Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 > HIV/GUM Teaching day > Flashcards

HIV/GUM Teaching day Flashcards

1
Q

What are the causes of abnormal vaginal discharge?

A

sexually transmitted infections, bacterial vaginosis, candidiasis, retained foreign body (e.g. tampon or condom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some causes for post-coital vaginal bleeding?

A

(vaginal bleeding after sexual intercourse): cervical ectropion, cervicitis caused by sexually transmitted infections, vulvovaginal atrophy, cervical cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the causes of intermenstrual vaginal bleeding?

A

physiological (ovulation), contraception (progesterone depot), sexually transmitted infections, polyps and fibroids, and malignancy (e.g. uterine cancer, cervical cancer, vaginal cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of post-menstrual bleeding?

A

vaginal atrophy, sexually transmitted infections, hormone replacement therapy and malignancy (e.g. uterine cancer, cervical cancer and vaginal cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some causes of dyspaneunia?

A

(Pain during sex)
sexually transmitted infections, vaginal atrophy, endometriosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some causes of abdominal and pelvic pain?

A

pelvic inflammatory disease, urinary tract infection, ectopic pregnancy, ruptured ovarian cyst, endometriosis, and ovarian torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some causes of vulval skin changes/itching/lesions?

A

vulval candidiasis, genital warts, genital herpes, syphilis (chancre), vaginal atrophy, lichen sclerosis and vulval malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What needs to be asked in terms of somebody’s genital discharge?

A

Volume
Colour
Consistency
Smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is mycoplasma gentalium?

A

A bacteria that causes a STI

Causes discharge, pain on urination, pain in testicles, burning or itching in urethra

Diagnosis: PCR from urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common cause of non-gonococcal urethritis?

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which STI’s can you see under a microscope?

A

Gonorrhoea - will show lots of pus

Not Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is balanitis?

A

Penile tip swelling
- Will appear swollen, itchy, and painful

Most common cause is bad hygiene in uncircumcised men (smegma irritation)

Treatment: hygiene and emollients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why might you want a midstream urine sample?

A

Midstream investigates the contents of the bladder so used to investigate a UTI

The first bit of urine will be from the urethra, so is useful for STI diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the cause of urethral discharge in men?

A

STI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for chlamydia

A

2 Doses of doxycycline per day (morning and night) for a week

No sex for a week because it takes that long to clear
If vomits, drug wont work and further therapy will be needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is scabies?

A

Itchy rash caused by mites spread through skin to skin contact

Treated with creams and lotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is epididyal-orchitis?

A

When the epididymis becomes inflamed and spread to the whole testicle

Treated with antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is lichen sclerosis?

A

Itchy white patches on the genitals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the presentation of a gonorrhoea infection?

A

Sometimes no symptoms
Thick green or yellow discharge
Pain urinating
Bleeding between periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the presentation of a chlamydia infection?

A

Urethritis
Mucoid or watery urethral discharge
Painful urination
Epididymitis (with or without symptomatic urethritis) with unilateral testicular pain
Tenderness and swelling
Abnormal vaginal bleeding
Chancre

Chlamydia can infect the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is trichomonas vaginalis?

A

A STI caused by a parasite

Frequently asymptomatic
Purulent, frothy discharge
Vulvar and cervical lesions
Abdominal pain
Dysuria
Dyspareunia
Itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is pelvic inflammatory disease?

A

When and infection spread to upper female reproductive system

Normally there is a mucus plug at the cervix to prevents pathogen from ascending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms of pelvic inflammatory disease (PID)?

A
  • Bilateral lower abdominal pain
  • Deep dyspareunia
  • Abnormal vaginal bleeding
  • Abnormal discharge
  • Systemic symptoms like fever, nausea, and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the signs of PID during examination?

A
  • Lower abdominal tenderness
  • Purulent cervical discharge
  • Cervical motion tenderness
  • Uterine tenderness
  • Mass
  • Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the complications of PID?

A
  • Ectopic pregnancy
  • Infertility, worse with recurrent PID due to scarring
  • Chronic PID
  • Chronic pain due to adhesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the treatment for PID?

A

Don’t delay treatment, start the triple treatment early:

  1. Ceftriaxone IM stat dose (gonorrhoea)
    - Issues with needle phobia
  2. Doxycycline 14 days (chlamydia)
    - Teratogenic, so don’t give with suspicion of pregnancy
  3. Metronidazole for 7-14 days (anaerobes)
    - Interacts with alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Gillick competence?

A

Assesses if young person is mature enough to consent to medical decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are Fraser guidelines?

