Session 6 - Genitalfections Flashcards Preview

Semester 4 - Reproductive System > Session 6 - Genitalfections > Flashcards

Flashcards in Session 6 - Genitalfections Deck (59)
1

Name two sources of epidemiological date for assesing rates of infection of the genital tract

Genitourinary medicine clinics
Communicable disease surveillance centres

2

What is the issue with data from a GUM clinic?

Data is an underestimate, as does not take into account people presenting through their GPs

3

Give five groups at particular risk of STI

o Young people
o Minority ethnic groups
o Those affected by poverty and social exclusion
o Low socio-economic status groups
o Those with poor educational opportunities
o Unemployed people
o Individuals born to teenage mothers

4

What five conditions are associated with STI?

o Pelvic Inflammatory Disease (PID)
o Impaired fertility
o Reproductive tract cancers
o Risk of infection with blood-borne viruses – HBV, HIV
o Risk of congenital or peripartum infection of neonate

5

Give four differential diagnosis for genital skin and mucous membane lesions

o Genital ulcers
o Vesicles or bullae
o Genital papules
o Anogenital warts

6

Give five differential diagnosis for urethritis

o Gonococcal urethritis
o Chlamydial urethritis
o Non-specific urethritis
o Post-gonococcal urethritis
o Non-infectious urethritis

7

Give one main differential for vulvo-vaginitis

o Bartholinitis

8

How much has the following increased since '95?
o Uncomplicated Gonorrhoea
o Genital Chlamydia –
o Infectious Syphilis –
o GUM clinic workload

o Uncomplicated Gonorrhoea – 102% Increase
o Genital Chlamydia – 107% Increase
o Infectious Syphilis – 57% Increase
o GUM clinic workload – 34% Increase

9

What organism causes chalmydia?

Chlamydia trachomatis

10

Describe chlamydia trachomatis

Gram -'ve obligate intracellular bacterium

11

How does chalmydia present in males?

o Urethritis, epididymitis, prostatitis, proctitis

12

How does chlamydia present in females?

o Urethritis, cervicitis, salpingitis, perihepatitis

13

How is chlamydia diagnosed?

o Doxycycline or Azithromycin

14

What causes gonorrhoeae?

Neisseria Gonorrhoeae is a Gram –‘ve intracellular diplococcus

15

What is the clinical presentation of gonnorohoea in men?

o Urethritis, epididymitis, prostatitis, proctitis, pharyngitis

16

What is the clinical presentation of gonnorohoea in women?

o Asymptomatic, endocervicitis, urethritis, PID

17

What does disseminated gonococcal infection present as?

o Bacteraemia, skin and joint lesions

18

How is gonnorohoea diagnosed?

o Smear and culture

19

What is the treatment of gonorrhoeae?

Ceftriaxone

20

What causes herpes?

Herpes Simplex Virus, an encapsulated, double stranded DNA virus.

21

What is the clinical presentation of primary genital herpes

o Extensive, painful genital ulceration, dysuria, inguinal lymphadenopathy, fever

22

What is the clinical presentation of recurrent genital herpes?

o Asymptomatic  Moderate

23

How is genital herpes diagnosed?

o Smear and swab of vesicle fluid and/or ulcer base

24

How is genital herpes treated?

Aciclovir

25

What causes genital warts?

HPV

26

What HPV strains cause the highest risk?

16 and 18

27

What is the clinical presentation of HPV?

o Cutaneous, mucosal and anogenital (anus and genital) warts
o Benign, painless, verrucous epithelial or mucosal outgrowths
o Penis, vulva, vagina, urethra, cervix, perianal skin

28

How is HPV diagnosed?

Clinical, biopsy and genome analysis, hybrid capture

29

How is HPV treated?

o None – frequent spontaneous resolution
o Topical podophyllin, cryotherapy, intralesional interferon

30

What causes syphilis?

Treponema pallidum

31

What are the four stages of syphillis?

1. Indurated, painless ulcer (chancre)
2. 6 – 8 weeks later
 Fever, rash, lymphadenopathy, mucosal lesions
Latent – Symptom free years
3. Chronic Granulomatous lesions
4. Cardiovascular and CNS pathology

32

How is syphilis diagnosed?

Dark field microscopy, serology

33

How is syphilis treated?

Penicillin and test of cure follow up

34

What is trichomonas vaginitis caused by?

