can syphilis be transmitted?
- sexual contact
- mother to child
True/false: syphilis enters the body through micro-abrasions in the skin or by mucous membranes.
What are the stages of syphilis?
- Secondary - Latent
Describe the primary stage of syphilis.
- Chancres develop on anal skin, genitals, cervix or mouth in the 3-4 weeks post exposure.
Chancres can take 6-8 weeks to heal.
Describe the secondary stage of syphilis.
- 4-8 weeks post exposure
- fever, malaise, headache and lymphadenopathy
- widespread macules
- condylomata lata (wart-like mucosal lesions)
The latent stage of syphilis.
Positive serology without symptoms.
Describe the tertiary stage of syphilis.
- Symptoms/complications may develop months or years later in 30% of untreated cases
- Skin gummas, CNS and CVD diseases
How is herpes simplex transmitted?
Direct contact with infected secretions and mucosal surfaces, usually in the genital area.
The pathogenesis of primary herpes simplex.
- Virus replicate in the cells and destroys the basal epithelial cells which cause blister.
- cell necrosis produces an inflammatory response.
- immune response heals the lesions but the virus travels down the sensory nerve to root ganglion where it stays for life.
The pathogenesis of secondary herpes simplex.
- This can be triggered by sun exposure, trauma, febrile illness, menstruation and emotional stress
- The virus travels down axons back to original site of infection.
- It may or may not produce lesions.
- Infection usually is milder and shorter than the primary infection.
What are the symptoms of herpes simplex?
- small red bumps or tiny white blisters
- pain or itching in genital area
- may have flu-like signs
What is the cause of genital warts?
What STI is transmitted by direct contact, sexual intercourse, mother-child or fomites (such as wet towels)?
What is the pathogenesis of genital warts?
- HPV replicates and produces lesions of squamous cells (warts).
- small papules on genitals
- most lesions resolves within 1-2 years - cell mediated immunity
- 15% may progress to cervical, vulval or anal cancer
Candidiasis is a _____ infection.
Candida albicans is the cause of what disorder?
Antibiotic use, DM, pregnancy and use of corticosteroids can lead to _____