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Repro and Sexual Health > Week 2 > Flashcards

Week 2 Flashcards

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1
Q

When are the average ages of menopause; Premature ovarian insufficiency and early menopause?

A

Respectively: 51, 40, 40-44

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2
Q

Define perimenopause

A

the period of time between development of menopausal symptoms and the menopause (one year after the last period) (usually years)

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3
Q

Is there management of perimenopause?

A

For perimenopause, we treat symptoms not hormone levels. Even if blood results are tested and normal we still try HRT

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4
Q

When do we test hormone levels in perimenopause?

A

In women between 40-45
In women >45 with atypical symptoms
Women aged >50 on hormonal contraception who want to stop it before 55

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5
Q

What are contraindications of HRT?

A

History of breast or endometrial cancer, unexplained vaginal bleeding, active liver disease, CHD, TIA or stroke

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6
Q

What types of HRT are given in women with hysterectomies or mirena coil

A

Estrogen only HRT

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7
Q

What types of HRT are given in women without hysterectomies or a mirena coil

A

Estrogen and progesterone

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8
Q

When can you stop contraceptives in a woman of 50-54?

A

One year after the last natural menstrual period

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9
Q

What is the mechanism of action of the copper coil for emergency contraception

A

prevention of implantation

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10
Q

What is the MoA of levonorgesterel and Ulipiristal Acetate

A

Delay Ovulation

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11
Q

How effective are Levonorgesterel and Ulipristal Acetate

A

60%-80%

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12
Q

In what situations would Levonorgesterel given over Ulipristal Acetate

A

When hormonal contraception has been used in the proceeding week or is planned on being used in the following week

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13
Q

How long should additional contraception be used for when CHC or POP is started, out with, the first 5 days of your period

A

7 days after CHC or traditional POP and 2 days after POP with desonestregel

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14
Q

What is the management for gonorrhoea?

A

Ceftriaxone 1G IM given as 2 injections, 1 in each butt cheek simultaneously, if antibiotic sensitivities ciprofloxacin 500mg orally

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15
Q

Describe the 4 classifications of FGM

A

Type 1: Clitirodectomy +/- prepuce
Type 2: partial/total removal of the clitoris and the labia minora +/- labia majora
Type 3: narrowing the vaginal orifice by creating a covering seal
Type 4: all other harmful procedures to the female genitalia for non-medical purposes

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16
Q

What bacteria causes syphilis?

A

spirochete bacterium Treponema pallidum

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17
Q

What is the MoA of Sayana Press/Depo Provera?

A

It lowers oestradiol and suppresses FSH

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18
Q

Which STI is caused by a protozoa and can cause strawberry cervix?

A

Trichomoniasis caused by trichomonas vaginalis

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19
Q

What is the management of candidiasis aka thrush?

A

clotrimazole 500mg pessary or fluconazole 150mg stat + clotrimazole 1% cream for external symptoms

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20
Q

How do you drain excess fluid in the pouch of Douglas?

A

via a needle placed through the posterior fornix of the vagina

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21
Q

Where does the ovarian artery originate?

A

The abdominal aorta

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22
Q

Where does the uterine artery originate from?

A

Internal iliac

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23
Q

Where does the vaginal artery originate from?

A

It is a branch of the uterine artery

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24
Q

What types of herpes most commonly causes genital herpes?

