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3a > Sexual > Flashcards

Sexual Flashcards

1
Q

name the pharmacological treatment for women with hypoactive sexual desire disorder

A

flibaserin

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2
Q

define sexual desire disorder

A

lack of desire for sex leading to distress

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3
Q

what is sildenafil?

A

phosphodiesterase 5 inhibitor

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4
Q

define paraphilia

A

sexual response from non sexual stimuli

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5
Q

define rapid ejaculation

A

ejaculation occuring too quickly for both partners to enjoy intercourse or within one minute

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6
Q

which investigations should be done in someone with a sexual desire disorder?

A

TFT, lipids, glucose, testosterone, SHBG, oestrogen, prolactin

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7
Q

which condition do you use flibanserin for?

A

female hypoactive sexual desire disorder, not arousal

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8
Q

what causes sexual disorders

A

bio-hyperprolactinaemia, low androgens, DM, CVD, thyroid disorders, neuro, SSRIs
psych-previous abuse, depression, body image
social-performance anxiety, relationship troubles, stress

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9
Q

how should you manage a woman with dyspareunia?

A

swabs
consider gynae causes-cysts/endometriosis
consider referral to psychosexual therapy

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10
Q

name what bacteria BV can be caused by?

A

lactobacilli

gardenerella vaginosis

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11
Q

give 2 antibiotic regimens used for chlamydia

A

1d azithromycin

7d doxycycline

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12
Q

what are the symptoms of secondary syphilis?

A 
fever, headache, myalgia
rash on palms and soles
mucous patches
rash-condylomata lata
lymphadenopathy
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13
Q

how is syphilis diagnosed

A

PCR blood

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14
Q

when does secondary syphilis resolve?

A

about 14 weeks later, then tertiary comes on 20-40 years later

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15
Q

herpes symptoms

A

flu like prodrome
myalgia
painful ulcers

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16
Q

can someone with active herpes have sex?

A

no-condoms aren’t very effective

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17
Q

which strains of hepatitis are transmitted sexually?

A

B and C

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18
Q

what should you think of when diagnosing someone with thrush

A

HIV and DM

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19
Q

treatment of chlamydia?

A

1d azithromycin or 7d doxycycline

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20
Q

asymptomatic screening methods?

A

NAAT of: endocervical swab or first pass urine

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21
Q

physical causes of sexual problems?

A

chronic diseases: DM, CVD, obesity, neuro
hormone: thyroid dysfunction, hyperprolactin, androgen deficiency
local-infection, irritation, congenital defect, endometriosis, tumour, cyst, FGM

22
Q

psychological causes of sexual problems?

A

stress depression anxiety
low self esteem
trauma or abuse

23
Q

iatrogenic causes of sexual problems?

A

SSRIs>low libido
beta blockers>ED
alpha blockers>reterograde ejaculation and so infertility
local damage from surgery-prostate surgery can lead to ED

24
Q

treatment for ED?

A

pharm is 1st line-either sildenafil or alproprostadil-have to be taken 45 min before sex
then ring, Kegel’s, vaccuum

25
Q

what are the 6 features of female sexual arousal disorder?

A 
little interest in sex
few thoughts about sex
decreased initiation of sex
little pleasure during sex
decreased interest in sex when exposed to erotic stimuli
little physical response to sex
26
Q

what different types of psychosexual therapy are there?

A 
CBT-how they think now
psychodynamic-looking at problems in past and how that can be changed now
systemic-looking at problem as a whole
couples
integrative-using different types
27
Q

what are the 5 key principles of couples therapy?

A 
improve communication
modify dysfunctional behaviour
decrease emotional avoidance
change view of relationship
promote strengths
28
Q

what does the asymptomatic STI screen look for?

A

chlamydia, gonorrhoea NAAT
HIV and syphilis blood test
add on hep b and c if high risk

29
Q

what puts someone at high risk of hepatitis?

A

IVDU, high risk country, MSM, sex workers

30
Q

what does the symptomatic screen look for

A

everything in asymptomatic as well as high vaginal swabs as well as urethral and pharangeal and rectal swabs, urinalysis depending on exposures

31
Q

give an example of primary prevention strategies in sexual health

A

reduce risk of acquiring so: education, awareness, free condoms, hep b vaccination

32
Q

why might a sexual health screen give inaccurate results?

A

poor technique

not past the 2 week window from exposure

33
Q

what are the features of trichomonas?

A

strawberry cervix and fishy grey discharge

34
Q

what are the risks of STIs in pregnancy?

A

chlamydia>low birthweight PPROM

gonorrhoea>opthalmis neonatorum, premature labour, miscarriage, PID

35
Q

what advice should be given to those prescribed metronidazole?

A

don’t drink!

36
Q

when will warts manifest?

A

immunosuppression as with pregnancy, age , DM, steroids

37
Q

how do you differentiate between BV and other diseases?

A

whiff test-put KOH on speculum (it is alkaline and BV is very acidic so this releases volitile amines)

38
Q

what are the causes of vaginismus

A

thrush
FGM
psychiatric

39
Q

define hypoactive sexual desire disorder

A

lack of desire for sex

40
Q

how do you differentiate between physical and psychiatric causes of ED?

A

psychiatric still have early morning erections, biological just cannot

41
Q

what is the definition of delayed orgasm?

A

occuring later than patient wants-it has to follow normal arousal

42
Q

how is NAAT taken in men?

A

first void

43
Q

how is herpes tested for?

A

PCR swab

44
Q

how is chlamydia different?

A

obligate intracellular gram negative bacteria

45
Q

give complications of chlamydia

A

lymphogranuloma venerum
PROM
low birthweight
Reiter’s

46
Q

what are clue cells

A

vaginal epithelial cells covered in bacteria

47
Q

drugs that can cause delayed ejaculation

A 
SSRI
antipsychotics
BB
baclofen
opiates
48
Q

causes of ED

A

DM, hyperprolactinaemia, hypogonadism, PVD, veno occlusive disease, kidney failure
SSRI

49
Q

vaginismus causes

A

organic-thrush, FGM, trauma, congenital abnormality

psychological-fear/dislike of partner, mistaken beliefs

50
Q

what disorder would you use integrated CBT for?

A

vaginismus

3a (11 decks)

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