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Phase 3a > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

Uncomplicated chlamydia

A

Infection has not ascended to the upper genital tract
- Chlamydia is AS in 70% women, 50% men

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2
Q

women S+S chlamydia

A
  • Post coital, IM bleeding
  • Increased or purulent discharge
  • Mucopurulent cervical discharge
  • Deep dyspareunia
  • Dysuria
  • Pelvic pain and tenderness
  • Inflamed cervix
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3
Q

Men S+S chlamydia

A
  • Dysuria
  • Urethral discharge
  • Urethral discomfort
  • Epididymo-orchitis or reactive arthritis
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4
Q

Ix chlamydia

A
  • Vaginal swab women
  • Men = 1st void urine
  • NAAT
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5
Q

Chlamydia Tx

A
  • Doxycycline 100mg 2x day for 7 days
  • Women pregnant, breastfeeding = azithromycin, amox or erythro
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6
Q

Other S+S chlamydia

A
  • Rectal = discharge and discomfort
  • Conjunctivitis
  • Oropharyngeal = pharyngitis and sore throat
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7
Q

Definition uncomplicated gonorrhoea

A
  • localised and primarily affects the mucous membranes or urethra, endocervix, rectum, pharynx and conjunctiva
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8
Q

Disseminated gonorrhoea

A
  • Uncommon
  • Petechial or pustular aral skin lesions
  • asymetrical arthralgia
  • Tenosynovitis
  • Septic arthritis
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9
Q

S+S gonorrhoea penis

A
  • Urethral discharge
  • Dysuria
  • 2-5 days after exposure
  • Mucopurulent or purulent urethral discharge
  • Sometimes epididymal tenderness or swelling
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10
Q

S+S gonorrhoea vagina

A
  • Asymptomatic
  • Develop within 10 days
  • Abdo pain
  • IM bleeding
  • Dyspareunia
  • Dysuria
  • Altered discharge
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11
Q

Ix gonorrhoea

A
  • NAAT showing neisseria gonorrhoeae by swab or urine
  • Uncomplicated anogenital or pharyngeal = IM ceftriaxone
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12
Q

Mx gonorrhoea

A

Cef and azith

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13
Q

1st episode genital herpes

A
  • blisters burst to leave erosions and ulcers on external geintaliea
  • 4-7 days after exposure
  • Dysuria
  • Discharge
  • Systemic
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14
Q

Recurrent herpes

A
  • reactivation
  • Blisters or ulcers unilaterally in single site
  • prodromal tingling and burning
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15
Q

Tx initial episode herpes

A
  • 200mg acyclovir 5X daily
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16
Q

BV definitoin

A
  • overgrowth of anaerobic organisms and a loss of lactobacilli
  • Vagina loses normal acidity and pH increases over 4.5
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17
Q

RF for BV

A
  • Sexually active
  • Douches, deoderant, vaginal washes, menstruation and semen in vagina
  • copper IUD
  • smoking
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18
Q

BV symptoms

A
  • Fishy smelling discharge
  • Examination may reveal thin white homogeneous discharge on walls
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19
Q

BV Tx

A
  • Oral metronidazole
  • intravaginal metronidazole or clindamycin gel
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20
Q

What bacterium causes syphilis

A
  • Spirochete bacterium treponema pallidum
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21
Q

Complications syphilis

A
  • Neurosyphilis
  • Cardiovascular
  • Gummatous syphilis
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22
Q

S+S syphilis

A
  • Genital lesions = solitary, painles, indurated, genital ulcer (chancre)
  • Non pruritic maculopapular rash
  • Moist wart like lesion (condylomata lata)
  • Patchy lesions on oral mucosa
  • Generalised lymphadenopathy
  • Unexplained neuro or opthalmological Sx
23
Q

Tx syphilis

A
  • 1st line = parenteral benzathine and procaine penicillin
24
Q

Ix syphilis

A
  • Swabs from lesions
  • Dark field microscopy
  • PCR
25
Q

Mycoplasma fenitalium

A
  • No cell wall = not visible by gram stain
  • Found in genital tract and rectum
  • Oropharynx rare
26
Q

MF S+S penis

A
  • Asymtpomatic
  • Urethral discharge
  • Dysuria
  • Penile irritation
  • Urethral discomfort
  • SARA
  • Epididymo orchitis
27
Q

MF S+S Vagina

A
  • Asymptomatic
  • Dysuria
  • PC/IM bleeding
  • Cervicitis
  • PID
  • SARA
  • Pre term delivery
28
Q

MF testing

A
  • Penis = 1st void
  • Vagina = viral swab
  • Test partners patient wants to have sex with again
29
Q

