Sexual health Flashcards
Which fungus most commonly causes thrush?
Candida albicans
What are the typical symptoms of thrush?
Erythema
Non-offensive discharge
Itching
What is the discharge typically like in thrush?
White curd-like discharge
Non-offensive smelling
If the vaginal discharge has an offensive smell, is BV or thrush more likely?
Most likely to be BV
Name 3 risk factors for thrush.
Antibiotic use
Steroids
Diabetes mellitus
What is the appearance of thrush on the genitalia?
Erythema
Satellite lesions: red pustular lesions with superficial white/creamy plaques that can be scraped off
White, curd like discharge
What is the first line medical treatment of thrush?
Topical fluconazole/canestan
What is the treatment for recurrent thrush where topical antifungals does not work?
Oral fluconazole
What are the symptoms of BV?
Fishy smelling grey/white discharge. Not associated with soreness or itching
Can be asymptomatic
What are the most common causes of BV?
Over use of vaginal products such as douches and vaginal washes.
What is the pH of the vagina in BV?
Over 4.5
What is the management of BV?
Oral metronidazole for 5-7 days
What are the most common symptoms of chlamydia?
Vaginal discharge
Post coital/intermenstrual bleeding
Pelvic pain
Deep dyspareunia
Dysuria
What investigations are carried out in suspected chlamydia?
In women: vulvo-vaginal or endocervical swab.
In men: first catch urine sample or urethral swab
Treatment for chlamydia?
Doxycycline BD for 7 days
What are the symptoms of gonorrhoea?
Thin watery, yellow/green discharge
Dysuria
Dyspareunia
Lower abdo pain
What signs are seen on bi manual in someone with gonorrhoea?
Cervical bleeding
Pelvic tenderness
Mucopurulent endocervical discharge
What is the treatment for gonorrhoea?
1g Ceftriaxone
Follow up testing
What organism is syphilis caused by?
Treponema pallidum
What are the signs or primary syphilis?
Infectious hard ulcer under the skin (chancre)
What is the incubation period after exposure for primary syphilis?
2-3 weeks
When does secondary syphilis develop after exposure?
3 months post infection
What are the symptoms of secondary syphilis?
Skin rash on hands and soles of feet.
Fever
Malaise
Arthralgia
Weight loss
Headaches
What are the investigations for syphilis?
Dark ground microscopy of chancre fluid
PCR testing of active lesion
Serology
What is the management of early syphilis?
1 IM dose benzathine penicillin
What is the management of late syphilis?
3 doses IM Benzathine penicillin at weekly intervals
What areas does trichomonas affect in both men and women?
In women it affects: urethra, vagina and paraurethral glands
In men it affects: Urethra and under foreskin
What type of organism is trichomonas?
A flagellated protozoan, which divides via binary fission.
What is the appearance of the cervix in trichomonas infection?
Strawberry cervix
What are the symptoms of trichomonas infection?
Offensive vaginal odour
Thick, frothy discharge
Itchiness of vulva
Treatment of trichomoniasis?
2g of metronidazole orally in a single dose or
Metronidazole 400-500mg twice daily for 5-7days
Which virus transmits genital herpes?
Herpes simplex virus
What are the symptoms of genital herpes?
Burning and itching around the genitals
Painful red blisters around genitals
What is the treatment for genital herpes?
Aciclovir
How can HIV be transmitted?
Unprotected sex
Reusing needles
Medical procedures
Vertical transmission from mother to baby
What is levonorgestrel?
An emergency contraception. It is a progesterone.
When should levonorgestrel be taken to be effective as an emergency contraceptive?
Within 72 hours of UPSI
If vomiting occurs within how many hours of taking levonogestrel must you take another dose?
Within 3 hours of taking you must take another dose as you are not protected.
When can hormonal contraception be used after taking levonogestrel?
It can be stated immediately
What is the mode of action of levonorgestrel?
It stops ovulation and inhibits implantation
What is the mechanism of action of ulipristal?
It inhibits ovulation
Within how long of UPSI can ulipristal be taken?
120 hours
When should hormonal contraception be started or restarted after using ulipristal?
5 days after ulipristal as it can reduce the effectiveness of the contraception
Which patients should you not give ulipristal to?
Those with severe asthma
When can a copper IUD be used for UPSI?
Within 5 days of UPSi
What is the mechanism of action of a Copper IUD in emergency contraception?
It prevents implantation and may inhibit fertilisation
How long should the copper IUD be left in for if used for emergency contraception?
Until at least the next period.
Name 9 absolute contraindications for the COCP.
Over 35 years old and smoking more than 15 a day
Migraine with aura
History of VTE
History of stroke of IHD
Breast feeding or < 6weeks post-partum
Uncontrolled hypertension
Current breast cancer
Major surgery with prolonged immobilisation
Positive antiphospholipid antibodies (SLE)
Name 7 UKMEC 3 criteria for COCP.
Over 35 smoking less than 15 a day
BMI over 35
FHx of VTE in relatives under 45
Controlled hypertension
Immobility
Carrier of BRCA1 or 2
Current gall bladder disease
Why is the COCP contraindicated in migraine with aura?
Increases risk of stroke
