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FCM Y1 SGUL > SEXUAL HEALTH > Flashcards

SEXUAL HEALTH Flashcards

1
Q

women = discharge, bleeding
dysuria

men = urethral discharge and dysuria

A

Chlamydia - usually asymptomatic 70%

Gonorrhea

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2
Q

investigations for gonorrhea and chlamydia

A

NAATs
women = vulvovaginal swabs and
men = first void urine sample

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3
Q

management of chlamydia?

A

Doxycycline 7 days
alternative = azithromycin
partner notification
sexual abstinence for 1 week

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4
Q

management of gonorrhea?

A

1mg IM ceftriaxone
uncertainty = oral ciprofloxacin
OR
Oral ceftriaxone 400mg + oral azithromycin

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5
Q

fishy offensive discharge - usually thin and white
+ve whiff test
stippled epithelial cells
pH >4.5

can be asymptomatic

A

bacterial vaginosis

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6
Q

management of bacterial vaginosis

A

oral metronidazole 5-7 days

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7
Q

primary state
painless chancre
local non-tender lymphadenopathy

secondary
systemic = fevers, lymphadenopathy, rash on trunk palms/soles
buccal ‘ small track’ ulcers
condyloma lata

tertiary
gumma - granulomatous lesions
ascending aortic aneurysm
tabes dorsalis

A

syphilis

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8
Q

investigations for syphilis

A

darkfield microscopy
swab from chancre/ulcer site
serology / TPHA = remains positive

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9
Q

management for syphilis

A

IM penicillin
OR
oral doxycycline as alternative

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10
Q

infertility investigations for females

A

LH & FSH
progesterone - 7 days prior to next period
TVUS
hysterosalpingogram

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11
Q

infertility investigations for males

A

semen analysis

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12
Q

primary presentation: sore throat, lymphadenopathy, malaise and myalgia or arthralgia
diarrhoea
maculopapular rash or mouth ulcers

followed by recurrent infections - pneumonia common

A

HIV

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13
Q

investigations for HIV

A

serology - venous sample from either at home or at clinic

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14
Q

management of HIV

A

combination of 3 ARTs
mainly 2 NRTI such as emtricitabine, tenofovir, zidovudine and abacavir
+
protease inhibitor indinavir or nelfinavir
OR
NNRTI = nevirapine or efavirenz

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15
Q

what is the recommended viral load for delivery

A

<50 for vaginal delivery at 36weeks

usually given a zidovudine infusion 4hrs prior to C-sections

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16
Q

PEP HIV

A

combination of ARTs at least 72hrs following exposure

serologic testing at 12weeks

17
Q

primary presentation = multiple painful lesions which can rupture and become crusty
vaginal/urethal discharge
local oedema
tingling/neuropathic pain in genitals, lower back, buttock & legs

A

herpes simplex virus (HSV-2)

18
Q

investigations of HSV

A

swab from site - viral culture/PCR

19
Q

management of HSV

A

primary infection = aciclovir 400mg TDS 5-10 days

supportive management includes = analgesia, lidocaine gel, bathing is warm salt water
increased fluids

20
Q

painless, small flat smooth papules
may become painful on irritation
soft cauliflower like growth

A

Human papillomavirus / genital warts

21
Q

HPV 6 & 11

A

genital warts

22
Q

HPV 16 & 18

A

cervical cancer/oncogenic

23
Q

management of HPV

A

podophyllotoxin topical - apply BD for 3/7 then review
Iriquimoid TDS nocte

treatment is 3-4weeks, immunosuppression
cryotherapy, surgical excision and specialist Tx

24
Q

vulval itching, dysuria, offensive fishy discharge
frothy yellow/green discharge
vulval/lower abdo pain

A

trichomonas

25
Q

investiagtions for trichomonas

A

microscopy of high vaginal swab/tip of penis swab
pH of vaginal wall
gram stain

26
Q

management of trichomonas

A

metronidazole 400-500mg BD for 5-7 days
OR
2g as a single dose

offer further STI screening
sexual abstinence for at least 1 week

27
Q

male sexual dysfunction

A

erectile dysfunction

premature ejaculation

28
Q

management of erectile dysfunction

A

lifestyle advice
psychosexual therapy
PDE5 inhibitors = sildenafil
specialist Tx

29
Q

management of premature ejaculation

A

pscyhosexual counselling, CBT
SSRIs, tramadol, terazosin and sildenafil
special Tx

30
Q

female sexual dysfunction

A

sexual interest arousal disorder
female orgasmic disorder
genito-pelvic penetration pain disorder

31
Q

management of female sexual dysfunction

A

psychotherapy

topical oestrogen

FCM Y1 SGUL (15 decks)

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