Gynae - sexual health

Question 1

What would you do for an examination in contraception appointments?

Answer 1

BP - do not give if systolic >140-159, diastolic > 90-94
BMI - Caution if >/=30
cervical smear >25
STI screen

Question 2

What are the aspects of Fraser competency?

Answer 2

Understands information
Doctor tries to persuade her to tell parents
Will have sex with or without contraception
Health will suffer without advice
In best interests of girl

Question 3

What are the incubation periods for common STIs?

Answer 3

9-90 days - syphilis
2 weeks - chlymydia, gonnorrhea
3 month - HIV
6 month - hepatitis

Question 4

What vaccinations would you offer to MSM?

Answer 4

Hep A and B

HPV

Question 5

How would you treat genital warts?

Answer 5

liquid nitrogen

creams - aldora, worticon

Question 6

What is the most common cause of genital warts?

Answer 6

HPV

Question 7

What are 3 STIs that cause mouth ulcers?

Answer 7

herpes
sphyillis
HIV

Question 8

What is it and how would you treat it?

thin, grey, discharge with fishy smell

Answer 8

Bacterial vaginosis
- increased pH from lactobacilli
Treatment - metronidazole

Question 9

Name 3 symptoms of chlamydia and gonorrhea and how would you treat them?

Answer 9

menstrual irregularity dysuria
rarely discharge - yellow, green, cloudy
Chlamydia - doxycyline
Gonorrhea - ciprofloxacin

Question 10

What is this, 3 risk factors and how would you treat it?

priuritus, soreness, rash, dysparuria, white, thick discharge

Answer 10

candida
RF- stress, DM, hormonal contraception, antibiotics, pregnancy
TREAT - imidazole (anti-fungal)

Question 11

What are the most common types of HPV and how would you manage them?

Answer 11

16 and 18 = risk of cancer
Treat with HPV vaccine
6 and 11 = risk of warts
Treat with imiquimod, trichoroacetic creams, liquid nitrogen freezing

Question 12

What are the 3 stages of sphyilis and how would you treat it?

Answer 12

Primary - chancre - in 9-90 day incubation
Secondary - rash all over, especially palms and soles, alopecia
Tertiary - any -itis e.g. dementia, neuro
Benzylpenicillin injections

Question 13

How do you treat PID?

Answer 13

IM cefriaoxine, PO doxycycline and PO metronidazole

Question 14

How to treat genital herpes in pregnacy?

Answer 14

If diagnosed within 6 weeks of due date - C-section
<28 weeks - antiviral treatment and again at 36 weeks til birth
>28 weeks - antiviral treatment until birth

Question 15

How does COCP affect cancer risk?

Answer 15

12% decreased risk of cancer esp bowel
increases cervical cancer especially is used for >8 years
do not need smear before starting

Question 16

What is involved in HAART treatment of HIV?

Answer 16

Highly active antiretroviral therapy 
2 NRTI (neucleoside reverse transcriptase inhibitors)
NNTRI (non-nuceloside reverse transcriptase inhibitor) / Boosted PI or integrase inhibitor

Question 17

What are 3 AIDS defining infections?

Answer 17

cryptosporidiosis, cerebral taxoplasmosis, HIV dementia, PML, oesophageal candidiasis, cryptococcal meningitis, primary CNS lymphoma