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Phase 3a > Sex Med > Flashcards

Sex Med Flashcards

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?

A

SSRIs
HRT
Oophrectomy

22
Q

What are psychological causes of female arousal disorder?

A

Depression
Anxiety
Eating disorders
PTSD (abuse)

23
Q

What are social causes of female arousal disorder?

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?

A

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

Behavioural:
Sensate focus

Tools:
Lubricants
Vibrators
Eros

25
Q

What are the physiological and iatrogenic causes of female orgasm disorder?

A

Obesity, CVD, Diabetes mellitus
Oestrogen/ androgen insufficiency (e.g. post menopausal)
Hypothyroidism

Pelvic floor weakness
SSRIs

26
Q

What are the psychological causes of female orgasm disorder?

A

Depression, anxiety, substance misuse

PTSD

27
Q

What are the social causes of female orgasm disorder?

A 
Couple script problems 
Couple relationship problems 
Previous abuse 
Cultural and religious issues 
Life stressors- e.g. work 
Environmental
28
Q

How does menopause effect sexual function?

A

Vaginal atrophy
Vaginal dryness
Reduced oestrogen and androgens
Change in self image- psychosocial effects of menopause

29
Q

What are the 4 types of relationship therapy?

A

Cognitive behavioural

Psychodynamic

Systemic

Integrative

30
Q

What are the physiological causes of rapid ejaculation?

A 
Genetic neuroreceptor sensitivity 
Penile hypersensitivity 
Hyperthyroidism 
Prostatitis 
Other sexual problems (e.g. ED)
31
Q

What are the psychological causes of rapid ejaculation?

A

Anxiety

32
Q

What are the social causes of rapid ejaculation?

A 
Early learned experiences 
Lack of sexual experiences 
Infrequent sexual activity 
Relationship issues 
Partner issues e.g. pain
33
Q

What is the management of rapid ejaculation?

A

Topical anaesthetics
SSRI

Couple psychosexual therapy

Behavioural interventions: sensate focus, stop start techniques, mindfulness

34
Q

What are the physiological causes of delayed ejaculation?

A 
Trauma/ surgery 
Age 
Infectious disorders 
Diabetes mellitus 
Spinal cord injury 
Alcoholic neuropathy 
Low testosterone

SSRIs
Thiazides

35
Q

What are psychological causes of delayed ejaculation?

A 
depression 
anxiety 
Poor arousal 
Poor body image 
PTSD (abuse)
*** ? retrograde ejaculation ***
36
Q

What are the social causes of delayed ejaculation?

A

Body image issues

Partner issues e.g. pain

37
Q

What investigations would you do in delayed ejaculation?

A

Physical examination

Blood tests: FBC, glucose, testosterone, B12/folate, PSA

Urine sample (retrograde ejaculation)

38
Q

What are is the management for delayed ejaculation?

A

Sexual growth programme
Individual or couples therapy
Kegel exercises
Use of vibrators

39
Q

What is vaginismus?

A

Spasm of the pelvic floor muscles that surround the vagina, occluding the opening
Resulting in impossible or painful penile entry

40
Q

What are the causes of vaginismus?

A

Physiological; Vulval infection (e.g. thrush), imperforate hymen, FGM

Anxiety, religious of cultural issues, previous abuse/trauma/ negative experience, relationship issues

41
Q

What is the management of vaginismus?

A

Treat any infections of structural abnormalities

Individual psychosexual therapy, sexual growth programme, CBT, mindfulness, breathing control, kegel exercises, vaginal trainers

42
Q

What is dyspareunia?

A

Pain during intercourse

43
Q

What are the causes of dyspareunia?

A 
Infection/ injury/ hypersensitivity 
Endometriosis 
IBS 
constipation 
Bartholin's cyst 
STDs

Previous abuse/ trauma
Anxiety

Partner: poor technique/timing/speed
intimacy issues
Disliking partner

44
Q

What is the management for dyspareunia?

A

Manage any infection
Couple therapy: CBT, psychodynamic, systemic, integrative

Sexual growth programme

45
Q

What are the stages of sexual response?

A
  1. desire
  2. arousal
  3. orgasm
  4. resolution
46
Q

What is Peyronie’s disease?

+ what are the subsequent sexual problems?

A

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
Q

What is the management of Peyronie’s disease?

A

Surgical correction
Vacuum pump

Can self resolve

48
Q

What does sex, gender identity and gender expression mean?

A

Sex: assigned, karyotype/ phenotype

Gender identity: Personal intrinsic sense of self

Gender expression: Personality, appearance and behaviour- fits into social and cultural norms

49
Q

What is gender dysphoria?

A

DISTRESS due to misalignment of sex and gender identity

50
Q

What is transgender
and
What is transexual?

A

Transgender- diverse gender variance

Transexual- seeking to change or changing primary or sexondary sex characteristics

51
Q

What is the management for trans MtF?

A

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
Q

What is the management for trans FtM?

A

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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