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3a sexual health > Vaginal Infections > Flashcards

Vaginal Infections Flashcards

(55 cards)

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1
Q

What is the most common STI in the developing world?

A

chlamydia

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2
Q

What organism causes thrush?

A

thrush = candidiasis

candida albicans - yeast like fungus

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3
Q

What are the risk factors for candidiasis (thrush)?

A

pregnancy
diabetes
antibiotic use
immunosuppression

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4
Q

How is thrush presented?

A

“cottage cheese” discharge
vulval irritation
itching
superficial dyspareunia

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5
Q

How is candidiasis diagnosed?

A

clinical diagnosis *

microscopic detection of mycelia spores on wet slides

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6
Q

How is thrush treated?

A

1st line = topical imidazole (canestan), clotrimazole pessary
2nd line= oral fluconazole (contraindicated in pregnancy)

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7
Q

Which organism causes chlamydia?

A

chlamydia trachomatis= small bacterium

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8
Q

What organism causes gonorrhoea?

A

neisseria gonorrhoea = gram -ve diplococcus

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9
Q

What are the risk factors for chlamydia and gonorrhoea?

A

sexually transmitted so previous STI, multiple partners, early sexual experience

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10
Q

How does chlamydia present?

A

asymptomatic in 70% females
dysuria
irregular bleeding
vaginal discharge

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11
Q

How does gonorrhoea present?

A 
asymptomatic
vaginal discharge 
urethritis 
cervicitis 
bartholinitis
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12
Q

What are the possible complications of chlamydia?

A 
pelvic inflammatory disease
Reiters syndrome 
infertility 
risk of ectopic pregnancy 
epididymitis
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13
Q

What are the possible complications of gonorrhoea?

A 
pelvic inflammatory disease
tubal infertility 
risk of ectopic pregnancy 
Bartholins abscess 
disseminated gonorrhoea - fever, pustular rash, septic arthritis
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14
Q

How is chlamydia and gonorrhoea diagnosed?

A

Nucleic Acid Amplification Test (NAAT) on 1st void urine

incubation period of 2 weeks

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15
Q

How is chlamydia treated?

A

azithromycin bd for 7 days

partner notification!

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16
Q

How is gonorrhoea treated?

A

IM ceftriaxzone

partner notification!

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17
Q

Which organism causes trichomoniasis?

A

trichomonas vaginalis = flagellate protozoa

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18
Q

How does trichomoniasis present?

A 
grey-green frothy discharge 
strawberry cervix
irritation 
dysuria 
ph>4.5
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19
Q

How is trichomoniasis diagnosed?

A

wet film microscopy

culture of vaginal swabs

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20
Q

How is trichomoniasis treated?

A

metronidazole oral

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21
Q

How does a herpes simplex virus present?

A

primary infection = most severe, acute
can have recurrent attacks from reactivation of latent virus

  1. prodrome - itching
  2. flu like illness
  3. vulvitis and pain
  4. small vesicles on vulva
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22
Q

What are some of the triggers that could cause a reactivation of the herpes simplex virus?

A

stress, sex, menstruation

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23
Q

how is herpes simplex virus diagnosed?

Study These Flashcards
A

PCR testing on vesicular fluid

24
Q

How is herpes simplex virus managed?

Study These Flashcards
A
  1. no cure
  2. symptomatic relief - analgesia, saline bathing
  3. oral acyclovir
  4. condoms when infected as contagious
25
Which symptoms are HSV 1 or 2 associated with?
HSV 1= lesions around mouth and lips HSV 2= genital lesions
26
What are the symptoms for bacterial vaginosis?
white fishy smelling discharge
27
How is bacterial vaginosis diagnosed?
USING AMSTELS CRITERIA (3/4): 1. white thin layer 2. positive whiff test 3. ph >4.5 4. CLUE cells
28
How is bacterial vaginosis treated?
oral metronidazole 5-7 days
29
How long is the incubation period for gonorrhoea/chlamydia?
2 weeks | if present before, may need to re-test
30
What should you NOT do with metronidazole?
drink alcohol!
31
List the complications of herpes simplex virus
meningitis sacral radiculopathy transverse myelitis disseminated infection
32
What are the risk factors for genital warts?
multiple partners | smoking
33
Which virus causes genital warts?
Human papillomavirus (type 6 and 11 especially)
34
How do genital warts present?
growth/lesions painless itchy dyspareunia
35
How is genital warts managed?
1. podophyllotoxin cream | 2. cryotherapy
36
List the risk factors for bacterial vaginosis
sexually active IUCD new partner
37
How is bacterial vaginosis diagnosed?
high vaginal swabs
38
What causes bacterial vaginosis?
anaerobes over growing in normal vaginal flora NOT A STI
39
List the risk factors for syphilis
multiple partners MSM HIV unprotected sex
40
Which organism causes syphilis?
spirochaete treponema pallidum
41
Describe the primary infection of syphilis
in first few days- weeks 1. chancre = painless ulcer at site of sexual contact 2. local non tender lymphadenopathy
42
Describe the secondary infection of syphilis
in 6-10 week 1. systemic symptoms e.g. fever 2. rash on trunk, palms and soles 3. buccal snail track ulcers 4. condulomata lata
43
Describe the tertiary infection of syphilis
years after 1. neurosyphilis 2. gumma= granulomatous lesions of skin and bone 3. argyll robertson pupil 4. ascending aortic aneurysm
44
How is syphilis diagnosed?
serology blood test
45
How is syphilis treated?
IM benzylpenicillin
46
Describe the adverse reaction you can get after treatment for syphilis
Jarish Herxheimer reaction! seen after 1st dose causes fever, rash, tachycardia
47
List the risk factors for acquiring HIV
sexual transmission - vaginal secretions, semen or blood needs sharing infected blood products needle stick injuries e.g. health care mother to child e.g. birth, breastfeeding
48
Describe how HIV initially present?
presents similar to glandular fever 3-12 weeks after infection... ``` malaise lymphadenopathy sore throat myalgia diarrhoea mouth ulcers maculopapular rash ```
49
Outline the possible complications of HIV
``` oral thrush shingles Kaposi sarcoma HIV dementia PML aspergillosis oesophageal candiasis ```
50
What is the management of HIV?
HAART 2 x NRTI e.g. zidovudine PLUS 1 x protease inhibitor OR 1 x non NRTI
51
List the tests done in an asymptomatic screen in the GUM clinic
1. first void urine NAAT for chlamydia and gonorrhoea 2. HIV and syphilis blood tests + Hep B/C serology if high risk
52
Who is at high risk of hepatitis B/C?
sex workers IVDU high risk areas MSM
53
Which tests are done for a symptomatic screen in GUM clinic?
1. high vaginal swabs 2. urethral swabs 3. pharyngeal/ rectal swabs (depending on exposure) 4. urinalysis
54
Describe the primary, secondary and tertiary prevention regarding sexual health
PRIMARY PREVENTION education, awareness, free condoms, Hep B vaccination SECONDARY PREVENTION targeted screening, partner notification/ contact tracing TERTIARY PREVENTION treat the disease!
55
Why do we treat GUM?
1. get rid of symptoms 2. control spread of disease 3. prevent long term complications e.g. PID, sub fertility, neurosyphilis

3a sexual health (3 decks)

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