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Sexual health Flashcards

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1
Q

CHLAMYDIA

What is the causative organism?

A

Chlamydia trichomatis

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2
Q

CHLAMYDIA

What are the symptoms is a female?

A

Asymptomatic

Increased vaginal discharge

Mucopurulent cervical discharge - yellow

Dysuria

PCB / IMB

Abdominal pain

Deep dyspareunia

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3
Q

CHLAMYDIA

What are the signs in a female patient?

A

Cervicitis

Cervical motion tenderness

Discharge

Abdominal pain

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4
Q

CHLAMYDIA

What are the symptoms in a male patient

A

Asymptomatic

Mucopurulent penile discharge

Dysuria / Urethritis

Testicular swelling

Pain on ejaculation

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5
Q

CHLAMYDIA

What are the signs in a male patient?

A

Abdominal tenderness

Epidiymo-orchitis

Reactive arthritis

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6
Q

CHLAMYDIA

What are the symptoms of rectal chlamydia

A

Asymptomatic

Anorectal discharge

Anorectal discomfort

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7
Q

CHLAMYDIA

What are the symptoms of oropharyngeal infection

A

Pharyngitis

Sore throat

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8
Q

CHLAMYDIA

How do you diagnose chlamydia in females

A

1st line: Vulvovaginal or endocervical swab - NAAT

2nd line: 1st catch urine

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9
Q

CHLAMYDIA

How do you diagnose chlamydia in males?

A

1st line: 1st catch urine

2nd line: Charcoal urethral swab for NAAT

*MSM - Anorectal and pharyngeal swabs

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10
Q

CHLAMYDIA

What extra test should be included for MSM patients with suspected chlamydia

A

Rectal swab - LGV

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11
Q

CHLAMYDIA

What is the manageemnt of chlamydia?

A

Doxycycline - 100mg BD 7 days

Erythromycin - If pregnant

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12
Q

CHLAMYDIA

Name 4 complications of chlamydia in women

A

PID
Infertility
Ectopic pregnancy
Conjunctivitis
Chronic pelvic pain

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13
Q

CHLAMYDIA

Name 4 complications of chlamydia in pregnancy?

A

Neonatal conjunctivitis
PROM
Low birth weight
Postpartum endometritis

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14
Q

CHLAMYDIA

What are the differentials for Chlamydia?

A

Mycoplasma genitalium

Lymphogranuloma venereum

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15
Q

CHLAMYDIA

What is Mycoplasma genitalium

A

Organism that causes a non-gonococcal urethritis

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16
Q

CHLAMYDIA

How do you diangose Mycoplasma genitalium

A

NAAT testing

Men - 1st pass urine

Female - Endocervical swab

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17
Q

CHLAMYDIA

What is required for a patient that has tested positive for mycoplasma genitalium

A

Tets for cure

Test for macrolide resistance

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18
Q

CHLAMYDIA

What is the treatment of mycoplasma genitalium

A

Doxycycline
Azithromycin

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19
Q

CHLAMYDIA

What is LGV

A

Lymphogranuloma venereum - common in MSM

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20
Q

CHLAMYDIA

Describe the stage of LGV

A

Primary - Painless ulcer

Secondary - Painful inguinal lymphadenitis

Tertiary - Proctitis / Tenesmus / Change in bowel habits

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21
Q

GONORRHOEA

What is the causative orgnaism

A

Neisseria gonorrhea

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22
Q

GONORRHOEA

How does gonorrhea present in females

A

Odourless purulent discharge

Dysuria

Pelvic pain

IMB

Dyspareunia

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23
Q

GONORRHOEA

What are the signs of gonorrhoea in a female patient

A

Discharge

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24
Q

GONORRHOEA

How does gonorrhoea present in a male patient?

