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Year 2 RE SCP > Introduction to Reproductive and Sexual Health History Taking > Flashcards

Introduction to Reproductive and Sexual Health History Taking Flashcards

1
Q

What are the Fraser guidelines?

A
  • guidelines applied specifically to advice and treatment that focuses on a young person’s sexual health and contraception
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2
Q

When discussing sexual history with female patients, what are the 6 things that need to be asked?

A

1 - changes in menstrual history
2 - contraceptive history
3 - previous gynaecological (female reproductive) history
4 - cervical smear history
5 - obstetric history (pregnancy, childbirth and the postpartum period)
6 - fertility history

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3
Q

What does gysmenorrhoea mean?

A
  • painful periods
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4
Q

What does dyspareunia mean?

A
  • pain during sexual intercourse
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5
Q

What does menorrhagia mean?

A
  • heavy periods
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6
Q

When we look at SOCRATES for assessment of pain, what does each letter stand for?

A
  • S = site
  • O = onset
  • C = character
  • R = radiates
  • A = associated symptoms
  • T= time/duration
  • E = exacerbating symptoms
  • S = severity
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7
Q

What is primary ammenorrhoea?

A
  • no period by age of 15
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8
Q

What is secondary ammenorrhoea?

A
  • absence of 3 or more periods in a row
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9
Q

What does oligomenorrhea mean?

A
  • infrequent periods
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10
Q

What is menorrhagia?

A
  • heavy or prolonged bleeding
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11
Q

Why is asking the date of a females last menstrual period important to ask?

A
  • may be pregnant
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12
Q

Some females may only have 6-7 periods or infrequent periods. What is a common cause of this seen in primary care?

A
  • polycystic ovary syndrome

- dysfunction of the ovaries

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13
Q

What is a red flag when asking questions during a reproductive history with a female, in relation to bleeding during the menstrual cycle?

A
  • intermenstrul bleeding (vaginal bleeding occurring at times other than during normal menstruation
  • could indicate cancer, but can also be fibroids
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14
Q

What is a red flag in female reproductive history questions, specifically relevant to sexual intercourse?

A
  • post coital bleeding (bleeding after sex) could be cervical cancer
  • infections can also cause this
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15
Q

When asking a woman about vaginal discharge, what do we need to ask?

A
  • do you normally get vaginal discharge?

- if not then how has it changed? (colour, texture, freqency)

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16
Q

When we ask a female about contraception, what are the 2 key questions we need to ask?

A

1 - currently using contraception

2 - previously used contraception

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17
Q

When we ask a female about contraception, the 2 key questions we need to ask are:

1 - currently using contraception
2 - previously used contraception

What 3 things do we need to know about for both of these?

A

1 - type of contraception
2 - duration of use
3 - compliance

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18
Q

When we ask about gynaecology history, which is the medical practice dealing with the health of the female reproductive system, what 4 important questions must we ask about?

A

1 - history of STIs
2 - previous gynaecological symptoms e.g dyspareunia, post-coital bleeding, pelvic pain, incontinence
3 - previous gynaecological diagnoses e.g endometriosis, prolapse, fibroids
4 - gynaecological treatments or surgeries e.g hormonal treatment, laparoscopy

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19
Q

What ages do women in the UK receive a smear test?

A
  • 25 - 64 years olds
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20
Q

How often do women receive a cervical smear test if they are ages 25-49 years old?

A
  • every 3 years
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21
Q

How often do women receive a cervical smear test if they are ages 50-64 years old?

A
  • every 5 years
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22
Q

How often do women receive a cervical smear test if they are aged >64 years old?

A
  • generally not at all

- if abnormal results have been identified

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23
Q

When we talk to a female about a cervical smear test, what are the 2 key questions we need to ask?

A

1 - when was your last smear test

2- if you have had a smear test what were the findings

24
Q

When we discuss a patients previous obstetric (medicine focused on pregnancy) history, what are the 3 key questions we must ask?

A

1 - have you ever been pregnant?
2 - if previously pregnant list all pregnancies chronologically
3 - have you had any miscarriages, terminations, ectopic pregnancies or still births

25
Q

When we discuss a patients previous obstetric (medicine focused on pregnancy) history, we ask if they have had any pregnancies. if the answer is yet, then we need to ascertain how many pregnancies and then list them chronologically, starting with the most recent. What 6 questions need to be asked about live pregnancies?

A 
1 - year of delivery
2 - gestation at delivery
3 - mode of delivery
4 - birth weight, sex, name/s
5 - any major complications in pregnancy or labour
6 - how baby/child is now
26
Q

What does gravidity mean?

A
  • total number of pregnancies including current one regardless of outcome
  • includes miscarriages, terminations etc…
27
Q

What does primigravida mean?

A
  • prima = latin for first
  • gravida = woman
  • primagravida = women with 1st pregnancy
28
Q

What does multigravida mean?

A
  • mutli = latin for multiple
  • gravida = latin for women
  • multigravida = a women who has been pregnant 2 or more times
29
Q

What does parity mean in relation to obstetrics?

A
  • number of pregnancies that have survived past 24 weeks

- called viability threshold and is regardless of the outcome

30
Q

What does nulliparous mean in relation to obstetrics?

A
  • nulli = latin for nothing
  • parous = latin for bearing or producing life
  • nulliparous means latin for not previously given birth
31
Q

What does primipara mean in relation to obstetrics?

A
  • primi = latin for first
  • para = latin for bearing or producing life
  • primipara means latin for given birth once
32
Q

What does multiparous mean in relation to obstetrics?

A
  • multi = latin for several
  • para = latin for bearing or producing life
  • multiparous means latin for given birth more than once
33
Q

What does grand multipara mean in relation to obstetrics?

