Sexual Health Flashcards
What is bacterial vaginosis? RF Features Criteria to diagnose Management
Over growth of anaerobic organisms such as gardinella vaginallis, fall in lactic acid producing lacto bacilli leading to a raised vaginal ph
Black, women wsw vaginal douching smoking
Vaginal discharge FISHY
Amsels criteria- 3 of the following need ot be present
thin, white homogenous discharge
clue cells on microscopy: stippled vaginal epithelial cells
vaginal pH > 4.5
positive whiff test (addition of potassium hydroxide results in fishy odour)
Management Oral metronidazole for 5-7 days Topical metronidazole oral clindmycin cocp
What is chlamydia? Rf Features Investigation Screening management
Most common STI in the UK caused by obligate intracellular pathogen, Chlamydia Trachomatis
Age under 25 years New or multiple sexual partners Unprotected sexual intercourse: vaginal, oral or anal Sharing unwashed sex toys Social deprivation
Usually goes on eputhelial surfaces urethritis vaginitis and cervicits proctitis PID epidymo-orchitiis Pharyngitis Chlamydial conjuctivitis
Investigation
NAAt- vulvovaginal swab in women
First Void urine in men
Screening programme for 15-24
Oral doxycylicine- avoid in pregnant
\2nd= azithromycin
what is genital warts
condylomata accuminata small (2 - 5 mm) fleshy protuberances which are slightly pigmented may bleed or itch Topical podophyllum or cryotherapy imiquimod
What is genitla herpes
invcestigation
management
and pregnancy
Caused by herpes simplex virus 1 and 2
Painful ulceration
FAM, lymphadenopathy
Urinary retention
NAAT test
saline bathing
analgesia
topical anaesthetic agents e.g. lidocaine
oral aciclovir
some patients with frequent exacerbations may benefit from longer-term aciclovir
elective caesarean section at term is advised if a primary attack of herpes occurs during pregnancy at greater than 28 weeks gestation
What is Lymphogranuloma venereum?
Features
Investigation
Management
curable sti affecting lymphatic vessels and nodes caused by chalmydia trachomatis
Starts with painless papule or ulcer on penis/vagina
Stage 1: small painless pustule which later forms an ulcer
Stage 2: painful inguinal lymphadenopathy; usually 10-30 days after the primary lesion
Stage 3: proctocolitis (most commonly seen in men who have sex with men); may mimic Crohn’s disease
NAAT-if positive for C.trachomatis, DNA may be tested for LGV-specific DNA
Management-Typically with 100mg oral doxycycline bd for 21 days
What is syphilis RF Features or primary secondary and tertiary Investigation Management \
Syphilis STI caused by spirochete treponema pallidum
Men who have sex with men
Intravenous drug users
Sex workers
Multiple sexual partners and the presence of other STIs: also the case for all other sexually transmitted infections
Primary- single chancer, lymphadenopathy
Secondary- fever headaches rash snail track ulcers alopecia
Tertiary all the features + Neuro
IX= treponemal specific antibody test- EIA
ull syphilis serology screen (usually EIA, TPPA and RPR)
Early syphilis (primary, secondary, early latent): single dose of IM benzathine benzylpenicillin Late latent and gummatous syphilis: 3 doses of IM benzathine penicillin once weekly for 3 weeks Cardiovascular syphilis: 3 days of oral prednisolone and 3 once-weekly doses of benzathine penicillin Neurosyphilis syphilis: 14 days of IM procaine penicillin and oral probenecid
WHat is trichomoniasis
RF
IX
Trichomoniasis is a sexually transmitted urogenital infection with the protozoan parasite, Trichomonas vaginalis, which can occur in both males and females. Female sex Race Young age Unprotected sexual intercourse
Features Frothy yellow green vaginal discharge thin white discharge from penis dysuria itching strawberry cervix
Vaginal pH test: alkaline pH >4.5 is suggestive of trichomoniasis (and bacterial vaginosis) [2]; normal vaginal pH in a woman of childbearing age is 3.5-4.5
High vaginal swab: a swab of the discharge from the posterior fornix should be labelled and sent for culture or wet mount microscopy for definitive diagnosi
Management
Oral metronidazole: for men and women, offer a 5-7 day course of 400-500mg metronidazole or a single 2g dose; this is also safe for pregnant and breastfeeding women [3]
Oral tinidazole: for men and (non-pregnant) women, a single 2g dose of tinidazole is an alternative to metronidazole; it is not safe in pregnancy
