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BARRIERS CRAM > Sexual health > Flashcards

Sexual health Flashcards

1
Q

Diseases that need contact tracing (+ times)

A

6mo: chlyamydia, hep B, hep C, seoncdary syphilis
3mo: primary syphilis
2mo: gonorrhoea
12mo: early latent syphilis

ALL SEXUAL CONTACTS: HIV, trichomoniasis (no clear guidelines)

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2
Q

Causes + Sx of cervicitis

A

Sx of cervicitis: (dysparunia, post coital +intermenstrual bleeding, change in discharge)

Causes

  • Chlamydia
  • Gonorrhoea
  • Mycoplasma genitalium
  • Trichomonas vaginalus
  • HSV
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3
Q

Causes of epididymorchitis

A
  • STI (chlamydia, gonorrhoea, enteric organisms (MSM)
  • UTI
  • Viral infection e.g. mumps
  • Systemic bacterial infection

Ddx testicular tortion, abscess, cancer

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4
Q

Standard STI testing in aysmptomatic <30

A

Males: chlamydia FPU NAAT
Females: (1) = endocervical swab NAAT, self collected swab NAAT, (2)= chlamydia FPU NAAT, ano rectal swab (if anal related)

Consider: Hep B, HIV, syphilis, gonorrhoea (MSM, ATSI)

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5
Q

Bacterial vaginosis: Organisms, clinical signs, Ix, Rx, Complications

A

Organisms: anaerobic bacteria e.g. gardeneilla vaginalus, atropobium vaginae
Sx: offensive, fishy discharge, raised pH
Ix: high vaginal swab- culture
Rx: metronidazole PO or vaginally
Complications : preterm labour, chorio, PID, abortion (risks increased following instrumentation/gynae procedures)

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6
Q

Bacteria causing syphilis

A

Treponema pallidum

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7
Q

Primary syphilis

A
  • Often asymptomatic
  • Painless genital ulcer/chancre (can be multiple) –> well defined with indurated base
  • Enlarged rubbery inguinal lymph nodes
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8
Q

Secondary syphilis

A
  • Constitutional symptoms
  • Skin rash- scaly, maculopapular can involve trunks, classically palms and soles
  • Oral lesions
  • Alopecia
  • Neurological: cranial nerve palsies, meningitis, opthalmalogical involvement
  • Mild hepatitis
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9
Q

Tertiary syphilis

A

Occurs in 1/3 if not treated for primary or secondary

  • Gummas: granulomatous lesions in skin/bone
  • CVD: aortitis, aneurysm, valve incompetence
  • Neurological: cerebral syphilis- meningoencephalitis
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10
Q

Ix for syphilis

A
  • NAAT swab
    Serology: EIA
    If + –> Rapid Plasma Reagin (RPR) + TP Particle Agglutination (TPPA)

EIA + TPPA stay + for life, RPR would indicate reinfection

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11
Q

Rx for syphilis

A

Benzathine penicillin STAT for all infective syphilis (inc. early latent)
3 doses if late latent (non-infective), >24mo since contracted

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12
Q

Sx of chlamydia

A

cervicitis, epididimo-orchitis, PID, proctitis, urethritis, conjunctivitis

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13
Q

Rx of chlamydia

A
  1. doxy 100mg PO 7 days

2. stat dose of azithromycin 1g PO

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14
Q

Sx of mycoplasma genitalium

A

cervicits, urethritis, pelvic pain (PID)

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15
Q

Rx of mycoplasma genitalium

A

similar to chlamydia but doxy + azithromycin

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16
Q

N.gonorrhoea Sx

A

cervicitis, epididimo-orchitis, PID, proctitis, urethritis, conjunctivitis, disseminated disease (macular rash with necrotic pusutles, septic arthritis)

17
Q

Rx n.gonnorheoa

A

ceftriaxone IM + azithromycin

18
Q

Ix for gonorrhoea

A

NAAT of swab/first pass urine + culture

19
Q

Trichomonas vaginalis Sx

A

vulval itch
inflamed vagina+cervix
raised pH of vagina
green, frothy, fishy

20
Q

Rx trichomonas

A

Metronidazole 2g stat dose

21
Q

Sx HSV infection

A

Painful vesicular ulcers, Erythema, itching, cervicitis, proctitis, systemic features

22
Q

Rx HSV infection

A

Valicyclovir (or acyclovir in pregnancy/can be used in anyone) - 10 day course reduced to 5 if rapid reduction in symptoms
Same drugs for recurrence- higher dose, shorter course

23
Q

HSV complications

A

Neonatal HSV, enhanced HIV transmission, neuropathic bladder, psychosexual morbidity

24
Q

HPV strains implicated in genital warts

A

6,11

25
Q

Rx of genital warts

A

Cryotherapy

Topical creams e.g. imiquimod

26
Q

Causes of pelvic inflammatory disease

A

Often polymycrobial- chlamydia, n.gonorrhoea, mycoplasma

If postprocedural usually caused be ascending vaginal flora (treat with augmentin or amp/gent/met if this pathology)

27
Q

Complications of PID

A

Chronic pain
Ectopic pregnancy
Infertility
Pyschosocial morbidity

28
Q

Rx of PID

A

Ceftriaxone + metronidazole +azi/doxy (can all be given IV IF SEVERE)

BARRIERS CRAM (10 decks)

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