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Phase 3a > Sex Med > Flashcards

Sex Med Flashcards

(52 cards)

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1
Q

What is the presentation of HIV?

A 
Opportunistic infections: 
- oral candidiasis 
- TB
- Pneumonia 
-
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2
Q

How do you diagnose HIV?

A

blood: ELISA antibodies

Saliva sample

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3
Q

How do you monitor HIV?

A

T4 viral load count

HIV viral load (RNA copies)

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4
Q

How do you prevent HIV?

A

Post or Pre Exposure Prophylaxis
PEP or PrEP
Reverse enzyme transcriptase

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5
Q

How do you treat HIV?

A

HAART

Highly Active Antiretroviral Therapy

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6
Q

What blood tests would you want to do in assessment of sexual problems?

A 
Fasting glucose 
Lipid profile 
TSH 
SHBG, testosterone, albumin 
Prolactin 
Oestrogen 
FBC
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7
Q

What chronic medical conditions can cause hypoactive sexual desire disorders?

A

Obesity
CVD
Diabetes mellitus
Anaemia

Hormonal:

  • androgen deficiency
  • hyperprolactinaemia
  • hypothyroidism
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8
Q

What psychological conditions can cause hypoactive sexual desire disorders?

A 
Depression 
Anxiety 
PTSD
Substance misuse 
Stress
Body image disorder
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9
Q

How should you approach a sexual disorder assessment?

A

Consider: Bio, Psycho and Social factors

Consider: Predisposing, Precipitating and Maintaining factors

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10
Q

What are social conditions/factors can cause hypoactive sexual desire disorder?

A 
Body image disorder 
Life stressors- e.g. work 
Previous trauma or abuse 
Couple script problems 
Erotic dissatisfaction 
Couple relationship problems
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11
Q

What are psychosexual treatment options for hypoactive sexual desire disorders?

A 
CBT 
Psychodynamic psychotherapy 
Individual psychosexual therapy
Sexual growth programme
Couples therapy 
Family therapy
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12
Q

What are medical treatment options for hypoactive sexual desire disorders?

A

Testosterone replacements (injection, transdermal patches, gel, buccal)

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13
Q

What are the medical causes of erectile disorder?

A

CVD, obesity, diabetes mellitus, neurological disease (nerve damage, MS, autonomic damage), alcoholism

Androgen deficiency, hyperprolactinaemia

Age related changes

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14
Q

What are iatrogenic causes of hypoactive sexual desire disorder?

A

Medication: SSRIs, COCP, HRT, anti-psychotics, b-blockers

Orchidectomy/ oophrectomy

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15
Q

What are psychological causes of erectile disorder?

A

Depression, anxiety, substance misuse

Performance anxiety

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16
Q

What are iatrogenic causes of erectile disorder?

A

prostate surgery
SSRIs
Antihypertensives

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17
Q

What are social causes of erectile disorder?

A

Couples script problems
Relationship problems
Cultural or religious issues

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18
Q

What are the medical management options for erectile dysfunction?

A

Sildenafil (viagra)

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19
Q

What are the non-medical management options for erectile dysfunction?

A 
Vacuum device 
Penile/ scrotal rings 
Enhancing lubes 
Vibrators 
Kegel exercises
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20
Q

What are medical conditions that cause female arousal disorder?

A

CVD, Obesity, Diabetes mellitus, chronic fatigue syndrome

Hypothyroidism, post-menopausal, breast feeding

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21
Q

What are iatrogenic causes of female arousal disorder?

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A

SSRIs
HRT
Oophrectomy

22
Q

What are psychological causes of female arousal disorder?

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A

Depression
Anxiety
Eating disorders
PTSD (abuse)

23
Q

What are social causes of female arousal disorder?

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A 
Couple script problems 
Body image disorders 
Life stressors e.g. work 
Previous trauma or abuse 
Couples relationship problems
24
Q

What is the management for female arousal disorder?

