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Phase 3a conditions list flashcards LOZZA > Sexual health > Flashcards

Sexual health Flashcards

(134 cards)

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1
Q

What are some risk factors for STIs (8)?

A
  • < 25 years
  • UPSI
  • IVDU
  • Immunosuppression
  • Men who have sex with men (MSM)
  • Lower socioeconomic status
  • Multiple partners
  • Sexually active
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2
Q

What are the important STIs to how about (9)?

A
  • Chlamydia
  • Gonorrhoea
  • Trichomonas vaginalis
  • HSV
  • HPV
  • Syphilis
  • Mycoplasma genitalium
  • HIV
  • Chancroid
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3
Q

What investigations are typically done to investigate for STIs in men (3)?

A
  • Men = first catch urine + MC&S = usually first line
  • Urethral swab
  • Bloods
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4
Q

What investigations are typically done to investigate for STIs in women (4)?

A
  • Vulvovaginal swab (done by themselves) = usually first line
  • Endocervical or high vaginal swabs
  • First catch urine
  • Bloods
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5
Q

What are the different types of swab that can be used to investigate STIs and what are they for (2)?

A
  • Charcoal swab = MC&S
  • Nucleic acid and amplification test (NAAT) swab = identification of DNA/ RNA
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6
Q

Who is eligible for the sexual health screening programme?

A

Sexually active 16-24 year olds

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7
Q

How frequently should 16-24 year olds be screened for STIs?

A

Annually or when they change partner

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8
Q

What is typically tested for if someone attends a GUM clinic for an STI screen (4)?

A
  • Chlamydia
  • Gonorrhoea
  • Syphilis (blood)
  • HIV (blood)
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9
Q

How far back should the contacts of those with chlamydia and gonorrhoea be traced and what should they be offered?

A
  • Chlamydia = 6 months
  • Gonorrhoea = 2 months
    offer them tests
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10
Q

What is the most common STI in the UK?

A

Chlamydia

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11
Q

What is the full name for chlamydia?

A

Chlamydia trachomatis

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12
Q

What type of bacteria is chlamydia trachomatis?

A

Gram negative cocci

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13
Q

What are the signs/ symptoms of chlamydia (4)?

A
  • Dysuria
  • Purulent (pus) discharge
  • Abnormal vaginal bleeding
  • Proctitis - discomfort, discharge, bleeding (inflam in rectum)
    often asymptomatic in women
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14
Q

How is chlamydia diagnosed?

A

NAAT
first catch urine or vulvovaginal swab

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15
Q

What are some examination finding of those with chlamydia (3)?

A
  • Pelvic/ abdo pain
  • Cervical motion tenderness
  • Purulent discharge
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16
Q

What additional swabs should be taken considered for chlamydia in certain patient groups (2)?

A
  • Rectal
  • Pharyngeal
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17
Q

How should chlamydia be treated?

A

100mg doxycycline BD for 7 days

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18
Q

What are some contraindications to doxycycline (2)?

A
  • Pregnant
  • Breastfeeding
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19
Q

What does doxycycline do if a pregnant woman takes it?

A

Can cause foetal teeth discolouration

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20
Q

How should chlamydia be treated in pregnancy/ breastfeeding?

A

Azithromycin 1g stat, then 500mg OD for 2 days

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21
Q

What are some complications of chlamydia (7)?

A
  • PID
  • Lymphogranuloma venereum
  • Infertility
  • Reactive arthritis
  • Neonatal infection (conjunctivitis/ pneumonia)
  • Pregnancy comp (low birth weight, pre-term, ectopic, PROM)
  • Fitz Hugh cutis
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22
Q

What is lymphogranuloma venereum?

A

Ulceration of genital area due to chlamydia infection

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23
Q

What are the signs/ symptoms of lymphogranuloma venereum (3)?

A
  • Ulceration of genital area
  • Proctitis (inflame of rectum)
  • Inguinal lymphadenopathy
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24
Q

Where else in the body does chlamydia commonly infect?

