Sexual Health Flashcards

(48 cards)

1
Q

Chlamydia incubation + S+S

A

Incubation: 4 weeks in men, unknown for women

S+S: thin + watery discharge, dysuria, PCB, IMB, dyspareunia

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2
Q

Complications of STIs + STI risks in pregnancy

A

Complications: PID, perihepatitis (Fitz-Hugh-Curtis), Reiters syndrome (arthritis, uveitis, conjunctivitis), tubal infertility, increased risk of ectopic

For men: epididymo-orchitis

STI risks in pregnancy: PROM, prematurity, low birth weight, postpartum endometriosis

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3
Q

Chlamydia investigations + treatment

A

Vulvovaginal swab, urine for PCR Azithromycin 1g single dose (safe in pregnancy) Doxycycline 100mg for 7 days

Obligate intracellular parasite

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4
Q

Gonorrhoea S+S + incubation

A

Incubation = 2-5 days S+S: green discharge (from cervical os, urethra, Skene’s or Bartholin’s glands) Dysuria, urethritis, IMB/ PMB

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5
Q

Gonorrhoea investigations + treatment

A

VVS for NAAT testing ECS for culture + sensitivity Ceftriaxone IM single dose + azithromycin 1g oral single dose (safe in pregnancy)

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6
Q

Herpes incubation + pathology

A

5-14 days Enters distal processes of sensory neuron + stays dormant in root ganglion. Periodically reactivates + travels down axon into basal skin layers

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7
Q

Herpes S+S

A

Primary infection: flu like symptoms, inguinal lymphadenopathy, vulvitis, ulcers = lasts 3 weeks

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8
Q

Herpes complications

A

Meningitis Sacral radiculopathy Transverse myelitis Myalgia Erythema multiforme

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9
Q

Herpes implications in pregnancy

A

Primary infection = miscarriage or labour Neonatal risks = transmission high with NVD if during primary maternal infection

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10
Q

Herpes management

A

Treatment with acyclovir helpful in first 5 days Delivery by CS if labour within 6 weeks of primary infection

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11
Q

Genital warts (causes, S+S, management)

A

HPV 6 + 11 S+S: tiny flat patches on vulval skin, may affect cervix Manage with podophyllin solution applied daily, cryotherapy

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12
Q

Syphilis primary infection (incubation, S+S)

A

10-90 days post infection Solitary, painless ulcer (chancre) + inguinal lymphadenopathy

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13
Q

Secondary syphilis presentation

A

Occurs within first 2 years of infection (usually 4-8 weeks after) Generalised polymorphic rash on palms + soles, non-itchy Macular lesions on trunk + arms Generalised lymphadenopathy Condyloma lata (wart lesions on genitals + mouth) Anterior uveitis

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14
Q

Latent syphilis

A

Disease present but asymptomatic

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15
Q

Tertiary syphilis presentation

A

Over 2 years Neurosyphilis, cardiovascular + gummata (nodular plaques in skin or bone, firm + coppery red)

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16
Q

Neurosyphilis presentation

A

Headache, 3/6/8 CN involvement, papilloedema, hemiplegia Paranchymatous (ataxia, lightening pain, absent reflexes)

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17
Q

Cardiovascular syphilis presentation

A

Aortic regurgitation, aortitis

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18
Q

Investigations for syphilis (+ microscopy findings)

A

NAAT or bloods Smear from primary lesion = spirochaetes

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19
Q

Management of syphilis

A

Ben-penicillin + procaine penicillin

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20
Q

Balanitis (who, causes, S+S, management)

A

Commonly affects boys under 4 y/o + uncircumcised males Causes: candida, bacterial infection, STI, poor hygiene, psoriasis S+S: redness, irritation, soreness, dysuria Management: treat underlying cause, avoid soaks

21
Q

Acute HIV S+S

A

Influenza like illness, rash Fever, myalgia, lymphadenopathy, pharyngitis

22
Q

Investigations for HIV

A

Ab to the core = deeloped in 2-6 weeks Repeat test after 3 months due to delayed seroconversion

23
Q

Management of HIV

A

HAART = combination antiretroviral regime

24
Q

Advanced HIV S+S

A

Persistent lymphadenopathy Fever, night sweats, diarrhoea, weight loss Oral candidiasis, herpes, seb dermatitis, impetigo

25
Bacterial vaginosis cause + S+S
Overgrowth of anaerobes (Gardnerella) White grey discharge, fishy smell pH \>4.5 - 6
26
BV implications in pregnancy
Late miscarriage Preterm birth PPROM
27
BV investigations + RF
Increasing vaginal pH (\>4.5) Clue cells on microscopy Hay/Ison criteria gram stained vaginal smear RF: douching, black ethnicity, smoking, STI
28
BV management
Metronidazole oral (beware of Disulfram reaction) + clindamycin cream (can weaken condoms so don't use during treatment)
29
Trichomonas S+S
Frothy green offensive smelling discharge Itching + soreness Dysuria Strawberry cervix Superficial dyspareunia
30
Trichomonas implications in pregnancy
Preterm delivery Low birth weight
31
Trichomonas investigations + management, what does it look like
Wet mount microscopy or VVS NAAT Metronidazole 2g stat dose + 400mg BD for 5-7 days (avoid in first trimester) Sexual partners should be treated simultaneously
32
Candidiasis RF
Antibiotics, pregnancy, COCP, DM, anaemia, high oestrogen
33
Candidiasis S+S
Itching + soreness, satellite lesions Thick curd like white discharge Dysuria Superficial dyspareunia
34
Candidiasis management
Clotrimazole pessary + cream (safe in pregnancy) Fluconazole oral = not safe in pregnancy
35
STD swabs + what they test for
HVS = MC+S, candida, TV, BV Endocervical = M,C+S, gonorrhoea + chlamydia
36
Complications of chlamydia
Reactive arthritis, urethritis, conjunctivitis Characteristic vesicle skin lesions: keratoderma blenorrhagica Also called Reiter's syndrome Lymphogranuloma venereum = lymphadenopathy Neonatal conjunctivitis + pneumonia
37
Genital warts management in pregnancy
Cryotherapy - podyphillin is contraindicated
38
Management of cryptococcal meningitis
IV amphoterecin B
39
What can syphilis cause in pregnancy?
Hutchinson teeth
40
What does chlamydia look like on a swab?
Gram negative intracellular rods
41
What is lichen planus?
Found around genitals, commonly on vulva Skin hypopigmentation + atrophy, giving shiny look White polygonal papules - can form plaques Treat with steroids Increases risk of vulval carcinoma
42
What bug causes syphilis + what are the long term complications?
Treponema pallidum Aortic regurg, dementia, tabes dorsalis, gummata
43
What do the following discharges signifiy: white cottage cheese, white/ thin, green, grey/ odorous, yellow/ green + frothy
Cottage cheese = candida White/ thin = chlamydia Green = gonorrhoea Grey + odorous = BV (Gardnerella) Yellow/ green + frothy = TV
44
Summary of vaginal infections
45
What is disseminated gonorrhoea?
Fever, pustular rash, polyarthralgia
46
Describe standard screening for men + women
Men: NAAT (urine or VVS) + serology MSM: 3 site testing NAAT Hep B + C for those at risk
47
What extra swabs can be done + for what?
Microscopy HVS (gram stain + wet mount) for BV + TV Micrscopy (gram stain of endo-urethral swab) for urethritis Mid stream urine dip + culture for testicular pain VVS NAAT - can do TV as well PCR for herpes + treponemes ulcers NAAT for mycoplasma gen
48
Who is at the greatest risk of HIV?
MSM