Study These Flashcards
A

Psychological:
CBT, psychodynamic psychotherapy, sexual growth programme, individual/ couple psychosexual therapy

Behavioural:
Sensate focus

Tools:
Lubricants
Vibrators
Eros

25
What are the physiological and iatrogenic causes of female orgasm disorder?
Obesity, CVD, Diabetes mellitus Oestrogen/ androgen insufficiency (e.g. post menopausal) Hypothyroidism Pelvic floor weakness SSRIs
26
What are the psychological causes of female orgasm disorder?
Depression, anxiety, substance misuse | PTSD
27
What are the social causes of female orgasm disorder?
``` Couple script problems Couple relationship problems Previous abuse Cultural and religious issues Life stressors- e.g. work Environmental ```
28
How does menopause effect sexual function?
Vaginal atrophy Vaginal dryness Reduced oestrogen and androgens Change in self image- psychosocial effects of menopause
29
What are the 4 types of relationship therapy?
Cognitive behavioural Psychodynamic Systemic Integrative
30
What are the physiological causes of rapid ejaculation?
``` Genetic neuroreceptor sensitivity Penile hypersensitivity Hyperthyroidism Prostatitis Other sexual problems (e.g. ED) ```
31
What are the psychological causes of rapid ejaculation?
Anxiety
32
What are the social causes of rapid ejaculation?
``` Early learned experiences Lack of sexual experiences Infrequent sexual activity Relationship issues Partner issues e.g. pain ```
33
What is the management of rapid ejaculation?
Topical anaesthetics SSRI Couple psychosexual therapy Behavioural interventions: sensate focus, stop start techniques, mindfulness
34
What are the physiological causes of delayed ejaculation?
``` Trauma/ surgery Age Infectious disorders Diabetes mellitus Spinal cord injury Alcoholic neuropathy Low testosterone ``` SSRIs Thiazides
35
What are psychological causes of delayed ejaculation?
``` depression anxiety Poor arousal Poor body image PTSD (abuse) *** ? retrograde ejaculation *** ```
36
What are the social causes of delayed ejaculation?
Body image issues | Partner issues e.g. pain
37
What investigations would you do in delayed ejaculation?
Physical examination Blood tests: FBC, glucose, testosterone, B12/folate, PSA Urine sample (retrograde ejaculation)
38
What are is the management for delayed ejaculation?
Sexual growth programme Individual or couples therapy Kegel exercises Use of vibrators
39
What is vaginismus?
Spasm of the pelvic floor muscles that surround the vagina, occluding the opening Resulting in impossible or painful penile entry
40
What are the causes of vaginismus?
Physiological; Vulval infection (e.g. thrush), imperforate hymen, FGM Anxiety, religious of cultural issues, previous abuse/trauma/ negative experience, relationship issues
41
What is the management of vaginismus?
Treat any infections of structural abnormalities Individual psychosexual therapy, sexual growth programme, CBT, mindfulness, breathing control, kegel exercises, vaginal trainers
42
What is dyspareunia?
Pain during intercourse
43
What are the causes of dyspareunia?
``` Infection/ injury/ hypersensitivity Endometriosis IBS constipation Bartholin's cyst STDs ``` Previous abuse/ trauma Anxiety Partner: poor technique/timing/speed intimacy issues Disliking partner
44
What is the management for dyspareunia?
Manage any infection Couple therapy: CBT, psychodynamic, systemic, integrative Sexual growth programme
45
What are the stages of sexual response?
1. desire 2. arousal 3. orgasm 4. resolution
46
What is Peyronie's disease? + what are the subsequent sexual problems?
fibrous plaque in the corpus cavernosum (tunica albuginea) on the penis causing a curvature Painful sex Difficult sex Body image issues Partner problems: dissatisfaction, pain
47
What is the management of Peyronie's disease?
Surgical correction Vacuum pump Can self resolve
48
What does sex, gender identity and gender expression mean?
Sex: assigned, karyotype/ phenotype Gender identity: Personal intrinsic sense of self Gender expression: Personality, appearance and behaviour- fits into social and cultural norms
49
What is gender dysphoria?
DISTRESS due to misalignment of sex and gender identity
50
What is transgender and What is transexual?
Transgender- diverse gender variance Transexual- seeking to change or changing primary or sexondary sex characteristics
51
What is the management for trans MtF?
Medical: - Oestrogen supplements - Anti-androgens - Fertility management Psychosocial: - Social transition support - Psychotherapy - Speech therapy (feminisation) Surgical: - Vulvoplasty/ vaginoplasty - Mammoplasty (breast implants) - Facial feminisation surgery Other: - facial hair removal
52
What is the management for trans FtM?
Medical: - Testosterone supplements - GNrH analogues (to abolish menstrual cycle?) - Fertility management Psychosocial: - Social transition support - Psychotherapy - Speech therapy Surgical: - Phalloplasty - Hysterectomy/ oophrectomy - Mastectomy

Phase 3a (9 decks)

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