Flashcards in GUM Deck (12)
What are the extra genital manifestations of gonorrhoea?
What type of bacteria causes gonorrhoea?
gram -ve diplococcus
it infects the columnar epithelium of the urethra, endocervix, rectum, pharynx, conjunctiva
incubation period 2-5days
How do IUDs work?
What are the complications?
What are the contraindications?
They inhibit implantation and impair sperm migration
1. may be expelled
2. increased risk of PID
3. heavy and painful periods
Contraindications: pregnancy, current PID or STI, trophoblastic disease, cancer of ovary, endometirum or cervix, distorted uterine cavity
How do IUS' work?
What benefits does it have?
It causes reversible endometrial atrophy making implantation less likely and amenorrhoea (in 20%)
It may benefit patients with endometriosis, adenomysosis, fibroids and endometrial hyperplasia.
When can a IUD be used as emergency contraception?
Ideally withint 120 hrs of sexual intercourse (5days).
If sexual intercourse is over 5 days ago can be used up to 5 days after likely ovulation (day 19 of a 14 day cycle).
Which tablets can be used for emergency contraception and when can you take them?
Levonorgestrel - can be take up to 72hrs after sexual intercourse ( can be used more than once per cycle if needed)
Ulipristal acetate - can be taken up to 120 hours after sexual intercourse.
In both effective contraception needs to be used until the period.
What are the contraindications for the combined oral contraceptive pill?
Diabetes with neuropathy, retinopathy, nephropathy or vasculopathy,
Smoking >15/day if >35yrs
Migrane with aura
past stroke or venous or arterial thrombosis
Breast cancer in last 5 yrs
Heart disease with pulmonary hypertension or embolus risk
Liver adenoma, hepatoma, decompensated cirrhosis, active hepatitis
What are the cautions in using the COCP?
Venous (avoid if >2 of these): first degree relative hisotry of VTE aged 30, varicose veins, immobility
Arterial avoid if >2 of these): smoker, aged >35, BP >140/90, migraine without aura, BMI >30, DM, firs degree relative with arterial disease
What are the characterisitcs of thrust infection?
White curdy discharge
Red sore, itchy vulva
On steriods, has diabetes, antibiotics, immunosupressed
What is characteristic of trichomoniasis infection?
Bubbly thin discharge
Motile flaggellates on wet film
What is characteristic of bacteria vaginosis
Altered bacterial flora clue cells on wet microscopy