A

Type 1: probably because of condomless oral sex

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25
What is the management of Syphilis?
Single dose of Benzathene penicillin IM Injection
26
Which STI is most likely to cause a rash on the palms of the hands and soles of the feet
Syphilis
27
What is the window for Post-exposure Prophylaxis (PEP) against HIV?
72 hours
28
What is the management of PCP?
High dose Co-trimoxazole +/- steroid
29
When is prophylaxis for PCP given and what is given?
Co-trimoxazole given when a person with HIV’s CD4 count goes <200
30
What is the CD4 threshold for cerebral toxoplasmosis?
CD4: <150
31
What is the CD4 threshold for CMV?
CD4: <50
32
What is the CD4 threshold for PCP?
CD4: <200
33
What are the 3 components of the single tablet anti-retroviral therapy (ART)
Tenofovir + emtricitabine + efavirenz
34
Name 3 AIDS defining cancers
Kaposi's Sarcoma, non-hodgkins lymphoma, cervical cancer
35
What is the target site for HIV?
CD4+ receptors (CD4 cells are helper t cells)
36
Can mothers with HIV breastfeed?
NO
37
What is the management of a woman with HIV having a baby?
1. HAART during pregnancy 2. Vaginal delivery only if UNDETECTABLE VIRAL LOAD (c-section if detectable) 3. 2-4/52 PEP for neonate 4. Exclusive formula feeding
38
What is the pharmacological management of Pelvic inflammatory disease?
14 days metronidazole and doxycycline b.d. or IV if in hospital
39
What are some risk factors for PID?
<25 years old PMHx of PID more than 1 and/or a new sexual partner not using barrier contraception having and IUD
40
What are some risk factors for PID?
<25 years old PMHx of PID more than 1 and/or a new sexual partner not using barrier contraception having and IUD
41
What is the pharmacological management of chlamydia?
doxycycline bd 7 days or if there is any chance theyre pregnant azithromycin for 3 days
42
What is the pharmacological management of bacterial vaginosis?
Metronidazole for 5 days
43
What is the presentation of bacterial vaginosis?
may be asymptomatic (in 50%) - fishy smelling discharge - no irritation/discomfirt/itch
44
If a women has a PMHx of breast cancer, what is the best form of contraception for her?
Copper coil (IUD)
45
List some of the benefits of taking HRT
SYMPTOM RELIEF: reduction of vasomotor symptoms, improvement of low mood associated with the (peri-) menopause, increased cognitive function, increased sexual function Decreased osteoporosis Decreased CVD
46
What is the first line pharmacological management of GMS?
Local/topical oestrogens +/- moisturisers and lubricants
47
Which red flag symptoms require urgent cessation of the Oral Contraceptive Pill?
- high blood pressure - new onset headache or neurological symptoms - acute chest-pain / SOB
48
How long can HIV tests be negative after HIV infection?
3 months
49
What is the management of premenstrual syndrome?
1. Lifestyle: exercise, relaxation, yoga, breathing, vitamin B6 2. Pharmacology: CHC Progesterone mirena IUS or POP + estradiol patches
50
What are some triggers of vaginismus?
- fearing that your vagina is too small - a bad first sexual experience - an unpleasant medical examination - believing sex is shameful or wrong - a painful medical condition, like thrush
51
Can you take lithium during pregnancy?
Yes (It is important to take it to lower the risk of puerperium psychosis)
52
Does sodium valproate affect the efficacy of any contraceptive measures?
No
53
Which anti-convulsants are liver enzyme inducers?
- phenytoin - carbamazepine NOT lamotrigine
54
What forms of contraception are contraindicated if on lamotrigine?
Oral contraceptives (due to potential interactions)
55
If a patient is on a liver enzyme inducer for epilepsy, what is the best form of contraception for her?
Cu-IUD
56
Under what age would we generally offer STI screening even if they have had the same partner for >1 year
25
57
What form of contraception does high BMI have risks that outweigh the benefits, and at what BMI?
CHC BMI>35 this is because of VTE risk
58
A patient used to suffer from migraines with aura, but they stopped 6 years ago, can CHC be prescribed?
In migraines with aura 5+ years ago, the risks of CHC outweigh the benefits
59
Is past pelvic inflammatory disease a contraindication for coils?
No- not at all
60
Which contraceptives does smoking affect?
Only CHC this is because of VTE risk
61
What is the social limit for a TOP?
23 weeks + 6 days
62
How do you perform an HIV test?
A blood test where antibodies are tested is the typical screening test for HIV. The p24 antigen is a specific HIV antigen in the blood that can be tested for. This can give a positive result earlier in the infection compared with the antibody test.
63
What colour is discharge due to candidiasis?
Creamy white discharge with redness
64
What is the appearance of discharge due to bacterial vaginosis
fishy malodorous discharge. It is grey and whitish in colour
65
How does trichomoniasis usually present
Asymptomatic in about 70% If symptomatic, yellowish/green frothy along with itching
66
How do you test men for chlamydia?
Urine sample
67
What is the biggest contributor to HIV ART resistance?
Poor adherence to medication
68
How long is the incubation period of gonorrhoea?
2-5 days
69
What is the management of trichomoniasis?
Metronidazole
70
If Gonorrhoea is diagnosed, what must you do?
- Treat the gonorrhoea - Test for, chlamydia, syphilis and HIV (Hep B if risk factors) - Partner notification
71
When in a woman's cycle does PMS affect sufferers?
Luteal phase (after ovulation, relief with period)
72
When can you stop contraceptives in a woman of under 50 if she's lost her period?
2 years
73
What is the copper coil's MoA when not used for emergency contraception
Prevention of fertilisation (through toxicity to sperm and ova)
74
Which cancers risk increases with use of CHC?
Breast and cervical (breast far more)

Repro and Sexual Health (7 decks)

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