S9) Infections of the Reproductive Tract Flashcards Preview

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Flashcards in S9) Infections of the Reproductive Tract Deck (55)
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1

What are the main public health messages required to limit STI's?

- Practice safe sexual behaviour

- Reduce total number of partners

- Seek better sexual health education

- Seek early treatment for suspected STI

- Avoid alcohol/illicit drug abuse

2

Identify 6 factors which affect the transmission of genital tract infections

- Age

- Condom use

- Sexual orientation

- Socioeconomic status

- Number of partners

- Ethnicity

 

3

Identify 5 of the most commonly occuring STI's

- Chlamydia

- Gonorrhea

- Genital herpes

- Genital warts

- Syphillis

4

What is the causative organism in chlamydia?

Chlamydia trachomatis

5

What is the causative organism in gonorrhea?

Neisseria gonorrhea

6

What is the causative organism in genital warts?

Human papilloma virus

7

What is the causative organism in genital herpes?

Herpes simplex virus (1&2)

8

Briefly, describe the incidence of different STI diagnoses in men

9

Briefly, describe the incidence of different STI diagnoses in women

10

Briefly, describe the incidence of different STI diagnoses in men by ethnic group

11

Briefly, describe the incidence of different STI diagnoses in women by ethnic group

12

How does chlamydia present in males?

- Urethritis

- Dysuria

- Epididymitis

- Prostatitis

- Conjunctivitis 

- Asymptomatic pharyngeal infection

13

How does chlamydia present in females?

- Increased discharge

- Dyspareunia (painful sex)

- Post coital bleeds 

- Intermenstrual bleeds

- Conjunctivitis

- Asymptomatic pharyngeal infection

14

How is chlamydia diagnosed in men?

- First catch urine NAAT (nucleic acid amplification testing)

- Rectal NAAT

- Pharyngeal NAAT

15

How is chlamydia diagnosed in women?

- Vulvovaginal & endocervical swabs for NAAT

- Rectal NAAT

- Pharyngeal NAAT

16

Describe the treatment of chlamydia in men and women

- Doxycycline / Azithromycin (1st line)

- Erythromycin / Ofloxacin (2nd line)

17

How does gonorrhea present in men?

- Urethral discharge

- Dysuria

- Anal discharge

- Asymptomatic pharyngeal infection

18

How does gonorrhea present in women?

- Altered discharge 

- Lower abdominal pain

- Asymptomatic pharyngeal infection

- Asymptomatic rectal infection

19

How is gonorrhea diagnosed?

- Microscopy of gram stained genital specimen

- NAATs

- Cultures 

20

Describe the treatment of gonorrhea

- Ceftriaxone & azithromycin

- Spectinomycin (alternative for penicillin allergy)

21

Why are both azithromycin and ceftriaxone given as treatment for gonorrhea?

Azithromycin prevents antibiotic resistance to ceftriaxone and also treats the possible co-infection of chlamydia

22

How does genital herpes present?

- Painful ulceration

- Dysuria

- Vagina discharge

- Fever

- Myalgia

23

How is genital herpes diagnosed?

- Type specific serology

- Virus detection of vesical fluid/ulcer base

24

Describe the treatment of HSV

- General advice

- Suppressive treatment for recurrent HSV

- Aciclovir, valciclovir/famciclovir

25

How do anogenital warts present?

Benign, painless outgrowths on penis / vulva, vagina, urethra and cervix

26

How are genital warts diagnosed?

Biopsy in atypical lesions

27

Describe the treatment of anogenital warts

- No treatment (spontaneous resolution)

- Topical application (podophyllotoxin)

- Physical ablation (excision, cryotherapy, electrosurgery)

28

What is a preventative measure for anogenital warts?

HPV vaccination

29

What is the causative organism in syphilus?

Treponema pallidum

30

How does syphilis present?

- 1– painless ulcer 

- 2– rash, mucosal lesions, multi-system involvement

- Latent – symptom-free years

- 3– neurosyphilis, CV syphilis, parenchymous (40 years later)

31

What is the causative organism in trichomoniasis?

