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cOGtext > Sexual and Reproductive Health > Flashcards

Sexual and Reproductive Health Flashcards

1
Q

Which organism causes syphilis?

A

Treponema Pallidum

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2
Q

What is the primary lesion in syphilis caused?

A

A chancre

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3
Q

What is the treatment of syphilis?

A

1 injection of IM long-acting benzathine penicillin

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4
Q

What causes genital herpes?

A

Herpes simplex virus (types 1 and 2)

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5
Q

How do you test for genital herpes?

A

Swab in virus transport medium of deroofed blister for PCR test – this is highly sensitive and specific

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6
Q

What is the treatment of genital herpes?

A

400mg of oral acyclovir TDS for 5 days (may be helpful if taken early enough) and pain relief

Consider topical lidocaine 5% ointment if very painful (do patch test before though)

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7
Q

What is the presentation of trichomonas vaginalis?

A

Causes frothy/musty/green vaginal discharge and irritation in females

Strawberry cervix appearance on examination

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8
Q

What is the treatment of trichomonas vaginalis?

A

Oral metronidazole BD for 7 days (should probably treat the male partner(s) too as there are no good tests for males)

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9
Q

What is the treatment of pubic lice?

A

Malathion lotion

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10
Q

Which strains of HPV cause genital warts?

A

HPV 6 and 11.

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11
Q

What does neisseria gonorrhoea look like under the microscope and what is its gram stain (positive/negative)?

A

Gram-negative intracellular diplococcus.

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12
Q

How does gonorrhoea present in males?

A

Purulent discharge and pain with urination

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13
Q

How do you treat gonorrhoea?

A

1 injection of 500mg IM ceftriaxone (used to be IM ceftriaxone + oral azithromycin)

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14
Q

How does chlamydia present in females?

A

Postcoital bleeding or inter-menstrual bleeding, lower abdominal pain, dyspareunia, mucopurulent cervicitis

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15
Q

How do you treat chlamydia?

A

Oral doxycycline 100mg BD for 7 days (previously was 1g single oral dose of Azithromycin)

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16
Q

Which complication can arise in females as a result of chlamydia?

A

Pelvic Inflammatory Disease (PID)

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17
Q

How are most female STIs investigated with i.e. what is the test of choice?

A

Self-taken vulvo-vaginal swab

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18
Q

How are most male STIs investigated with?

A

First pass urine sample

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19
Q

What is ‘quick start’ contraception?

A

Describes the initiation of a contraceptive method prior to day 1-5 of the menstrual cycle

20
Q

When can the copper coil be inserted?

A

Any time of the cycle (as long as ongoing pregnancy is excluded).

21
Q

What do you need to examine prior to inserting the copper coil?

A

Do a PV exam to check the uterus size/shape.

22
Q

How does the copper coil work?

A

Copper is toxic to sperm and prevents fertilisation from occurring by creating an inhospitable endometrium.

23
Q

How long is the intra-uterine system (IUS) licensed for?

A

5 years.

24
Q

When would you ideally insert the IUS?

A

In the first 7 days of period.

25
Q

How long is the progesterone only implant licensed for?

A

3 years.

26
Q

How does the implant work?

A

Thins endometrium and thickens cervical mucus.

27
Q

When would you ideally start the progesterone only implant?

A

In the first 5 days of period.

28
Q

What is a total contraindication to starting the progesterone only implant?

A

Current breast cancer.

29
Q

How often can the progesterone-only injectable (depo-provera) be given?

A

12-weekly intervals.

30
Q

How does the depo-provera work?

A

Inhibits ovulation

31
Q

When would you ideally start the depo-provera?

A

In the first 5 days of period.

32
Q

Can you name some associated risks with the depo-provera?

A
  • Irregular bleeding
  • Weight gain due to increased appetite
  • Beware of the use in young woman and in women with low body weight due to concern about the bone mineral density
  • Return of normal fertility may be delayed on discontinuation
33
Q

How does the progesterone-only pill (POP) work?

A

Inhibits ovulation.

34
Q

When would you ideally start the POP?

A

In the first 5 days of period.

35
Q

How does the combined oral contraceptive pill (COCP) work?

A

Primarily inhibits ovulation.

36
Q

When would you ideally start the COCP (same for patch and ring)?

A

In the first 5 days of period.

37
Q

What are some risks of the COCP and things you need to measure/check before prescribing the COCP?

A
  • Risk of VTE
  • Measure BP and BMI before starting
  • Check smear status
  • Reduces the risk of developing both endometrial and ovarian cancer
  • Small increased risk of cervical cancer with use of >5 years
38
Q

Name some contraindications of the COCP?

A
  • Migraine with aura
  • Current breast cancer
  • Age ≥ 35 AND smokes ≥15 cigarettes per day
  • Systolic ≥160 mmHg or
  • diastolic ≥100 mmHg
  • Vascular disease (CHD, angina, stroke, PVD, hypertensive retinopathy, and TIA)
  • History of VTE or current VTE
  • Atrial fibrillation
  • Positive antiphospholipid antibodies
39
Q

What is the most effective form of emergency contraception?

A

The copper IUD.

40
Q

Ulipristal Acetate (UPA) is licensed for how long after UPSI?

A

120 hours.

41
Q

Levonorgestrel (LNG) is licensed for how long after UPSI?

A

72 hours.

42
Q

When should the dose of LNG be doubled?

A

When weight is >70kg or BMI is >26.

43
Q

When can both the copper IUD and IUS be used post-partum?

A
  • Insertion within the first 48 hours OR >4 weeks of vaginal or c-section delivery is safe
  • Can also be inserted immediately after first- or second-trimester, surgical or medical abortion
44
Q

When can you use the COCP post-partum?

A
  • If breastfeeding – delay use until at least 6 weeks after birth due to risk of VTE (UKMEC 4)
  • If not breastfeeding – can start after 3 weeks (UKMEC 4)
45
Q

When can you use the POP post-partum?

A
  • Can use post-partum immediately
  • No effect on breastfeeding
  • Not required in non-breastfeeding women for contraception until day 21
  • Can be started immediately following surgical abortion or medical abortion

cOGtext (11 decks)

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