MF Tx

A

Non complicated
- 1st line doxy 100mg BD 7 days followed by azith 1g on day 1, 500mg day 2 and 3
- 2nd line = moxifloxacin
Complicated
- Moxifloxacin 400mg OD 14 days

  • Test of ure at 5 weeks
30
Q

Complicated gonorrhoea

A
  • Proctitis
  • Conjunctivitis
  • PID
  • Tenosynovitis
  • Arthritis
  • SARA
  • DGI
31
Q

Causes SARA

A
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • Mycoplasma genitalium
32
Q

Shigella

A
  • Causes bloody diarrhoea, fever, cramps
  • Mistaken for food poisoning
  • Bi and gay men at risk
    TX if severe (fever, blood, sepsis)
  • If tx needed discuss with microbiology
33
Q

Primary syphilis

A
  • Primary chancre = 95% genital skin
  • Incubation 9-90 days
  • Dusky macule - papule
  • Regional nodes 1-2 weeks after chancre
34
Q

Secondary syphillis

A
  • 4-10 weeks after infection
  • Untreated 25% of people will develop signs of secondary syphilis
  • Primary chancre may be present concurrently (30%)
  • May have no hx primary chancre
35
Q

S+S Secondary syphilis

A
  • Rash
  • Mucous membrane lesions
  • Lymphadenopathy
  • Optic sx
36
Q

Prep

A
  • Tenofovir DF/emtricitabine licensed and comissioned in UK
  • Daily dosing or event based
    >99% effective
37
Q

1st line pep regimen

A
  • Tenofovir disoproxil 245mg/emtricitabine 200mg with raltegravir 1200mg OD for 28 days
38
Q

What causes trichomoniasis

A
  • Flagellated protozoan trichomonas vaginalis
39
Q

S+S trichomoniasis vagina

A
  • Dysuria
  • Offensive odour
  • Discharge
  • Itching
  • Asymptomatic
40
Q

S+S trichomoniasis penis

A
  • Asymptomatic
  • Urethral discharge
  • Dysuria
41
Q

trichomoniasis Ix

A
  • High vaginal swab
  • Urethral swab +/- 1st void for penis
42
Q

Trich Tx

A
  • oral metronidazole 400 - 500mg 2x day for 7 days
  • Or single 2g dose
  • Abstinence for 1 week until treatment and follow up
43
Q

S+S genital warts

A
  • Lesions may be single or multiple and tend to occur in areas of high friction.
  • Warts on dry, hairy skin tend to be firm and keratinized (horny).
  • Those on warm, moist, non–hair-bearing skin tend to be soft and non-keratinized.
  • Lesions may be broad-based or pedunculated (attached by a stalk), and some are pigmented
44
Q

Genital warts treatment

A
  • No treatment — one-third of visible warts disappear spontaneously within 6 months.
  • Self-applied treatments (podophyllotoxin 0.5% solution, or 0.15% cream, imiquimod 5% cream, sinecatechins 10% ointment).
  • Ablative methods (such as cryotherapy, excision, and electrocautery)
45
Q

How HIV transmitted

A
  • Sexual activity
  • Vertically from mother to child
  • By inoculation
46
Q

Presentation of primary HIV infection

A
  • Flu like illness in first few weeks
  • Asymptomatic stage once symptoms PHI resolve
  • Advanced = <200 CD4
47
Q

When to consider HIV

A
  • Common sx or infections unusually severe, prolonged, recurrent or unexplained
  • Conditions related to immunosuppression = shingles, candidiasis
  • Glandular fever like illness
  • Lymphadenopathy of unknown origin
  • Pyrexia of unknown origin
  • Weight loss >10kg
  • Lifestyle and social RF
48
Q

Infants HIV S+S

A
  • Fail to thrive
  • Pneumocystis pneumonia
  • CMV
  • HIV encephalopathy
49
Q

Most common tumour in those with HIV

A

Kaposi’s sarcoma
- Dark purple or brown intradermal skin lesions

50
Q

Resp conditions associated with HIV

A
  • Pneumocystis pneumonia = fever, dry cough, crackles, SOB
  • TB
51
Q

Neuro conditions associated with HIV

A
  • Cryptococcal meningitis
  • Cerebral toxoplasmosis
  • Cerebral lymphoma
  • CMV retinitis
52
Q

Oral conditions and HIV

A
  • Oral candidiasis
  • Aphthous ulcers
  • Oral hairy leukoplakia
  • Gingivitis
  • Abscess
53
Q

complications maternal chlamydia

A
  • Chorioamnionitis
  • Neonatal conjunctivitis
  • Neonatal pneumonia
  • Prelabour rupture of membranes
54
Q

features maternal syphilis

A
  • Generalised lymphadenopathy
  • Hepatosplenomegaly
  • Rash
  • Skeletal malformations

Phase 3a (23 decks)

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