A

Odourless purulent discharge

Dysuria

Testicular pain / swelling

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25
GONORRHOEA How do rectal and pharyngeal gonorrhoea infection present?
Usually asymptomatic Anal - rectal discomfort Pharyngeal - sore throat
26
GONORRHOEA How do you diagnose gonorrhoea in women and men
Women - vulvovaginal swab - charcoal endocervical swab for MC&S Men - 1st pass urine
27
GONORRHOEA What is the management of gonorrhoea
IM 1g Ceftriaxone - If sensitivities are unknown Oral ciprofloxacin - If sensitivities known
28
GONORRHOEA Describe the test for cure for gonorrhoea
Asymptomatic - NAAT - 7 days after tx for RNA NAAT - 14 days after treatment for DNA NAAT Symptomatic - cultures - 72 hours after treatment
29
GONORRHOEA Name 5 complications associated with gonorrhoea
PID Infertility Conjunctivitis Disseminated gonococcal infection Septic arthritis Endocarditis Epidiymo-orchitis Prostatitis
30
GONORRHOEA What is disseminated gonococcal infection
complication of untreated gonococcal infection - bacteria spreads to skin and joints non-specific skin lesions - dermatitis Polyarthralgia Migratory polyarthritis Tenosynovitis Systemic symptoms - fever and fatigue
31
SYPHILIS What is the causative organism
Treponema pallidum
32
SYPHILIS How can syphilis be transmitted
Oral / vaginal / anal sex Vertical transmission IVDU Blood transfusions
33
SYPHILIS Describe the primary stage
Painless chancre Painless lymphadenopathy
34
SYPHILIS Describe the secondary stage
Maculopapular rash - palms and soles of feet Low grade fever Lymphadenopathy Oral lesions Alopecia Condylomata lata
35
SYPHILIS Describe the tertiary stage
Gummatous lesions - granulomatous lesions with necrotic centre affecting skin, organs and bones Aortic aneurysms Aortic regurgitation Neurosyphilis
36
SYPHILIS Describe neurosyphilis
Headache Dementia Paralysis Sensory impairment Tabes dorsalis - demyelination of posterior columns of spinal cord Argyll Robertson pupil
37
SYPHILIS Describe the Argyll-Robertson pupil
Constricted pupil that accommodates when focussing on a near object but does not react to light Irregular shape
38
SYPHILIS What is latent syphilis
Occurs after secodnary syphillis - patient is asymptomatic despite still being infected
39
SYPHILIS What is the difference between early latent and late latent syphilis
Early latent - within 2 years of initial infection Late latent - from 2 years after initial infection
40
SYPHILIS Describe the testing required for syphilis
Syphilis serology Non-treponemal tests: Not sepcific for syphilis so high rate of FP Rapid plasma reagin - PRP VDRL Assess the quantity of antibodies being produced Negative following treatment Treponemal specific tests: Specific for syphilis TP-IEA TPHA Qualitative only
41
SYPHILIS What are the causes of false positivies in non treponemal tests - cardiolipin
Pregnancy SLE TB Malaria HIV
42
SYPHILIS What is the management of syphilis
Single dose of IM Benpen
43
TRICHOMONAS What is the causative organism
Trichomonas vaginalis
44
TRICHOMONAS What can trichomonas increase the chances of
Contracting HIV - Damaging vaginal mucosa Bacterial vaginosis Cervical cancer PID
45
TRICHOMONAS How does trichomonas present
Vaginal discharge - frothy green Ithcing Dysuria Dysparerunia
46
TRICHOMONAS What signs are present in a patient with trichomonas
strawberry cervix vaginal pH > 4.5
47
TRICHOMONAS How is trichomonas diangosed
women - Charcoal swab with microscopy of posterior fornix or self taken vulvovaginal swab wet mount - mobile trophitizes men - 1st catch urine
48
BACTERIAL VAGINOSIS What is the causative orgaism
Gardenella vaginalis
49
BACTERIAL VAGINOSIS What is BV
Overgrowth fo anaerobic bacteria and Loss of lactobacilli Increase risk of developing an STI
50
BACTERIAL VAGINOSIS Name 5 risk factors for BV
Multiple sexual partners douching recent antibiotics smoking copper coil
51
BACTERIAL VAGINOSIS How does bacterial vaginosis present
Watery grey discharge - fishy smelling Asymptomatic
52
BACTERIAL VAGINOSIS What are not typical features of BV
Pain Itching Irritation
53
BACTERIAL VAGINOSIS How doy you diangose BV
pH > 4.5 Charcoal swab - High vaginal or vulvovaginal Clue cells - microscopy
54
BACTERIAL VAGINOSIS What are the risks of BV infection in pregnancy
Miscarriage Preterm delivery PROM Chorioamnionitis Low birth weight Post partum endometritis
55
HERPES Where does the virus lay dormant in the sensory nerve ganglia
HSV1 - Trigeminal nerve ganglion HSV2 - Sacral nerve ganglia
56
HERPES How does genital herpes present
Painful ulcers Painful lymphaednopathy neuropathic pain dysuria flu like sx
57
HERPES How is it diangosed
clincal diagnosis Viral PCR - can e taken
58
PELVIC INFLAMMATORY DISEASE Name 3 causative rognaisms
Chlamydia trichomatis Neisseria gonorrhoea Mycoplasma genitalium Gardenella vaginalis
59
PELVIC INFLAMMATORY DISEASE Name 4 risk factors for PID
Not using barrier contraception multiple sexual partners younger age existing STI IUD Previous PID
60
PELVIC INFLAMMATORY DISEASE Describe the symptoms of PID
Lower abdominal pain abnormal vaginal discharge dysparerunia fever dysuria IMB / PCB
61
PELVIC INFLAMMATORY DISEASE Describe the signs of PID
Pelvic tenderness Cervical motion tenderness Cervicitis Purulent discharge
62
PELVIC INFLAMMATORY DISEASE How do you diagnose PID
Pregnancy test - exclude ectopic NAAT - Chlamydia and gonorrhoea NAAT - Mycoplasma HIV test Syphilis test High vaginal swab Bloods - CRP
63
PELVIC INFLAMMATORY DISEASE What is the management of PID
IM Ceftriaxone - Gonorrhoea Doxycycline - Chlamydia Metronidazole - Gardenella
64
PELVIC INFLAMMATORY DISEASE What are the complications of PID
Sepsis Abscess Infertility Ectopic pregnancy
65
PELVIC INFLAMMATORY DISEASE What is Fitz-Hugh-Curtis syndrome
Inflammation and infection of the liver capsule (Glisson’s capsule), leading to adhesions between the liver and peritoneum. Bacteria may spread from the pelvis via the peritoneal cavity, lymphatic system or blood.
66
HIV Name 4 AIDS defining illnesses
Kaposi's sarcoma Pneumocystitis jirovecii penumonia CMV infection Candidiasis - oesphoageal or bronchial Lymphoma TB
67
HIV What is given prophylactically to patients with a low CD4 count
Co-trimoxazole - protect against pneumocystosis pneumonia
68
HIV What shoudl HIV patients avoid
live vaccines
69
SEXUAL HEALTH Describe triple swabs
Endocervical NAAT - CT Endocervical charcoal swab - NG HVS - CHarcoal for bacterial and fungal infections
70
CANDIDIASIS Describe the presentation
Cottage cheese discharge Pruritus Erythema Swelling Superficial dysparerunia
71
SEXUAL HEALTH Which sexual health conditions increase vaginal pH
BV TV
72
SEXUAL HEALTH Which sexual health conditions decrease vaginal pH
Candidiasis

Finals revision (17 decks)

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