A
  • women who has given birth to more than 5 times
34
Q

Gravidity (G) is the total number of pregnancies including current one regardless of outcome, includes miscarriages, terminations etc…, and parity (P) is the number of pregnancies that have survived past 24 weeks (viability threshold), regardless of outcome. Sania is pregnant for the first time and is 22 weeks pregnant, what would here G and P be?

A
  • G = 1
  • P = 0
  • so G1P0
35
Q

Gravidity (G) is the total number of pregnancies including current one regardless of outcome, includes miscarriages, terminations etc…, and parity (P) is the number of pregnancies that have survived past 24 weeks (viability threshold), regardless of outcome. Rachel is currently 8 weeks pregnant, has a 4 year old son and previously had a miscarriage at 10 weeks, what would here G and P be?

A
  • G = 3 (pregnant, has a 4 year old and a miscarriage)
  • P = 1 (1 child passed the 24 week viability threshold that is now 4)
  • +1 = child that did not pass parity (24 week viability threshold)
  • G3P1+1
36
Q

When we speak to a patient about fertility issues, what is primary and secondary infertility?

A
  • primary = couple who cannot pregnant after at least 1 year having sex without using birth control methods
  • secondary = refers to couples who have been able to get pregnant at least once, but now are unable to
37
Q

When we speak to a patient about fertility issues, what 4 important questions, other than primary and secondary infertility issues do we need to ask?

A
  • duration to trying to get pregnant
  • frequency of intercourse
  • timing of intercourse (relative to menstrual cycle, ovulation is best)
  • sexual difficulties experienced (may be male or female related)
38
Q

When we are talking to a male patient, what acronym is relevant if a patient is presenting with pelvic, genitalia pain or swelling?

A
  • S = site
  • O = onset
  • C = character
  • R = radiates
  • A = associated symptoms
  • T= time/duration
  • E = exacerbating symptoms
  • S = severity
39
Q

When we are talking to a male patient who is presenting with pelvic, genitalia pain or swelling, the acronym below is useful:

  • S = site
  • O = onset
  • C = character
  • R = radiates
  • A = associated symptoms
  • T= time/duration
  • E = exacerbating symptoms
  • S = severity

What other 3 things do we need to ask that is relevant to the pelvic, genitalia pain or swelling?

A

1 - establish whether unilateral or bilateral
2 - history of trauma
3 - penile skin lesions

40
Q

When speaking to a male patient, what 4 questions should we ask that are relevant to arousal levels?

A

1 - morning erections
2 - reduced libido
3 - erectile dysfunction
4 - difficulty reaching organism

41
Q

What is the legal age of consent for sex in the UK?

A
  • 16 years old
42
Q

What is Statutory Rape?

A
  • sex with a child 13 years or under

- because children under 13 cannot give consent

43
Q

What must be done if a child under the age of 13 admits to having sex during a consultation?

A
  • inform the police and social services

- need to protect the child

44
Q

If a child under 16 years of age presents with repeated attendances for STIs, or termination of pregnancy, what should we always consider?

A
  • potential for sexual exploitation or sexual abuse
45
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps, what are they?

A 
1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy
46
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps:

1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy

What sort of information do we need to ask about partners?

A
  • are partners casual or regular
  • gender
  • length of relationships
  • number of partners in last 12 months
  • non-consensual sex
  • age of first sexual experience
  • risk factors for partners: IV drug use, sex with others (eg. Females with male
  • bisexual partners), from areas of high HIV prevalence
  • safeguarding concerns: Violence
47
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps:

1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy

What sort of information do we need to ask about practices?

A
  • oral sex (hepatitis B, herpes, gonorrhoea)
  • anal sex (GI pathogens eg. Giardia)
  • vaginal sex
  • sex toys (infection can be spread through shared use)
48
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps:

1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy

What sort of information do we need to ask about protection?

A
  • use of barrier protection (condoms)
  • frequency of use
  • failure of device eg. Condom splitting
49
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps:

1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy

What sort of information do we need to ask about past history of STIs?

A
  • has the patient previously been tested for HIV and other STIs
  • previously diagnoses or STIs
  • recurring symptoms
  • has current or former partner(s) have been tested or diagnosed with any STIs
50
Q

When we are asking a patient about their sexual history, we need to think of the 5 Ps:

1 - Partners
2 - Practices
3 - Protection
4 - Past history of STIs
5 - Pregnancy

What sort of information do we need to ask about pregnancies?

A
  • does patient have any children
  • previous pregnancies, miscarriages, terminations
  • timelines of possible future pregnancy planning
  • current methods of contraception, compliance
  • establish whether additional advice may be needed around contraception
51
Q

What are the 5 most commonly presenting complaints in females in relation to genital issues?

A

1 - unusual vaginal discharge
2 - lower abdominal pain / deep dyspareunia (pain during sex)
3 - dysuria (painful urination)
4 - vulval skin problems (external female genital area)
5 - unusual vaginal bleeding (including post-coital and inter-menstrual bleeding)

52
Q

What are the 5 most commonly presenting complaints in males in relation to genital issues?

A 
1 - urethral discharge 
2 - testicular discomfort or swelling
3 - dysuria (pain upon urination)
4 - genital skin problems 
5 - peri-anal/anal symptoms (in men who have sex with men (MSM))
53
Q

What is gonorrhoea?

A
  • a sexually transmitted infection (STI)

- caused by bacteria called Neisseria gonorrhoeae or gonococcus

54
Q

Although the number of patients with gonorrhoea is increasing, what is the most commonly diagnosed STI?

A
  • chlamydia
55
Q

What does NATSAL stand for?

A
  • National Surveys of Sexual Attitudes and Lifestyles

- look at 10 year periods

Year 2 RE SCP (8 decks)

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