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YEAR 4 O+G > GUM > Flashcards

GUM Flashcards

1
Q

organism: chlamydia

A

chlamydia trachomatis
gram-ve
most common STI in UK and causes infertility

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2
Q

GUM STI screening

A

HIV
syphilis
chlamydia
gonorrhoea

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3
Q

testing: chlamydia and gonorrhoea

A

NAAT

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4
Q

high vaginal swab: tests for

A
  • BV
  • candidiasis
  • trichomonas vaginalis
  • group B strep
  • gonorrhoea
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5
Q

presentation: chlamydia

A
  • mainly asymptomatic
  • yellow-green ischarge
  • pelvic pain
  • abnormal vaginal bleeding
  • dyspareunia
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6
Q

ix: chlamydia

A

NAAT vulvovaginal swab
yellow endocervical high vagianl swab for MC&S

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7
Q

rx: chlamydia

A

doxycycline 100mg BD 7 days
doxcycline - chlamydia

(not in pregnancy/BF - azythromycin 1g stat and 2 days 500mg/erythromycin 500mg QID 7 days)

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8
Q

complications: chlamydia

A
  • PID
  • chronic pelvic pain
  • infertility
  • ectopic pregnancy
  • conjunctivitis
  • reactive arthritis
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9
Q

organism: gonorrhoea

A

gram -ve diplococcus

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10
Q

presemntation: gonorrohoea

A

more likely to be symptomatic than chlamydia
* odourless, perulent dishcarge (can be green-yello)
* dysuria
* pelvic pain

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11
Q

ix: gonorrohoea

A

NAAT
charcoal swab for MC&S

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12
Q

rx: gonorrhoea

A

IM ceftriaxone 1g single dose if senstivities unknown
single dose PO ciprofloxacin 500mg is sensitivities known

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13
Q

presentation: BV

A

fishy smelling watery grey/white discharge
no itch/pain

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14
Q

ix: BV

A
  • high vaginal swab
  • vaginal high pH
  • CLUE CELLS on MC&S
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15
Q

key word: clue cells

A

BV

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16
Q

rx: BV

A

asymptomatic = no treatment
symptomatic = metronidazole 7 days

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17
Q

key words: metronidazole treatment advice

A

avoid alcohol

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18
Q

complications: BV

A

miscarriage
preterm delivery
PROM
chorioamnionitis
LBW
postpartum endometritis

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19
Q

presentation: candidiasis

A

thick white cottage cheese like discharge
no smeel
itchy/painful

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20
Q

ix: candidiasis

A

charcoal swab for MC7S

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21
Q

rx: candidiasis

A

clotrimazole cream/pessary
PO fluconazole
canesten due (tablet and cream)

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22
Q

presentation: trichomonas

A

asymptomatic
frothy yellow-green fishy discharge
itching

23
Q

ix: trichomonas

A

ph >4.5
strawberry cervix on speculum
HV swab for MC&S

24
Q

rx: trichomonas

A

metronidazole

25
Q

presentation: mycoplasma genitalium

A

urethritis
similar to chlamydia

26
Q

ix: mycolplasma genitalium

A

NAAT swab
test cure after

27
Q

rx: mycoplasma genitalium

A

doxycycline BD 7 days THEN azithromycin 1g stat THEN 500mg OD for 2 days

28
Q

organism: syphilus

A
  • treponema pallidum
  • spirochete with spiral shaped bacteria
29
Q

stages: syphillis

A

primary - painless ulcer “chancre”
secondary - systemic symptoms (skin and mucmous membranes - can resolve after 3-12 weeks and enter latent stage)
latent - symptoms disappear but still infected (early up to 2 years, late - after 2 years)
tertiary - gummas and CV/neuro complications

30
Q

presentation: neurosyphilis

A

argyll-robertson ppil - constricted pupil that occomodates focusing on nera object but not reacting to light