A

The eye causing conjunctivitis

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25
What is the full name for gonorrhoea?
Neiserria gonorrhoea
26
What type of bacteria is neiserria gonorrhoea?
Gram -ve diplococci
27
What are the signs/ symptoms of gonorrhoea (3)?
* Dysuria * Odourless **green** discharge * Pelvic pain
28
How is gonorrhoea diagnosed?
First catch urine or vulvovaginal NAAT
29
What is important to do before commencing antibiotics for gonorrhoea?
Charcoal swab (urethral or endocervical) for MC&S *to determine Abx resistance*
30
How is gonorrhoea typically managed if the sensitivities are not known?
IM ceftriaxone 1g stat
31
What are some complications of gonorrhoea (5)?
* Septic arthritis * Disseminated gonococcal infection * Conjunctivitis * Neonatal infections (ophthalmia neonatorum) * Infection of nearby organs (proctitis, prostatitis, epididymo-orchitis)
32
Does chlamydia or gonorrhoea more commonly cause reactive and septic arthritis?
* Chlamydia = reactive * Gonorrhoea = septic
33
What is ophthalmia neonatorum and how is it managed?
Neonatal conjunctivitis *it is a medical emergency when caused by gonorrhoea and can lead to blindness*
34
What are the signs/ symptoms of disseminated gonococcal infection (3)?
* Polyarthralgia (migratory) * Systemic Sx e.g. fever, fatigue * Various non-specific skin lesions
35
What is the most common STI worldwide?
Trichomonas vaginalis
36
What sort of organism is trichomonas vaginalis?
Flagellated protazoa
37
What are the signs/ symptoms of trichomonas vaginalis (5)?
* Dysuria * **Yellow frothy offensive discharge** * Itching * Strawberry cervix * Balantitis (inflammation of penis glans)
38
How is trichomonas vaginalis diagnosed (2)?
* Charcoal high vagina swab + microscopy * Men = first catch urine + microscopy
39
What is an additional finding in women with trichomonas vaginalis?
High vaginal pH *like in BV*
40
How is trichomonas vaginalis managed?
Metronidazole
41
What else is important to do/ tell in those diagnosed with trichomonas vaginalis (2)?
* **Do not drink alcohol** - reacts with metronidazole and can induce hypotension * Contact trace
42
What can cause ulcers in the genital region?
HSV 2
43
How is HSV 2 diagnosed?
PCR (swab)
44
How is HSV 2 treated?
Aciclovir
45
What causes genital warts?
HPV 6 and 11
46
What is the presentation of genital warts?
Painless warts on genitals
47
How can genital warts be prevented?
HPV vaccines
48
How are genital warts treated?
Podophyllotoxin cream/ imiquimod cream
49
What bacteria causes syphilis?
Treponema pallidum
50
What type of bacteria is treponema pallidum?
-ve spirochete
51
What are the stages of syphilis (4)?
* Primary syphilis * Secondary syphilis * Latent syphilis * Tertiary syphilis
52
How long is syphilis incubation period?
21 days
53
What is the presentation of primary syphilis?
Painless ulcer at infection site (**chancre**)
54
What are the signs/ symptoms of secondary syphilis (5)?
* **Maculopapular rash** * 'Snail track' ulcers * Alopecia * Low grade fever * Lymphadenopathy *typically last 3-12 weeks*
55
What is the presentation of tertiary syphilis?
**Gummatous lesions** - granulomas that can develop in multiple organs throughout the body
56
What is a complication of tertiary syphilis (3)?
* Neurosyphilis * A^3 (abdominal aortic aneurysm) * Higher risk of HIV transmission
57
What are the symptoms of neurosyphilis (4)?
* Headache * Altered behaviour * Sensory impairment * Argyll-robertson pupil (accommodates but no light reflex)
58
How is syphilis diagnosed (2)?
* Serology testing * Infection site swabs + NAAT
59
What serology tests are done for syphilis (2)?
* Rapid plasma reagin (RPR) * Venereal disease research laboratory (VDRL)
60
How is syphilis managed?
IM Benzathine benzylpenicillin (benzathine pen g)
61
What is a complication of treatment for syphilis?