Flagellatd protozoan, trichomonas vaginalis

35

What are the key features of trichomonas vaginalis?

o Thin, frothy, offensive discharge
o Irritation, dysuria, vaginal inflammation

36

What is the treatment of trichomonas vaginitis?

Metronidazole

37

What are two types of parasites which cause genital infection?

Scabies mite
Pubic louse

38

Give two infections which occur post partum

Vulvovaginal Candidiasis
Bacterial Vaginosis

39

What causes vulvovaginal candidiasis?

Candida albicans

40

Give six risk factors for vulvovaginal candidiasis

 Antibiotics, oral contraceptives, pregnancy, obesity, steroids, diabetes

41

Give symptoms vulvovaginal candidiasis

o Profuse, white, curd-like discharge
o Vaginal itch, discomfort and erythema

42

How is vulvovaginal candidiasis diagnosed?

High vaginal smear and culture

43

How is vulvovaginal candidiasis treated?

Topic azoles or oral fluconazole

44

What distinguished bacterial vaginosis from vaginitis?

No inflammation of vaginal wall
- Caused by unsetlled normal flora

45

What is the main symptom of bacterial vaginosis?

Offensive fishy discharge

46

How does one diagnose bacterial vagnosis

 pH > 5, KOH whiff test
 High Vaginal Smear – Gram variable coccobacilli, reduced numbers of lactobacilli

47

How does one treat bacterial vaginosis

Metronidazole

48

Give five types of pelvic inflammatory disease

o Endometritis
o Salpingitis
o Oophoritis
o Pelvic peritonitis
o +/- tubo ovarian abscess

49

Give five PID risk factors

o Young age at first intercourse
o Multiple sexual partners (polygyny)
o High frequency of sexual intercourse
o High rate of acquiring new partners within pervious 30 days
o Alcohol/Drug use
o Cigarette smoking (2x increased risk)
o IUDs increase risk at point of insertion/removal for a few weeks

50

Give 5 bacteria that can cause PID

o Nesseria Gonorrhoea
 Gram –‘ve intracellular diplococci
o Chlamydia Trachomatis
 Gram –‘ve extracellular (infective) organism
o Bacterial Vaginosis
 Anareobes, Enteric Gram –‘ve Bacteroides
o Streptococci
o Haemophillis Influenzae
o Cytomegalovirus
o Mycobacterium Tuberculosis

51

Give two immediate sequelae of PDI

 Tubo-ovarian abscess
 Pyo-salpinx

52

Give five long term sequlae of PID

 Ectopic Pregnancy (1 episode of PID  7x increased risk)
 Infertility (1 episode of PID  12% increase, 2  25%, 3+  50-75%)
 Dyspareunia (Painful sexual intercourse)
 Chronic PID / Chronic pelvic pain
 Pelvic adhesions

53

What is the pathogenesis of PID

Infection of the cervix (endocervicitis) spreads, either directly or via lymphatics to the endometrium, uterine tubes and the pelvic peritoneum

54

Give four factors associated with the ascent of bacteria in PID

o Instrumentation
 Cervical dilation, coil insertion
o Hormonal changes associated with menstruation
 Lowers bacteriostatic effect of cervical secretion
o Retrograde menstruation
 Infection more common after a period
o Virulence of the organisms in acute chlamydial and gonococcal PID

55

Give four laboratory tests for PID

Pregnancy test
Triple and urethral swabs
Midstream urine
C-reactive protein

56

What is a triple swab?

 High vaginal swab – Bacteria vaginosis organisms
 Endocervical swab – Neisseria gonorrhoea
 Endocervical swab - Chlamydia trachomatis

57

Give six differential diagnoses for PID

o Ectopic pregnancy
o Acute appendicitis
o Irritable Bowel Syndrome (IBS)
o Ovarian cyst accidents (torsion, rupture, haemorrhage)
o Urinary Tract Infection (UTI)
o Functional pelvic pain of unknown origin

58

What is chronic pelvic inflammatory disease?

Symptoms >6 months duration
o Pelvic pain
o Secondary dysmenorrhoea
o Deep dyspareunia
o Menstrual disturbance
o Recurrent acute painful exacerbations

59

Give five clinical sequalae of chronic pelvic inflammatory disease

o Infertility
o Ectopic pregnancy
o Chronic pelvic pain
o Pelvic adhesions/tubo-ovarian complex
o Abnormal / painful periods