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YEAR 4 O+G > GUM > Flashcards

GUM Flashcards

(53 cards)

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1
Q

organism: chlamydia

A

chlamydia trachomatis
gram-ve
most common STI in UK and causes infertility

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2
Q

GUM STI screening

A

HIV
syphilis
chlamydia
gonorrhoea

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3
Q

testing: chlamydia and gonorrhoea

A

NAAT

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4
Q

high vaginal swab: tests for

A
  • BV
  • candidiasis
  • trichomonas vaginalis
  • group B strep
  • gonorrhoea
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5
Q

presentation: chlamydia

A
  • mainly asymptomatic
  • yellow-green ischarge
  • pelvic pain
  • abnormal vaginal bleeding
  • dyspareunia
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6
Q

ix: chlamydia

A

NAAT vulvovaginal swab
yellow endocervical high vagianl swab for MC&S

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7
Q

rx: chlamydia

A

doxycycline 100mg BD 7 days
doxcycline - chlamydia

(not in pregnancy/BF - azythromycin 1g stat and 2 days 500mg/erythromycin 500mg QID 7 days)

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8
Q

complications: chlamydia

A
  • PID
  • chronic pelvic pain
  • infertility
  • ectopic pregnancy
  • conjunctivitis
  • reactive arthritis
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9
Q

organism: gonorrhoea

A

gram -ve diplococcus

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10
Q

presemntation: gonorrohoea

A

more likely to be symptomatic than chlamydia
* odourless, perulent dishcarge (can be green-yello)
* dysuria
* pelvic pain

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11
Q

ix: gonorrohoea

A

NAAT
charcoal swab for MC&S

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12
Q

rx: gonorrhoea

A

IM ceftriaxone 1g single dose if senstivities unknown
single dose PO ciprofloxacin 500mg is sensitivities known

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13
Q

presentation: BV

A

fishy smelling watery grey/white discharge
no itch/pain

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14
Q

ix: BV

A
  • high vaginal swab
  • vaginal high pH
  • CLUE CELLS on MC&S
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15
Q

key word: clue cells

A

BV

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16
Q

rx: BV

A

asymptomatic = no treatment
symptomatic = metronidazole 7 days

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17
Q

key words: metronidazole treatment advice

A

avoid alcohol

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18
Q

complications: BV

A

miscarriage
preterm delivery
PROM
chorioamnionitis
LBW
postpartum endometritis

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19
Q

presentation: candidiasis

A

thick white cottage cheese like discharge
no smeel
itchy/painful

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20
Q

ix: candidiasis

A

charcoal swab for MC7S

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21
Q

rx: candidiasis

A

clotrimazole cream/pessary
PO fluconazole
canesten due (tablet and cream)

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22
Q

presentation: trichomonas

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A

asymptomatic
frothy yellow-green fishy discharge
itching

23
Q

ix: trichomonas

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A

ph >4.5
strawberry cervix on speculum
HV swab for MC&S

24
Q

rx: trichomonas

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A

metronidazole

25
presentation: mycoplasma genitalium
urethritis similar to chlamydia
26
ix: mycolplasma genitalium
NAAT swab test cure after
27
rx: mycoplasma genitalium
doxycycline BD 7 days THEN azithromycin 1g stat THEN 500mg OD for 2 days
28
organism: syphilus
* treponema pallidum * spirochete with spiral shaped bacteria
29
stages: syphillis
primary - painless ulcer "chancre" secondary - systemic symptoms (skin and mucmous membranes - can resolve after 3-12 weeks and enter latent stage) latent - symptoms disappear but still infected (early up to 2 years, late - after 2 years) tertiary - gummas and CV/neuro complications
30
presentation: neurosyphilis
argyll-robertson ppil - constricted pupil that occomodates focusing on nera object but not reacting to light
31
diagnosis: syphilis
antibody testing - PCR dark field microscopy
32
rx: syphilis
IM benzathine benzylpenicillin
33
presenation: HSV2 herpes
* ulcers/blistering lesions * neuropathic pain * flu-like symptoms * dysuria * inguinal lymphadenopathy * symptoms ca last 3 weeks in primary infection
34
rx: genital herpes
aciclovir paracetamol instilagel wear loose clothing
35
def: PID
pelvic inflammatory disease inflammation and infection of pelvic organs cause of tubular infertility and chronic pelvic pain
36
causes: PID
chlamydia gonorrhoea mycoplasma
37
presentation: PID
* pelvic pain * abnormal vaginal dishcharge * abnormal bleeding * dyspareunia * fever/signs of sepsis * dysuria
38
ix: pID
* NAAT swabs * HV swab * HIV ad syphilis test
39
rx: PID
1. IM ceftriaxone 1g to cover gonorrhoea 2. doxycyline to cover chlamydia 100mg 14 days 3. metronidazole 400mg 14 days for anaerobes
40
complications: PID
* sepsis * abscess * infertility * chronic pelvic pain * ectoic pregnancy * Fitz-High-Curtis syndrome
41
def: Fitz-Hugh-Curtis syndrome
* inflammation and infection of liver capsul * causes adhesions between liver and peritoneum * causes RUQ pain * tx: ahesiolysis via laparoscopy
42
most common cause: PID
chlamydia
43
MOA: COCP
* stops ovulation * thickens cervical mucous * thins endometrium
44
contraindications: COCP
* uncontrolled hypertension * >35 and >15 cigarettes/day * migraine with aura * previous VTE * vascular disease/stroke * liver irrhosis/tumours * IHD/AF/cardiomyopathy * SLE and APL syndrome
45
instructions for taking: COCP
* start pill ay any time in cycle * day 1-5 protected immediately * otherwise use 7 days additional contraception
46
missed pill rules: COCP
missing 1 pill: * take missed pil straight away * continue taking pack as normal * emergency contraception not required missing 2+ pills: * take most recent pill missed straight away * use condoms/abstain from sex 7 daysa * emergency contraception if day 1-7 cycle
47
MOA: POP
stops ovulation thickens cervical mucous thins endometrium
48
contraindications: POP
* active breast cancer * severe liver cirrhosis * liver tumour
49
starinstructions for taking: POP
* can start any time in cycle * if day 1-5 preotected immediately * otherwise use additional conraception for 2 days after starting
50
missed pill rules: POP
<12 hours: take missd pill straight away and continue taking pack as normal >12 hours: take missed pill straight away - if missed more than 1 only take 1 use condoms for next 2 days if you had sex within time of missed pill = emergency contraception
51
emergency contaception: Levonogestrel (Levonelle)
* taken within72 hours UPSI * unlikely effective after ovulation (day 14+) * 1.5mg single dose * 3mg single dose if BMI>26 * BF ok * start COCP immediately
52
emergency contraception: ullipristal acetate (ellaone)
* taken within 120h of UPSI * unlikely to be effective after ovulation (day 14+) * more effective than levonelle * wait 5 days before COCP or POP * single 30mg dose * BF avoided * avoided in severe asthma
53
emergency contraception: copper coil
can be inserted within 5 days of UPSI/within 5 days og estimated date of ovulation most effective first line

YEAR 4 O+G (6 decks)

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