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Reproductive System > Week 6 - Infections of the Genital Tract > Flashcards

Week 6 - Infections of the Genital Tract Flashcards

1
Q

What is the most likely infective organism in a 19 year old female with no symptoms, mucopurulent discharge and cervical motion tenderness noted on speculum examination?

A

Chlamydia trachomatis - infections usually asymptomatic

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2
Q

Which infective organism causes a painless chancre in the early stages of infection?

A

Treponema pallidum

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3
Q

Describe the nature of the discharge produced by Trichomonas vaginalis infection.

A
  • Foul-smelling

- Yellow-green vaginal discharge

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4
Q

What is the most likely infective organism in a patient presenting with vaginitis and a thin, grey vaginal discharge with a fishy, amine odour?

A

Gardnarella vaginalis

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5
Q

What is the nature of discharge produced by Candida albicans infection?

A
  1. Thick
  2. White
  3. Cottage-cheese like
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6
Q

What is the most likely infective organism for a male who is sexually active with symptoms of urethritis and whose urine sample showed the presence of gram-negative diplococci?

A

Chlamydia trachomatis

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7
Q

Which 2 organisms are the most common sexually transmitted organisms?

A
  1. Neisseria gonorrhoeae

2. Chlamydia trachomatis

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8
Q

Describe the structural features of Chlamydia trachomatis.

A
  1. Small
  2. Round/ovoid bacterium
  3. Rigid cell wall that resembles a gram negative envelope
  4. The morphology of the organism changes dependent on the stage in the life cycle
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9
Q

What is the normal vaginal pH range?

A

3.5-4.5

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10
Q

What is the dominant organism in normal vaginal flora?

A

Lactobacillus sp

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11
Q

Which microorganism is the pathogen that can cause bacterial vaginosis?

A

Gardnarella vaginalis

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12
Q

Which microorganism is the pathogen that can cause conjunctivitis in newborns?

A

Chlamydia trachomatis

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13
Q

State the causes of genital ulcers.

A
  1. Herpes simplex virus - HSV
  2. Syphilis
  3. Chanchroid - Haemophilus ducreyi
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14
Q

What can vesicles of Bullae be caused by?

A

HSV

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15
Q

State the causes of genital papules.

A
  1. Transient manifestations of STIs
  2. Condylomata acuminata - anogenital warts
  3. Umbilicated lesions of Molluscum contagiosum virus
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16
Q

State the important features of genital ulcers.

A
  1. Number
  2. Size
  3. Tenderness
  4. Base
  5. Edge
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17
Q

State the causative agents for non-gonococcal urethritis.

A
  1. Chlamydia trachomatis
  2. Mycoplasma
  3. Ureaplasma
  4. Trichomonas HSV
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18
Q

State the types of urethritis.

A
  1. Gonococcal urethritis
  2. Non-gonococcal urethritis
  3. Post-gonococcal urethritis
19
Q

State the causes of vulvo-vaginitis.

A
  1. Candidiasis
  2. Trichomoniasis
  3. Staphylococcal
  4. Foreign body
  5. HSV
20
Q

State the causes of cervicitis.

A
  1. C. trachomatis
  2. N. gonorrhoeae
  3. HSV
  4. HPV
21
Q

State the causes of bartholinitis.

A
  1. Polymicrobial infections with endogenous flora

2. Rarely STIs

22
Q

What features does a laboratory diagnosis of bacterial vaginosis consist of?

A
  1. Pungent odour with the KOH whiff test
  2. Vaginal pH of greater than 4.5
  3. Presence of clue cells on a wet mount lacking many PNMs
23
Q

How is bacterial vaginosis thought to occur?

A

From a synergistic infection involving the overgrowth of normal bacterial flora including Gardnerella vaginalis

24
Q

State the symptoms of bacterial vaginosis.

A
  1. Vaginal discharge
  2. Odour
  3. Itch
  4. Dyspareunia
  5. Soreness
25
Q

State the differential diagnoses you would consider for a 19 year old male presenting with pain on passing urine, a creamy urethral discharge, slight reddening of the surrounding glans penis, no fever and no previous history of genital urinary problems.

A
  1. Chlamydial urethritis
  2. Gonococcal urethritis
  3. Non-specific urethritis
26
Q

What antibiotics would you consider for treatment of gonorrhoea?

A
  • Ciprofloxacin not currently recommended because of widespread resistance worldwide
  • Ceftriaxone 500 mg Im + Azithromycin 1 g PO given
  • Also consider treatment for chlamydia in the regime
27
Q

Why do you think mixed infections with Chlamydia and Gonorrhoea are common?

A
  1. Common at-risk behaviours and associated factors
  2. Long-term asymptomatic infection
  3. Identical mode of transmission
  4. High prevalence rates of Chlamydia trachomatis infection
28
Q

Outline treatment for Human papillomaviruses.

A
  1. None - spontaneous resolution: 1 year - 70%, 2 years - 90%
  2. Topical podophyllin, cryotherapy, intralesional interferon, imiquimod, surgery
29
Q

Outline the methods of screening for HPV.

A
  1. Cervical pap smear cytology
  2. Colposcopy + acetowhite test
  3. Cervical swab - HPV hybrid capture - 40% of 20-24 year olds positive
30
Q

Outline the techniques used for diagnosis of HPV.

A
  1. Clinical
  2. Biopsy + genome analysis
  3. Hybrid capture
31
Q

Outline the 2 types of vaccine used for HPV.

A
  1. Cervarix - for HPV 16 and 18 - initially used in UK

2. Gardasil - for HPV 6, 11, 16 and 18 - used from 2011

32
Q

Who is the HPV vaccine offered to?

A

Girls aged 12-13 year old (2 doses)

33
Q

What infections can Chlamydia trachomatis cause in neonates?

A
  1. Inclusion conjunctivitis

2. Pneumonia

34
Q

State the techniques used for diagnosis of Chlamydia trachomatis.

A
  1. Endocervical and cervical swabs - NAAT (IF, EIA, culture)
  2. First void urine - NAAT
  3. Neonatal infection - conjunctival swab (NAAT)
35
Q

Outline the treatment for Chlamydia trachomatis infections.

A
  1. Doxycycline/azithromycin

2. Erythromycin in children

36
Q

Who does the chlamydia screening programme target?

A

Sexually active under 25s

37
Q

State the symptoms of primary genital herpes.

A
  1. Extensive painful genital ulceration
  2. Dysuria
  3. Inguinal lymphadenopathy
  4. Fever
38
Q

State how you can diagnose herpes simples virus.

A

PCR of vesicle fluid and/or ulcer base

39
Q

Which type of herpes simplex virus is associated with genital herpes?

A

HSV2

40
Q

What is herpes simplex virus 1 usually associated with?

A

Cold sores

41
Q

What is the treatment for herpes simplex virus?

A

Aciclovir - primary and severe disease

42
Q

What types of infection can Neisseria gonorrhoeae cause in females?

A
  1. Asymptomatic
  2. Endocervicitis
  3. Urethritis
  4. PID which may lead to infertility
43
Q

What effects can disseminated gonococcal infections have?

A
  1. Bacteraemia

2. Skin and joint lesions

44
Q

Outline the techniques used to screen for human papillomavirus infection.

A
  1. Cervical pap smear cytology
  2. Colposcopy + acetowhite test
  3. Cervical swab - HPV hybrid capture (40% of 20-24 year olds positive)

Reproductive System (9 decks)

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