Notes in OG7.4 Infectious Diseases and Gynaecology

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Published	10/04/2024	Most common cause of abnormal vaginal discharge in reproductive age → {{c1::bacterial vaginosis}}
Published	10/04/2024	Diagnosis of bacterial vaginosis requires use of the {{c1::Amsel}} criteria
Published	10/04/2024	Amsel criteria for the diagnosis of bacterial vaginosis (3 required):- {{c1::Characteristic discharge }}- {{c1::Clue cells on micr…
Published	10/04/2024	Patients with bacterial vaginosis have an {{c1::↑}} risk of sexually transmitted infections
Published	10/04/2024	Patients with bacterial vaginosis and a previous hysterectomy have an ↑ risk of {{c1::post-hysterectomy vaginal cuff infection}}
Published	10/04/2024	Patients with bacterial vaginosis have an ↑ risk of {{c1::preterm}} delivery
Published	10/04/2024	Treatment for bacterial vaginosis → {{c1::1 dose metronidazole 2 grams PO}}
Published	10/04/2024	Treatment for recurrent bacterial vaginosis → {{c1::metronidazole + clindamycin 2% cream::2 RXs}}treating partner may resolve issue
Published	10/04/2024	Diagnosis of chlamydia → {{c1::NAAT::test}} on {{c1::endocervical swab::sample }} or {{c1::first-void urine }}
Published	10/04/2024	Treatment of Chlamydia:{{c1::Azithromycin 1g PO stat }}OR{{c1::Doxycycline 100 mg BD PO for 7 days }}OR {{c1::Erythromycin 500 mg QDS P…
Published	10/04/2024	Treatment of Chlamydia in pregnancy → {{c1::Azithromycin 1g PO stat}}
Published	10/04/2024	What do you do after you treat someone for chlamydia? {{c1::Notify}}
Published	10/04/2024	Diagnosis of gonorrhoea → {{c1::NAAT::test}} on {{c1::endocervical or vaginal swab }} or {{c1::First catch urine }}
Published	10/04/2024	Treatment of Gonorrhea → {{c1::Ceftriaxone 500 mg IM stat}} AND {{c1::Azithromycin 1g PO stat}}with test of cure in 1-3 weeks
Published	10/04/2024	Treatment of partner of a patient with gonorrhea → {{c1::Azithromycin stat}}
Published	10/04/2024	Complications of trichomoniasis:- {{c1::Enhanced HIV transmission }}- {{c1::Preterm delivery }}- {{c1::Neonatal infection&nbs…
Published	10/04/2024	Diagnosis of Trichomoniasis → {{c1::NAAT}} and {{c1::swab}} for microscopy, culture, sensitivity
Published	10/04/2024	Treatment of trichomoniasis → {{c1::Metronidazole}}
Published	10/04/2024	Second most common cause of vaginitis → {{c1::Candidiasis}}
Published	10/04/2024	Recurrent candidiasis → {{c1::≥ 4 cases in a year::definition}}
Published	10/04/2024	Genital herpes may be associated with {{c1::prodromal}} paraesthesia
Published	10/04/2024	HSV diagnosis → {{c1::PCR of vesicular fluid}} or {{c1::serology }}
Published	10/04/2024	Treatment for HSV infection →valacyclovir {{c1::500}} mg TDS x 5 days ORacyclovir {{c1::400}} mg TDS x 5 days
Published	10/04/2024	Management of recurrent HSV infection:- {{c1::OCPs to avoid menstruation }}- {{c1::Avoid tampon use }}- {{c1::Consider short …
Published	10/04/2024	HSV with primary episode in the first or second trimester → {{c1::Valacyclovir 500 mg PO BD x 5 days::tx}}, then prophylaxis {{c1::(500 mg P…
Published	10/04/2024	HSV with primary episode in the third trimester → {{c1::Valacyclovir 500 mg PO BD::RX}} then prophylactic dose of {{c1::500 mg PO OD}} …
Published	10/04/2024	Early latent syphilis → {{c1::< 2 years since infection and asymptomatic::definition}}
Published	10/04/2024	Late latent syphilis → {{c1::> 2 years since infection and asymptomatic::definition}}
Published	10/04/2024	If penicillin allergic and primary, secondary or early latent syphilis → {{c1::doxycycline or ceftriaxone or erythromycin (pregnancy)}}
Published	10/04/2024	First line antibiotics for pelvic inflammatory disease in outpatient setting → {{c1::Ceftriaxone IM stat + metronidazole AND ofloxacin:…
Published	10/04/2024	Post-exposure prophylaxis for HIV → {{c1::2+1}} for {{c1::1 month::time }}
Published	10/04/2024	After post-exposure prophylaxis for HIV, test for HIV at {{c1::3}} and {{c1::6 }} months
Published	10/04/2024	Complications of chlamydia{{c1::pelvic inflammatory disease}} +/- {{c1::tubo-ovarian}} abscess{{c1::adhesions}}{{c1::infertility}}{{c1::reactive arthr…
Published	10/04/2024	Diagnosis of gonorrheaNAAT of swab from {{c1::urethra, cervix, vagina, throat, or rectum::5 locations}}first pass urine much less reliable in {{c1::wo…
Published	10/04/2024	Complications of gonorrhea {{c1::pelvic inflammatory disease}}{{c1::Bartholin's}} abscess{{c1::septic arthritis}}{{c1::Fitz-Hugh-Curtis syndrome}…
Published	10/04/2024	Treatment of HPVdifficult to eradicate, treat patient + partner{{c1::podophyllin}}: applied weekly by healthcare professional, avoid in pregnancy{{c1:…
Published	10/04/2024	Diagnosing syphilis{{c1::treponemal enzyme immunoassay}}: IgM or IgG{{c1::VDRL}} or {{c1::RPR}}: gives specific titer result, easiest to detect primar…
Published	10/04/2024	Treatment of primary syphilis = 1 dose {{c1::benzathine penicillin G 2.4 million units IM}}
Published	10/04/2024	Treatment of late syphilis = benzathine penicillin G 2.4 million units IM {{c1::1x/week for 3 weeks::duration}}
Published	10/04/2024	{{c1::40}}% of cases of syphilis treated during pregnancy result in Jarisch-Herxheimer reactioncan cause fetal distress and premature labor{{c1::6-12:…
Published	10/04/2024	HIV testingscreening = {{c1::ELISA}}, positive 2-6 weeks after infectiondiagnosis = {{c1::Western blot}} detects HIV Abscombined = 99.9% accurate
Published	10/04/2024	Complications of bacterial vaginosisincreased risk of {{c1::preterm labor}}{{c1::intra-amniotic infection}}increased susceptibility to {{c1::HIV}}post…
Published	10/04/2024	Diagnosis of candidal infectionoften clinical diagnosisconfirm with {{c1::high vaginal swab with microscopy}}
Published	10/04/2024	treatment of candidal infectiontopical {{c1::clotrimazole}} cream and/or pessaryoral: 1 dose {{c1::fluconazole}} 150 mg BUT strongly contraindicated i…
Published	10/04/2024	Pelvic inflammatory disease presents with{{c1::lower abdominal pain}}{{c1::dyspareunia}}{{c1::discharge: foul, purulent}}{{c1::irregular vaginal bleed…
Published	10/04/2024	complications of pelvic inflammatory disease{{c1::ectopic pregnancy}}{{c1::infertility}}{{c1::chronic pelvic pain}}{{c1::tubo-ovarian abscess}}
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