GUM Flashcards
(55 cards)
What is an STI?
A group of infecious diseases predominantly spread through very close (sexual) contact
Difficult to catch by non-sexual means
Name 5 viral STIs
HSV HPV Molluscum contagiosum Hepatitis HIV
Which is the most difficult to spread sexually?
Hep C
What causes swimming pool eye?
Chlamydia trachmatis
What can clothes/bedding sharing spread?
Phthirus pubis
Name 2 non sexually acquired genital infections
Candidal species
Gardnerella vaginalis
Name some local symptoms
Dysuria Rash Ulceration Pain Lumps Tenesmus Infestations Discharge Scrotal swelling Coital pain, Bleeding, Menses irregularity
Systemic symptoms
Rashes, fever, lymphadenopathy Jaundice Arthropathy Eye problems Bowel symptoms Malignancies, fevers, weight loss (HIV)
How can a non-sexually active person get syphilis?
Congenital syphilis
Endemic syphilis, children playing
What is gay bowel disease?
Shigella
Giardia
Entamoeba
GI organisms
What are the complication of poorly managed STIs?
PID Ectopic pregnancy Epidiymitis Infertility Neonatal complications and damaged babies Shortened lives of young working people
Risk of 1st sexual encounter
25% HSV1
HPV
10% chlamydia
What are the 6 points in the management of STIs?
1) accurate diagnosis
2) Look for and exclude other genital pathogens
3) Effective (curative) treatment
4) Tests of cure
5) Contact tracing, timely partner screening and treatment
6) Patient education & appropriate counselling
What are the 3 ways you can breech confidentiality in GUM?
With patient’s permission
If the other person is involved with the care of that condition
Exceptional circumstances (court order)
Is it an offence to have sex with someone if you are HIV+ve?
Only if you know you are HIV+ and transmit the disease
It is a criminal offence to knowingly infect someone with HIV
For contact tracing, what is said?
No pt details are given
“We are worried about your health, can you come and get tested?”
Risk factors for STIs?
Young age (less than 20) Single 2 or more partners in preceding 6 months Use of non barrier contraception Residence in inner city Symptoms in partner Current STI Hx of STI Ethnicity (for some STIs)
What is involved in a full sexual history?
PC (dysuria, discharge, frequency, dyspareunia)
HPC
PMH
Past hx of STIs (diagnosis, date, where treated?)
DH (recent abx exposure, slef medication, Hep B vaccination)
Contraception
Menstrual Hx (IMB? PCB?)
Smear Hx
Pregnancies
Sexual Hx
Last passed urine (reliability of urethral tests)
HIV risk assessment
What Qs are asked in a sexual history?
Last sexual intercourse: When Context (regular/casual partner) Sex of partner Length of relationship Nature of contact (vaginal, anal, oral) Condom use Consistency of condom use Locality of partner and nationality
All partners in last 3 months plus one more
What Qs form a HIV risk assessment?
Have you ever slept with a man who’s had sex with other men? Or a partner of MSM?
Have you or your partner knowingly had sex with someone who’s HIV positive?
Have you had unprotected anal intercourse?
Have you ever paid for sex or has sex for money?
Have you or your partner ever injected drugs?
Have you ever had any surgical procedures abroad (tattoo/piercing)?
Nationality of previous partners
Blood donation between 1975-85
What usually causes urtheritis in males?
Chalmydia (45%)
Gonococcal (5%)
Non chlamydial (50%) mycoplasma, ureaplasma, herpes, trichomonas, adenovirus
What is seen in microscopy for gonorrhoea?
More than 5 pus cells per high powered field (segmented nuclei)
Gram -ve diplococci
What guidance/regulations govern confidentiality in GUM?
Department of health (DH) general guidance that covers all medical consultations
Specific extra advice from DH to all sexual health services
General advice from GMC
(NOT privileged as that is only for baristers)
What is the likely diagnosis for: 25yr old female with grey fishy smelling discharge, pH 5
BV
