Gynae Part 2 Flashcards
(87 cards)
What are common symptoms of STIs?
Pain, discharge, itching, urinary symptoms
These symptoms can vary depending on the specific STI.
What factors are included in sexual history when assessing STIs?
- Time since last contact
- Number of partners in last 3 months
- Gender of partners
- Partnership type and contactability
- Previous STDs
- Contraception use
- Type of sex
Contraception use includes methods like condoms and barriers.
What vaccinations are relevant in the context of STIs?
HPV vaccination
HPV vaccination is crucial in preventing certain types of STIs.
What swabs are typically taken for STI investigations?
1) Endocervical
- Chlamydia, Gonorrhoea
2) High vaginal
- VP3: Candida, Gardnerella, Trichomonas
- HSV (if vesicles present)
Endocervical swabs are specifically used for chlamydia and gonorrhoea.
What is the tx of genital herpes?
Acyclovir
Symptoms can become more pronounced when the immune system is compromised.
What is the treatment for Trichomonas?
Metronidazole
Partners should also be screened and treated.
What is the management for Gonorrhea?
- IM ceftriaxone 1g single dose
- PO cipro 500mg once
- Test of cure required
Gonorrhea can be difficult to eradicate.
What is the classic triad of symptoms for Pelvic Inflammatory Disease (PID)?
Abdominal pain, fever, vaginal discharge
PID can lead to severe complications if not treated.
What are common risk factors for developing PID?
- Multiple sex partners
- No barrier contraception
- Diabetes
- Immunocompromised state
Understanding risk factors is essential for prevention and early intervention.
What are the complications associated with PID?
Fitz Hugh Curtis syndrome, septic shock
Fitz Hugh Curtis syndrome involves perihepatic adhesions secondary to PID.
What is the general management approach for STDs?
- Build rapport
- Identify condition as STD
- Breaking bad news
- Advise on preventing disease transmission
- Advise conditions needing test of cure (gonorrhea, chlamydia if pregnant)
- Mandatory notification
Effective management includes communication and education.
Fill in the blank: The treatment for Chlamydia in non-pregnant women includes _______.
[Doxycycline]
Doxycycline is contraindicated in pregnancy.
True or False: A test of cure is required for Gonorrhea.
True
This is important due to the difficulties in eradicating the infection.
What are features of trichomonas
Yellow-green discharge
strawberry cervix
What is the tx for chlamydia
doxycycline
azithromycin
What is contraceptive efficacy?
Assessed by measuring the number of unplanned pregnancies that occur during a specified period of exposure using a particular contraception method
Methods include the Pearl index and life table analysis.
What is the Pearl index?
Number of failures per 100 women-years (HWY) of exposure
Rate per HWY = (total no. of accidental pregnancies x 12 x 100) / (total months of use).
Name three types of barrier contraception.
- Condoms
- Cervical caps
- Diaphragms
What is the mechanism of spermicides?
Causes sperm cell membrane to break.
What is the mechanism of progesterone-only contraceptives?
- Suppresses FSH/LH, stops ovulation
- Thickens cervical mucus to block sperm penetration
- Induces endometrial thinning & atrophy
List some benefits of progesterone-only contraceptives.
- Regulates cycles
- Reduces menstrual loss
- Reduces ovarian/endometrial cancer risk
- Relieves dysmenorrhea
- Protects against cysts/fibroids
What are some side effects of progesterone-only contraceptives?
- Reduced bone density
- Breakthrough bleeding
How long does it take for combined contraceptives to work?
7 days to work, protects for 7 days if missed.
What are some absolute contraindications to combined oral contraceptives (COC)?
- Thrombotic disorders
- CVA
- Coronary artery disease
- Impaired liver function
- Oestrogen-dependent malignancies
- Pregnancy
- Breastfeeding
- Undiagnosed irregular genital tract bleeding
- Migraine with aura