Trichomonas vaginalis (flagellated protozoa)

32

How does trichomoniasis present?

- Urethral discharge

- Dysuria

33

What is scabies?

Scabies is a skin condition caused by an infestation of the human itch mite called Sarcoptes scabiei

34

What are pubic lice?

Pubic lice are small parasites (crab louse – Phthirus pubis) affecting the genital area 

35

What is bacterial vaginosis?

- Bacterial vaginosis is a female genital tract infection which is not sexually transmitted

- It is the most common cause of abnormal discharge, odour and irritation in women of childbearing age

36

What are the causative organisms in bacterial vaginosis?

- Gadnerella vaginalis

- Prevotella spp

- Mobiluncus spp

37

How is bacterial vaginosis diagnosed?

- High vagina gram stained smear

- Vaginal pH > 4.5

- Pungent odour with the KOH ‘whiff test’

- Presence of clue cells on a wet mount

38

How is bacterial vaginosis treated?

Metronidazole

39

What is vulvovaginal candidiasis?

Vulvovaginal candidiasis is a genital tract infection referring to vaginal and vulval symptoms caused by a yeast

40

What are the causative organisms of vulvovaginal candidiasis?

- Candida albicans

- Other non-albicans candida species

41

How does vulvovaginal candidiasis present?

- Vaginal discharge

- Vulval itch

- Soreness

- Dyspareunia

42

State 5 risk factors for vulvovaginal candidiasis

- Pregnancy

- Antibiotics

- Oestrogen oral contraceptives

- Diabetes

- Immunosupression

43

How is vulvovaginal candidiasis diagnosed?

High vaginal smear (± culture)

44

Describe the treatment of vulvovaginal candidiasis

- Topical azoles

- Oral azoles 

45

What is LGV?

Lymphogranuloma venereum is an STI caused by C. trachomatis serotypes L1-3 and presents with a rapidly healing papule then inguinal bubo

46

What is chancroid?

Chancroid is a bacterial STD presenting as painful genital ulcers which are caused by infection with Haemophilus ducreyi

47

What is Donovanosis?

Donovanosis is a tropical sexually transmitted infection presenting as genital nodules which progress to ulcers, caused by Klebsiella granulomatis

48

Provide a differential diagnosis for a patient presenting with genital skin and mucous membrane lesions

Genital ulcers – HSV, syphilis, chanchroid

- Vesicles of Bullae – HSV

- Genital papules – anogenital warts

49

Provide a differential diagnosis for a patient presenting with urethritis

Gonococcal urethritis

Non-gonococcal urethritis – C.trachomatis, ureaplasma, mycoplasma, HSV 

- Post-gonococcal urethritis 

50

Provide a differential diagnosis for a female patient presenting with a pelvic infection

Pregnancy related – chorioamnionitis, post-partum endometriosis

- Pelvic Inflammatory Disease

51

Provide a differential diagnosis for a patient presenting with vulvo-vaginitis and cervicitis

- Vulvovaginitis – candiasis, trichomoniasis, HSV

- Cervicitis – C. trachomatis, N. gonorrhea, HSV, HPV

- Bartholinitis

- Bacterial vaginosis

52

Provide a differential diagnosis for a patient presenting with prostatitis

- Acute bacterial prostatitis

- Chronic bacterial prostatitis

- Chronic pelvic pain syndrome

53

Provide a differential diagnosis for a patient presenting with epididymitis

- Non-specific bacterial epididymitis

- Sexually transmitted epididymitis

54

Provide a differential diagnosis for a patient presenting with orchitis

- Viral orchitis (mumps, coxsackie B)

- Pyogenic bacterial orchitis 

55

What is the illness iceberg and how does this concept apply in the case of STI's?

- The illness iceberg states that patients presenting to the GP are a small representative of a larger population of people with a specific condition

- In terms of an STI, most are asymptomatic so patients presenting to the GP are a small minority of those with STI's as they have symptoms