Jarisch-herxheimer reaction *contents of bacteria spilling in blood - a bit like tumour lysis syndrome*
62
What STI is known for resistance to an increasing number of antibiotics?
Mycoplasma genitalium
63
What is the typical presentation of MG?
Urethritis
64
What are the signs/ symptoms of urethritis (2)?
* Dysuria * Discharge
65
How is MG investigated?
* First catch/ vaginal swab NAAT * Charcoal swab + MC&S (for macrolide resistance)
66
How is MG treated (2)?
1. Doxycycline + azithromycin 2. Moxifloxacin
67
What causes chancroid?
Bacteria (haemophilus ducreyi)
68
What are the signs/ symptoms of chancroid (3)?
* Painful genital ulceration * Discharge * Lymphadenopathy
69
How is chancroid treated?
Azithromycin *ch**a**ncroid = **a**zythromycin*
70
What are two STI-like conditions that are not sexually transmissible?
* Bacterial vaginosis * Thrush
71
What is bacterial vaginosis?
Overgrowth of bacteria, especially anaerobes, in the vagina
72
What is usually the cause of BV?
Loss of lactobacilli 'the friendly bacteria'
73
What is the most common anaerobe causing BV?
Gardnerella vaginalis *overgrown garden??*
74
What are some risk factors for BV (4)?
* Multiple partners * Excessive PV cleaning * Recent Abx * Smoking
75
What reduces the risk of getting BV (2)?
* COCP * Condom use
76
What is the typical presentation of BV?
**Fishing smell watery grey discharge**
77
What criteria can be used to diagnose BV?
Amstel criteria ***amste**rdam because they have lots of sexual partners there*
78
What are the Amstel criteria for diagnosis of BV (4)?
* pH > 4.5 * White/ grey discharge * **Clue cells** on microscopy * +ve whiff test *3/4 for diagnosis*
79
What are clue cells?
Epithelial cells of vagina with Gardnerella vaginalis stuck in them
80
How is BV managed (2)?
* Conservative advice (e.g. stop smoking, stop douching/ cleaning) * **Metronidazole**
81
What are some complications of BV (4)?
* Increased risk of STIs * Miscarriage/ preterm * PROM * Postpartum endometritis
82
What causes thrush?
Candida infection
83
What are some risk factors for thrush (4)?
* Increased oestrogen (pregnancy, fertile, COCP) * Poorly controlled diabetes * Immunosuppression * Recent Abx
84
What are the signs/ symptoms of thrush (2)?
* Thick white **'cottage cheese'** discharge that does not smell * Itchy
85
How is thrush investigated (3)?
* Clinical diagnosis * pH < 4.5 * Charcoal swab + microscopy (if in doubt)
86
How is thrush managed (2)?
* Oral fluconazole stat or * Clotrimazole cream
87
What is important to inform women treated for thrush about?
Antifungal creams can damage condoms/ prevent spermicides working so alternative contraception needed for 5 days
88
What is pelvic inflammatory disease?
Infection and inflammation of the organs of the pelvis caused by infection ascending through the cervix
89
Which structures can become inflamed in PID (3)?
* Endometritis * Salpingitis (Fallopian tubes) * Oophoritis (ovaries) *peritonitis can occur*
90
What causes PID most commonly (3)?
* **Chlamydia** = MC * Neiserria gonorrhoea * MG *can be caused by others such as H. influenzae, E. coli*
91
What are the signs/ symptoms of PID (6)?
* Pelvic/ lower abdo pain * Deep dyspareunia * Abnormal vaginal bleeding * Discharge * Fever * Dysuria
92
What are some risk factors for PID (5)?
* Coil * No barrier contraception * Multiple partners * Younger age * Previous PID
93
What are some examination finding of PID (4)?
* Abdo/ pelvic tenderness * Cervical motion tenderness * Discharge * Fever
94
How is PID investigated (4)?
* High vaginal swabs + MC&S (often negative) * Pregnancy test (ectopic) * Bloods (HIV, syphilis) * TVUSS
95
How is PID treated with antibiotics?
* Ceftriaxone * Doxycycline * Metronidazole
96
When should PID be referred to hospital (2)?
* Pregnant woman * Signs of sepsis
97
What are some complications of PID (5)?
