Haunted by the past QUIZ

Name some natural defences of the female genital tract

• 1) Anatomical Features– Simple squamous epithelium in vagina– Associated skin folds (labia major + minor)– Cervix is a physical barrier to most infections from ascending to uterus +

oviducts• 2) Normal microbial flora• 3) Acid environment (pH 5)

– Maintained by lactobacilli (major defence)– Vaginal epithelium produces glycogen in response to circulating E– Lactobacilli metabolise glycogen to lactic acid ¯pH

• 4) Cervical mucus– Antibacterial activity + contains lysozyme

• 5) Ciliated cells of uterus– Constantly drive mucous towards natural orifices carrying with it any bacteria

• 6) Regular menstruation

Match

1. Gonorrhea 2. Chlamydia 3. Syphilis4. Bacterial

vaginosis 5. Chancroid 6. LGV7. Genital

Herpes 8. Genital Warts

1. Treponema pallidum

2. Neisseria gonorrhea 3. Gardenella vaginalis 4. Chlamydia

trachomatis 5. HSV6. Haemophilus

ducreyi 7. HPV

What are 4 ways to detect pathogens?

• 1. Selective media (organisms that grow)• 2. NAAT for organisms that do not grow well or

are non-cultivable & have conserved DNA/RNA• 3. Serology (for organisms that produce an

antibody response)• 4. Microscopy (IF, special stains, wet mounts as

indication and for visible but noncultivable organisms)

Match

• Best sample to detect this organism– for antibody detection– for antigen detection– for culture, Gram stain,

molecular testing

•Pus•Blood •Urine

What is the incubation period of syphilis?

• 3 weeks

What are the clinical features of Chlamydia?

• Females: asymptomatic in 70% – mucopurulent cervical– Discharge– Dysuria– dyspareunia and– pelvic pain– abnormal bleeding

• Males: asymptomatic up to 50% – Dysuria, discharge, epididymitis, prostatitis

What are some risk factors for acquiring Chlamydia?

• under 25 yrs• more than one partner• recent change of partner• unprotected sex• homeless youth• drug, alcohol and substance use

True or false?

• Ectopic pregnancy - Produces pain only with acute dilatation of the tube, if the tube ruptures pain is relieved a little and is replaced by generalized pelvic and abdominal pain as the haemoperitoneum develops

• Functional cysts (follicle, corpus luteum) rupture less readily than do benign or malignant neoplasms

What can cause this sort of pain?

• Acute onset of bilateral lower abdominal pain that increases with movement, fever, purulent vaginal discharge

• Pain often associated with menses• Direct and rebound tenderness, cervical

motion tenderness and bilateral adnexal tenderness

PID

What are some DDx for Differential diagnosis of SecondaryDysmenorrhoea

• Endometriosis• Uterine or vaginal abnormalities with obstruction of

menstrual flow (hydrometrocolpos)• Intrauterine synechiae (Asherman’s synd)• Endometrial polyps or IUDs• Uterine leiomyomata• Adenomyosis• Pelvic congestion syndrome (chronic pelvic pain

caused by ovarian and internal iliac varices)

What are some complications of PID?

• Tubo-ovarian abscess• Peritonitis• Intestinal obstruction• Bacteraemia• Infertility

What type of ovarian cancer?

What is the clinical marker for granulosa cell tumors?

• Inhibin • may secrete oestrogen + potentially malignant

Who am I?

What age group are dysgerminoma more common?

• Teens, 20s • Unilateral, 15+ cm, sheets of germ cells, with

c.t. septae containing lymphocytes

Give a brief summary of the immunology of HIV

• HIV binds to gp120 glycoprotein, to CD4 receptors on helper T lymphocytes, monocytes, macrophages, and neural cells

• CD4+ cells migrate to lymphoid tissue where the virus replicates release and in turn infect new CD4+ cells

• As infection progress depletion or impaired function of CD4+ cells decrease immune function

What are the stages of HIV infection?

• Acute infection – asymptomatic • Seroconversion – malaise, myalgia,

pharyngitis, maculopapular rash • Asymptomatic infection • Persistent generalised lymphadenopathy • AIDS-related complex • AIDS