Genito-urinary Flashcards
stress incontinence Mx
duloxetine
urge incontinence Mx
oxybutynin
candidiasis Px in men and women, Mx
Women: white curdy discharge
Men: red glazed plaques
Mx: fluconazole
Bacterial vaginosis Px and Mx
fishy odour, grey discharge
Metronizadole / clindamycin
Trichomoniasis Px and Mx
yellow frothy discharge
metronizadole
Chlamydia Px, Dx, Mx
dysuria, intermenstrual bleeding, discharge
NAAT test from endocervical swab
Mx = doxycycline
Gonorrhoea Px Mx 1st and 2nd line
dysuria, intermenstrual bleeding, discharge
Mx: IM ceftriaxone
oral cefalaxine + oral azithromycin
Genital herpes Px, Dx and Mx , cause
painful genital ulcers, vaginal discharge, dysuria
NAAT test
Aciclovir
Caused by: herpes simplex 2
genital warts cause and Px
HPV
painless lumps
bilateral abdominal pain, adnexal tenderness, fever
cervical motion tenderness
Pelvic inflammatory disease Px
Fitz Hugh Curtis Syndrome
happens in PID, when adhesions form between the liver and abdominal wall. causes inflammation and RUQ pain
Mx of PID
ofloxacin
metronizadole
HIV in pregnancy
<50 copies = vaginal delivery, >50 = C section
breast feeding is not recommended
primary syphilis Px
genital / perianal lesions, painless
Turns into a chancre
secondary syphilis
Fever, myalgia
maculopapular rash on legs, face, arms
Enlarged lymph nodes
tertiary syphilis
granulomatous like lesions, neuropsyphilis
Mx of syphilis
1 dose benzathine penicilline (IM???)
Px of Benign prostatic hyperplasia
enlarged smooth, asymmetrical prostate, palpable bladder, weak urine flow, urgency, terminal dribbling
Mx of BPH
tamsulosin
finasteride
acute scrotal pain, swelling, not settled by pain, 2ndary to UTI
epididymo-orchitis
severe testicle pain, loss of cremasteric reflex in young boys, + Mx
testicular torsion
Mx = surgery
diagnosing PCOS
- anovulation
- hyperandrogenism (hirsutism)
- ovarian volume >10cm
chlamydia shape and gram stain
gram -ve rod
gonorrhoea shape and gram stain
gram -ve diplococci
Paraphimosis Px and Mx
the foreskin is retracted but cannot be replaced, this constricts the venous return of the penis and causes the glans penis to swell up
Mx: Soak it in hypertonic solution to draw fluid out, then attempt to manually replace the foreskin.
Phimosis Px and Mx
when the foreskin can’t be retracted, due to scarring of the foreskin.
Mx: supportive, maintain hygiene
Low sperm count and mobile mass in the scrotum
Could be a varicocele enlargement of the pampiform plexus, meaning that blood isn’t cooled to the optimum temp before it reaches testes, which reduces sperm production
what to test initially for erectile dysfunction
HbA1C
what to test initially in male infertilityq
semen analysis
red swollen head of penis
paraphimosis
curvature during erection
peyronies disease
Dx of BPH (imaging)
ultrasound with post-voidal bladder volume
1st and 2nd and 3rd line for menorrhagia
- mirena coil
- mefanemic acid
- tranexamic acid
contraindications to cocp
> 35 yrs >20 cigs a day
hypertension
current breast cancer
previous VTE
hepatitis, liver cirrhosis
migraines with aura
what to give if cocp is contraindicated
pop
implant
semen analysis normal values
vol: ≥ 1.5ml
pH: ≥ 7.2
concentration: ≥ 15 million per ml
number: ≥ 39 million per ejaculation
motility: ≥ 40%
lymphogranuloma venereum Px and cause
caused by chalmydia trachomatis
presents with genital ulcers and painful inguinal lymphadenopathy
Mx of lymphogranuloma vereneum
three weeks of doxycycline
renal colic pain relief
IM diclofenac 75mg
lichen planus Px
red/purple plaques with overlying lacy white stripes
lichen sclerosus Px
pale shiny skin
white plaques
what strains of HPV are assoc with cervical cancer
16 & 18
what strains of HPV are assoc with genital warts
11
what organism gives rise to syphilis
treponema pallidum
what infection is commonly associated with reactive arthritis
chlamydia
yellow/green frothy malodorous discharge
strawberry cervix
what is this and MX
trichomonas
metronidazole BD for 7 days
how to treat bladder cancer
TURBT + intravesical chemo (Bcg)
management of chlamydia
7 days of doxycycline 12 hourly
azithromycin dose for chlamydia
1g single dose and then
500mg OD for two days
missed pill at the start or end of pack
what to do
take missed pill
emergency contraception
missed pill in middle of the pack
what to do
take missed pill
continue as normal
condoms for 7 days
most common testicular tumour under 4 years
yolk cell tumour
what cells does yolk sac tumour
schiller duval cells
what. is noted on histology in leydig cell tumour
reinke crystals
what is used to treat chlamydia in pregnancy (3 drugs)
amoxicillin
azithromycin
erythomycin
ulcer on penis
painful vs painless inguinal lymphadenopathy
painful = lymphogranuloma vereneum
painless = syphilis
treatment of pubic lice 2 options
malathion or permethrin cream
flagellated protozoa
trichomonad vaginalis
investigation of choice for chlamydia and gonorrhoea in females
vulvovaginal swab for NAAT testing
painless vs painful penile ulcer cause
painless = syphilis
painful = herpes HSV2
2 tests for syphilis and their results in positive, successfully treated and false positive
Non-treponemal (VDRL test) + treponemal (TP-EIA test)
If they have had syphilis, the TP-EIA will stay positive for life
If they have been successfully treated, the VDRL will go negative after 6 months
Positive VDRL + negative TP-EIA = false positive
4 causes of false positive syphilis result
SLE
TB
malaria
HIV
