Sexual health

Question 1

Which sexual health screening is offered to everyone who goes to GUM clinic?

Answer 1

Chlamydia
Gonorrhoea
Syphilis
HIV

Question 2

What is the window period?

Answer 2

The period of time between first infection and for the infection to show on tests. During this window period a person may be positive but results show negative

Question 3

How long is the window period for HIV?

Answer 3

4 weeks

Question 4

How to test for chlamydia and gonorrhoea in female?

Answer 4

• Vulvo-vaginal swab NAAT (nucleic acid amplification test)
• Throat swab and rectal swab can also be done if higher risk
• First pass urine culture
• Urethral swab

Question 5

How to test for HIV and syphilis?

Answer 5

Blood test

Question 6

Window period for chlamydia and gonorrhoea?

Answer 6

2 weeks

Question 7

Explain to someone the window period for chlamydia/gonorrhoea

Answer 7

This means that a negative test today means that you didn’t have chlamydia/gonorrhoea 2 weeks ago, however, it will not be able to give us any information about whether you have caught it in the last few days/since you’ve had unprotected sex

Question 8

How to tests for chlamydia and gonorrhoea in men?

Answer 8

First pass urine culture
Urethral swab NAAT
Throat swab and rectal swab can also be done

Question 9

Window period for syphilis?

Answer 9

12 weeks

Question 10

Treatment for chlamydia?

Answer 10

• Azithromycin 1g stat

- Doxycycline 100mg BD 7 days

Question 11

Additional management/considerations of chlamydia/gonorrhoeal infection?

Answer 11

• Contact tracing (current and recent (last 3 months) partners)
• Abstain from sex for 1 week

Question 12

Treatment for gonorrhoea?

Answer 12

Ceftriaxone 1g IM, ciprofloxacillin once sensitivities confirmed

Question 13

Features of TV?

Answer 13

• Bubbly, watery white/green discharge
• Vulval itching
• Strawberry cervix

Question 14

Investigation of TV?

Answer 14

• Speculum and vaginal swab from posterior fornix
• Urethral culture
• First pass urine culture

Question 15

Vaginal pH in TV?

Answer 15

> 4.5

Question 16

Treatment for TV?

Answer 16

Metronidazole

Question 17

Causes of candidiasis?

Answer 17

• Vaginal douching
• Perfumed soaps
• Tight synthetic clothing

Question 18

Features of candidiasis?

Answer 18

• Vulval itch and soreness
• Vaginal discharge
• Normal vaginal pH

Question 19

Investigations of candidiasis?

Answer 19

Only in symptomatic women, vaginal swab from anterior fornix for microscopy and culture

Question 20

Treatment for candidiasis?

Answer 20

• Topical clotrimazole cream

- Fluconazole tablet (contraindicated in pregnancy)

Question 21

Causes of BV?

Answer 21

• Vaginal douching
• Receptive cunnilingus
• Recent change of sex partner

Question 22

Features of BV?

Answer 22

• Watery, white, fish smelling discharge
• No itch
• Vaginal pH elevated

Question 23

Investigations for BV?

Answer 23

Symptomatic women only, vaginal swab shows clue cells on microscopy

Question 24

Treatment for BV?

Answer 24

Metronidazole/clindamycin

Question 25

Treatment for genital warts?

Answer 25

• Podophyllotoxin cream (contraindicated in pregnancy)

- Cryotherapy

Question 26

Features of syphilis?

Answer 26

• Painless chancre (primary)

- Rash affecting palms and soles (secondary syphilis)

Question 27

Treatment of syphilis?

Answer 27

Penicillin

Question 28

Normal vaginal pH?

Answer 28

3.8-4.5

Question 29

Important info if taking metronidazole antibiotics?

Answer 29

No alcohol

Question 30

What point of care test can be done for gonorrhoea?

Answer 30

Can take swab and do microscopy for gram negative diplococci on same day