Sexual Health Flashcards
Most common STI in UK?
Clamydia
What kind of pathogen is clamydia trachomatis?
Gram -ve rod bacteria
How does Clamydia typically present?
Diagnosis?
Dysuria, Dyspareunia, abnormal discharge, pelvic pain
Diagnosis
Men - first catch urine or urethral swab for culture
Women - endocervical or vulvovaginal swab
Treatment for chlamydia in patient with no allergies?
If first line contraindicated/patient pregnant?
Doxy 100mg BD for 7 days
Azithromycin 1g for Day 1 then 500mg for 2 days
25 year old male, profuse purulent discharge, last had unprotected sex with casual partner 7 days ago. No ulceration, swelling or blistering. Gram -ve intracellular diplococci evident, diagnosis?
How is this STI diagnosed?
Gonorrhoea
Diagnosed via an endocervical swab and NAAT testing
How do you treat Gonorrhoea?
Single dose IM Ceftriaxone
Treatment of Molluscum Contagiosum presentation in genital region?
No treatment is advised for Molluscum Contagiosum presentation, regardless of region of the body
Offensive, ‘fishy smelling’, profuse, green-ish vaginal discharge. No visable lesions present. Diagnosis?
How is it diagnosed?
Trichomonas vaginalis
High vaginal swab for culture
NAAT testing is possible
Type of pathogen responsible for Trichomonas vaginalis?
Flagellated, anaerobic protozoa
Treatment for Trichomonas vaginalis?
Oral Metronidazole (5 days)
20 year old female presents with fishy smelling, thin, grey vaginal discharge. Diagnosis?
Pathogen causing this?
Bacterial vaginosis
Gardnerella vaginalis
Is BV an STI?
No caused by overgrowth of commensal bacteria within the vagina. It is more prevalent in sexually active women though
How is BV diagnosed?
High vaginal swab for culture
pH test is also useful - normal vaginal pH is 4-4.5, pH over this can be indicative of BV
Management of BV?
Oral Metronidazole 400mg BD for 5-7 days
What are HPV 6 & 11 associated with?
Genital warts
What are HPV 16 and 18 associated with?
Cervical cancer
What is the triad of Reactive Arthritis?
Arthritis, Conjunctivitis and Urethritis
Painless indurated ulcer which is positive to dark-field examination?
Primary Syphilis
Pathogen responsible for Syphillis?
Treponema pallidum
How many stage of Syphilis are there? What are they?
Roughly when do they come on?
Primary - single painless ulcer/chancre at inoculation site
- 3-4 weeks after exposure
Secondary - maculopapular rash on palms and soles, condylomata lata, snail track ulcers (white patches) in mouth,
- 3-10 weeks after disappearance of chancre
Latent - asymptomatic, approx 1 year after exposure
Tertiary - Infects internal organs - neurosyphilis, cardiovascular system affects, dementia etc etc
- 1-10 years after exposure
How do you diagnose syphilis?
VDRL - non specific
Treponema pallidum agglutination assay (TPPA) - specific
Diagnostic - serology
(can be positive from 4 weeks but can take up to 3 months)
Management for Syphilis?
Primary - benzathine benzylpenicillin IM
2nd line - Oral Azithromycin or Doxy
Best contraceptive option for young woman in stable relationship not wanting children soon who suffers from menorrhagia and FH of migraines with aura…
Mirena coil (IUS)
Best contraceptive for a young (21) female who had unprotected sex at a party two days ago. She doesn’t want children in the next 5 years…?
Copper coil (IUD)
Female patient, aged over 35 years who is a smoker, looking for contraceptives. Which contraceptive should be avoided?
COCP
When should the implant be fitted in a womans cycle?
On day 1-5 of menstrual cycle, after this – precautions for 7 days are recommended
Which contraceptive is linked to weight gain?
Depot injection
What is the main SE of the POP?
Main SE - unscheduled/irregular bleeding - should settle after 3 months though
Can also have breast tenderness, headache and acne