A

Apply to under 16’s requesting contraception and sexual health treatment without parental permission or knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What extra questions are asked to under 18’s is sexual health?

A
  • Where do you live?
  • What are you relationships like?
  • What do you do during the day? Are you going to school or truanting?
  • Are you involved in other young people organisations Eg. CAHMS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the McCormack pain scale?

A

Assesses abdominal and pelvic rebound tenderness in quadrants

Maximal score is 36

30
Q

What are some differentials for a rash?

A
  1. Primary HIV infection
  2. Syphilis
  3. Drug reaction
  4. Viral illness
  5. Skin disease
31
Q

What are the main symptoms of an acute HIV infection (seroconversion disease)?

A
  • Systemic fever and weight loss
  • Malaise
  • Headache
  • Rash
  • Myalgia
  • Mouth sores
  • Nausea and vomiting
32
Q

What is the difference of presentation of primary vs secondary syphilis?

A

Primary: single chancre
Secondary: multiple cutaneous lesions
Tertiary: Systemic involvement

33
Q

What is a chancre?

A

A firm painless lesions that oozes fluid that contains syphilis bacteria. It heals after 1-5 weeks but infection remains

Appears where the bacteria entered the body

Lymph nodes nearby may be inflamed

34
Q

What is a NAAT test?

A

Nucleic acid amplification test

Can be used to diagnose STI’s

35
Q

What is the Jarisch-Herxheimer reaction?

A

Fever, headache, malaise, rigors, and joint pains lasting several hours after beginning syphilis treatment
- Controlled with analgesics and rest

Patients need to be alerted of this possibility

36
Q

What is the Procaine reaction?

A

A reaction to procaine penicillin (used for neurosyphilis)

A sensation of impending doom and hallucinations lasting 30mins. it’s self-limiting

37
Q

What tests are done to STI’s?

A
  • NAAT test for gonorrhoea and chlamydia
    It’s highly sensitive but doesn’t give info about antimicrobial sensitivities
  • Culture for gonorrhoea
    Poor sensitivity but gives information about antimicrobial sensitivities
  • PCR test for herpes, syphilis, and mycoplasma
    It’s sensitive and easy, but expensive
38
Q

Which investigations are done for men having sex with men with symptoms?

A

Multiple sites need to be covered in case not all areas are positive

Oropharynx: gonorrhoea, chlamydia
Urethral: gonorrhoea, chlamydia
Rectal: Gonorrhoea, chlamydia
Blood: HIV, syphilis, hepatitis

39
Q

What happens if somebody has neurosyphilis symptoms but is allergic to penicillin?

A

Ceftriaxone daily because doxycycline doesn’t cross the blood brain barrier

40
Q

What is the management for bacterial STI’s?

A
  • Partner notification
  • Abstinence during treatment
  • Education about STI’s and transmission to prevent recurrence
  • Preventative measures: vaccine or PrEP
  • 3 monthly testing
41
Q

What are the differentials for genital ulcers?

A

Herpes simplex
- No cure, symptoms managed with acyclovir
- Causes multiple, painful ulcers with erythematosus

Syphilis
- Treated with antibiotics
- Causes a single, painless ulcer

42
Q

What is chem sex?

A

Sex using drugs

43
Q

What are the benefits and issues of chem sex?

A

Benefits
- Allows you to go on for longer
- Disinhibits to allow more experiences
- Enhances sexual experience
- Forget internalised homophobia

Issues
- Risky sexual behaviour
- Blood born viruses
- Non-consensual sex
- Risk of dependency and overdose
- Forget to take meds like PrEP
- Unable to enjoy sober sex

44
Q

What is the management of pneumocystis jirovecii (PCP)?

A
  • Oxygen
  • Antibiotics (co-trimoxazole is broad spectrum so also covers fungus)
  • Corticosteroids improve prognosis
45
Q

What is immune reconstitution inflammatory syndrome (IRIS)?

A

A hyperinflammatory response that occurs in the first six months of treatment of HIV/AIDS patients, a potential complication of the use of highly active antiretroviral therapy (HAART)

  • A weak immune system leads to many opportunistic infections that HAART can reveal and cause a shock to the body
46
Q

Which white blood cell will specifically be low in HIV?

A

Lymphocytes

47
Q

How is PCP diagnosed?

A

A sputum sample
- But PCP tends to cause a dry cough and breathlessness so difficult

X-ray shows ground-glass appearance but this is non-specific
Will hear crackles on auscultation

48
Q

What are the risks of beginning antiretroviral therapy following hospitalisation?