31
Q

diagnosis: syphilis

A

antibody testing - PCR
dark field microscopy

32
Q

rx: syphilis

A

IM benzathine benzylpenicillin

33
Q

presenation: HSV2 herpes

A
  • ulcers/blistering lesions
  • neuropathic pain
  • flu-like symptoms
  • dysuria
  • inguinal lymphadenopathy
  • symptoms ca last 3 weeks in primary infection
34
Q

rx: genital herpes

A

aciclovir
paracetamol
instilagel
wear loose clothing

35
Q

def: PID

A

pelvic inflammatory disease
inflammation and infection of pelvic organs
cause of tubular infertility and chronic pelvic pain

36
Q

causes: PID

A

chlamydia
gonorrhoea
mycoplasma

37
Q

presentation: PID

A
  • pelvic pain
  • abnormal vaginal dishcharge
  • abnormal bleeding
  • dyspareunia
  • fever/signs of sepsis
  • dysuria
38
Q

ix: pID

A
  • NAAT swabs
  • HV swab
  • HIV ad syphilis test
39
Q

rx: PID

A
  1. IM ceftriaxone 1g to cover gonorrhoea
  2. doxycyline to cover chlamydia 100mg 14 days
  3. metronidazole 400mg 14 days for anaerobes
40
Q

complications: PID

A
  • sepsis
  • abscess
  • infertility
  • chronic pelvic pain
  • ectoic pregnancy
  • Fitz-High-Curtis syndrome
41
Q

def: Fitz-Hugh-Curtis syndrome

A
  • inflammation and infection of liver capsul
  • causes adhesions between liver and peritoneum
  • causes RUQ pain
  • tx: ahesiolysis via laparoscopy
42
Q

most common cause: PID

A

chlamydia

43
Q

MOA: COCP

A
  • stops ovulation
  • thickens cervical mucous
  • thins endometrium
44
Q

contraindications: COCP

A
  • uncontrolled hypertension
  • > 35 and >15 cigarettes/day
  • migraine with aura
  • previous VTE
  • vascular disease/stroke
  • liver irrhosis/tumours
  • IHD/AF/cardiomyopathy
  • SLE and APL syndrome
45
Q

instructions for taking: COCP

A
  • start pill ay any time in cycle
  • day 1-5 protected immediately
  • otherwise use 7 days additional contraception
46
Q

missed pill rules: COCP

A

missing 1 pill:
* take missed pil straight away
* continue taking pack as normal
* emergency contraception not required

missing 2+ pills:
* take most recent pill missed straight away
* use condoms/abstain from sex 7 daysa
* emergency contraception if day 1-7 cycle

47
Q

MOA: POP

A

stops ovulation
thickens cervical mucous
thins endometrium

48
Q

contraindications: POP

A
  • active breast cancer
  • severe liver cirrhosis
  • liver tumour
49
Q

starinstructions for taking: POP

A
  • can start any time in cycle
  • if day 1-5 preotected immediately
  • otherwise use additional conraception for 2 days after starting
50
Q

missed pill rules: POP

A

<12 hours:
take missd pill straight away and continue taking pack as normal

> 12 hours:
take missed pill straight away - if missed more than 1 only take 1
use condoms for next 2 days
if you had sex within time of missed pill = emergency contraception

51
Q

emergency contaception: Levonogestrel (Levonelle)

A
  • taken within72 hours UPSI
  • unlikely effective after ovulation (day 14+)
  • 1.5mg single dose
  • 3mg single dose if BMI>26
  • BF ok
  • start COCP immediately
52
Q

emergency contraception: ullipristal acetate (ellaone)

A
  • taken within 120h of UPSI
  • unlikely to be effective after ovulation (day 14+)
  • more effective than levonelle
  • wait 5 days before COCP or POP
  • single 30mg dose
  • BF avoided
  • avoided in severe asthma
53
Q

emergency contraception: copper coil

A

can be inserted within 5 days of UPSI/within 5 days og estimated date of ovulation
most effective
first line

YEAR 4 O+G (6 decks)

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