* Infertility * High risk for ectopic pregnancy * Chronic pelvic pain * Sepsis * Fitz-hugh-curtis syndrome
98
What is Fitz-hugh-curtis syndrome?
Inflammation and infection of the liver capsule
99
What are some causes of balanitis (3)?
* Candidia = mc * Trichomonas vaginalis * Lichen sclerosis
100
How does balanitis typically present?
White itchy lesions with thick discharge
101
What is a complication of balanitis?
Balanitis xerotica obliterans *long term inflammation leading to damage*
102
What parasite can infect the pubic area?
Public lice
103
What is the typical presentation of pubic lice?
Severely itchy pubic area with visible movement
104
How are pubic lice treated?
Permethrin
105
What is it known as when you are not interested in sex but you want to be?
Hypoactive sexual desire disorder (HSDD)
106
What are 3 ways HSDD will present itself?
* Decreased sex desire * Decreased response to partners sexual cues * Don't initiate sex
107
What are some risk factors/ causes for HSDD (3)?
* Depression/ anxiety * DM, hypothyroid * Meds (e.g. opioids, SSRIs)
108
How can HSDD be managed (4)?
* Reduce stress * Couples therapy * Exercise * **Flibanserin**
109
What is failure to orgasm despite stimulation known as?
Anorgasmia
110
What are some risk factors/ causes of anorgasmia (6)?
* Depression/ anxiety * Performance anxiety * DM/ hypothyroid * Postmenopausal * Post hysterectomy * Dyspareunia
111
How is anorgasmia managed (3)?
* Sexual education * Clitoral vacuum (increases blood flow) * COCP
112
What is involuntary contraction of the vaginal wall known as?
Vaginismus
113
What are some consequences of vaginismus (2)?
* No sexual penetration * Speculum + smear impossible/ difficult
114
What are some risk factors/ causes of vaginismus (4)?
* Trauma * Anxiety/ stress * Childbirth * FGM
115
How is vaginismus treated (3)?
* Sex education/ psychology * Keigel exercises * Vaginal dilation therapy
116
What is pain in vulva without an identifiable cause known as?
Vulvodynia
117
How is vulvodynia managed (4)?
* Reduce friction during sex (lubricants) * Keigel * Analgesia * TCAs
118
What can be done in sex education/ psychology to improve sex (3)?
* Couples therapy * CBT * Different techniques e.g. clitoral stimulation/ sex toys
119
What is erectile dysfunction known as?
Impotence
120
What are some causes of impotence (7)?
* Peripheral vascular disease/ atherosclerosis * DM * Spinal cord damage * High prolactin * Stress/ performance anxiety * MS * Meds e.g. SSRIs
121
How is erectile dysfunction managed (2)?
* Keigel exercises * **Sildenafil**
122
What is important to assess in men with erectile dysfunction?
QRISK score + do bloods *at risk of PVD + CHD*
123
What is premature ejaculation?
Ejaculation within 1 minute of sex
124
What are some causes of premature ejaculation (4)?
* Performance anxiety * Watching pornography * Hyperthyroid * Sex abuse
125
How is premature ejaculation managed (5)?
* Sex therapy * Stop, start, squeeze * Lidocaine cream * Keigel exercises * Dapoxetine
126
What is retrograde ejaculation?
When the sperm is ejaculated into the bladder due to the urethral sphincter not contracting
127
What are some causes of retrograde ejaculation (2)?
* Transurethral resection of the prostate (TURP) * ACE-i
128
How is retrograde ejaculation diagnosed?
Post ejaculatory void = lots of sperm
129
How is retrograde ejaculation treated (2)?
* Medications (tighten neck of bladder) e.g. TCAs * Surgery
130
What can cause a wonky erection?
T3 collagen deposits in tunica albuginae
131
What is it known as when you have a wonky erection due to collagen deposits?
Peyronie
132
What condition is peyronie associated with?
Dupuytrens contractures
133
How is peyronie diagnosed?
Penile USS
134
How is peyronies managed (2)?
* Surgical straitening * Injection of collagenase

Phase 3a conditions list flashcards LOZZA (31 decks)

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