A

Risks:
- Polypharmacy causing overlapping side effects
- Immune reconstitution inflammatory syndrome

Usually wait 1 week, treat infection, then start HIV treatment

49
Q

What are some complications of a PCP infection in HIV?

A
  • Pneumothorax
  • IRIS
  • Unresponsive infection

Other: DVT due to immobility

50
Q

What is the issue with HIV and Hep B co-infection?

A

Causes an accelerated progression of liver disease, including increased risks for hepatocellular carcinoma, and liver-related mortality

Also PrEP stops the Hep B treatment from working so they need to be immune to Hep B before beginning PrEP

51
Q

How is HIV monitored?

A
  • Check viral load 2-4 weeks after beginning the treatment
  • Monitor side effect and organ functions
  • Then yearly monitoring, usually electronic
52
Q

How can HIV be diagnosed in clinic?

A

Pin prick test or oral version

Takes up to 20mins for results

53
Q

What is the risk of HIV transmission between anal and vaginal sex?

A

Anal has higher risk

Receptive (being bottom person) has higher risk because of tears and injuries

54
Q

How does circumcision reduce the risk of transmission of STI’s?

A

It removes the receptor cells reducing the surface area that comes into contact with mucosa for transmission

55
Q

What are the side effects of PEP?

A
  • Nausea
  • Fatigue
  • Headaches
  • Loss of appetite
  • Dizziness
  • Trouble sleeping
  • Linked to psychological effects

Last during the first week of treatment

56
Q

How does PrEP work?

A

Prevents the HIV getting into the body and replicating by blocking enzymes

57
Q

What is the ipergay method of taking PrEP?

A

Take 2 doses 24 hours before the sex, and then continue for 2 days after the last sex

This is effective

58
Q

What are the different types of antiretroviral drugs?

A

Most commonly used:
- Integrase strand transfer inhibitors
- Nucleotide reverse transcriptase inhibitors

Others:
- Non-nucleotide reverse transcriptase inhibitors
- Fusion inhibitors
- CCR5 antagonists
- Protease inhibitors
- Post-attachment inhibitors

59
Q

How does HIV increase risk of heart disease?

A

It effects the endothelium of vessels and chronic disease causes long-term inflammation

Also associated with high cholesterol

60
Q

What are the fungal opportunistic infections of HIV?

A
  • PCP (pneumocystis pneumoniae)
  • Oesophageal thrush
  • Cryptococcus (meningitis)
  • Histoplasmosis (lung infection)
61
Q

What are the viral opportunistic infections of HIV?

A
  • EBV (Lymphoma)
  • Kaposis sarcoma
  • HPV
  • CMV (retinitis)
  • Polyomavirus JC (multifocal leukoencephalopathy (PML))
62
Q

What is multifocal leukoencephalopathy (PML)?

A

A demyelinating virus of the CNS

Most are affected, gets bad in immunosuppressed people (HIV)

63
Q

What are some opportunistic bacterial infections of HIV?

A
  • TB
  • Pneumonia
  • Mycobacterium avium complex (MAC)
64
Q

What is Mycobacterium avium complex (MAC)?

A

A respiratory infection that mimics presentation of lymphoma

Causes disseminated disease in immunosuppressed

65
Q

What are some opportunistic parasitic infections of HIV?

A
  • Cryptosporidiosis (chronic diarrhoea)
  • Toxoplasmosis (spreads to brain causing neuro symptoms)
66
Q

What are the features of PCP in HIV?

A
  • Progresses within weeks
  • Breathlessness on exertion leading to desaturation
  • Dry cough (can’t take sputum sample to diagnose)
67
Q

What is the presentation of Cryptococcal meningitis in HIV?

A
  • Positional headache (raised ICP)
  • Blurred vision
  • Fever
  • Papilledema (diagnostic)
68
Q

How does cryptococcus cause raised ICP?

A

Its blocks the coracoid plexus to stop resorption of CSF leading to raised ICP

69
Q

How can raised ICP caused by cryptococcus be managed?

A
  • Prescribe antifungals
  • Therapeutic lumbar puncture
  • Shunt if uncontrolled
70
Q

Which 2 organisms are the most common cause of meningitis in HIV?

A
  • Cryptococcus
  • Neisseria meningitidis (vaccine available)
71
Q

What is Creon?

A

Used for pancreatic insufficiency to replace digestive enzymes

72
Q

What is oral hairy leukoplakia?

A

White, streaky patches on the tongue triggered by EBV

Most common in HIV

Year 4 (83 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions