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Finals revision > Sexual health > Flashcards

Sexual health Flashcards

1
Q

CHLAMYDIA

What is the causative organism?

A

Chlamydia trichomatis

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2
Q

CHLAMYDIA

What are the symptoms is a female?

A

Asymptomatic

Increased vaginal discharge

Mucopurulent cervical discharge - yellow

Dysuria

PCB / IMB

Abdominal pain

Deep dyspareunia

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3
Q

CHLAMYDIA

What are the signs in a female patient?

A

Cervicitis

Cervical motion tenderness

Discharge

Abdominal pain

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4
Q

CHLAMYDIA

What are the symptoms in a male patient

A

Asymptomatic

Mucopurulent penile discharge

Dysuria / Urethritis

Testicular swelling

Pain on ejaculation

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5
Q

CHLAMYDIA

What are the signs in a male patient?

A

Abdominal tenderness

Epidiymo-orchitis

Reactive arthritis

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6
Q

CHLAMYDIA

What are the symptoms of rectal chlamydia

A

Asymptomatic

Anorectal discharge

Anorectal discomfort

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7
Q

CHLAMYDIA

What are the symptoms of oropharyngeal infection

A

Pharyngitis

Sore throat

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8
Q

CHLAMYDIA

How do you diagnose chlamydia in females

A

1st line: Vulvovaginal or endocervical swab - NAAT

2nd line: 1st catch urine

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9
Q

CHLAMYDIA

How do you diagnose chlamydia in males?

A

1st line: 1st catch urine

2nd line: Charcoal urethral swab for NAAT

*MSM - Anorectal and pharyngeal swabs

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10
Q

CHLAMYDIA

What extra test should be included for MSM patients with suspected chlamydia

A

Rectal swab - LGV

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11
Q

CHLAMYDIA

What is the manageemnt of chlamydia?

A

Doxycycline - 100mg BD 7 days

Erythromycin - If pregnant

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12
Q

CHLAMYDIA

Name 4 complications of chlamydia in women

A

PID
Infertility
Ectopic pregnancy
Conjunctivitis
Chronic pelvic pain

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13
Q

CHLAMYDIA

Name 4 complications of chlamydia in pregnancy?

A

Neonatal conjunctivitis
PROM
Low birth weight
Postpartum endometritis

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14
Q

CHLAMYDIA

What are the differentials for Chlamydia?

A

Mycoplasma genitalium

Lymphogranuloma venereum

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15
Q

CHLAMYDIA

What is Mycoplasma genitalium

A

Organism that causes a non-gonococcal urethritis

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16
Q

CHLAMYDIA

How do you diangose Mycoplasma genitalium

A

NAAT testing

Men - 1st pass urine

Female - Endocervical swab

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17
Q

CHLAMYDIA

What is required for a patient that has tested positive for mycoplasma genitalium

A

Tets for cure

Test for macrolide resistance

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18
Q

CHLAMYDIA

What is the treatment of mycoplasma genitalium

A

Doxycycline
Azithromycin

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19
Q

CHLAMYDIA

What is LGV

A

Lymphogranuloma venereum - common in MSM

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20
Q

CHLAMYDIA

Describe the stage of LGV

A

Primary - Painless ulcer

Secondary - Painful inguinal lymphadenitis

Tertiary - Proctitis / Tenesmus / Change in bowel habits

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21
Q

GONORRHOEA

What is the causative orgnaism

A

Neisseria gonorrhea

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22
Q

GONORRHOEA

How does gonorrhea present in females

A

Odourless purulent discharge

Dysuria

Pelvic pain

IMB

Dyspareunia

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23
Q

GONORRHOEA

What are the signs of gonorrhoea in a female patient

A

Discharge

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24
Q

GONORRHOEA

How does gonorrhoea present in a male patient?

A

Odourless purulent discharge

Dysuria

Testicular pain / swelling

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25
Q

GONORRHOEA

How do rectal and pharyngeal gonorrhoea infection present?

A

Usually asymptomatic

Anal - rectal discomfort

Pharyngeal - sore throat

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26
Q

GONORRHOEA

How do you diagnose gonorrhoea in women and men

A

Women
- vulvovaginal swab
- charcoal endocervical swab for MC&S

Men
- 1st pass urine

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27
Q

GONORRHOEA

What is the management of gonorrhoea

A

IM 1g Ceftriaxone - If sensitivities are unknown

Oral ciprofloxacin - If sensitivities known

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28
Q

GONORRHOEA

Describe the test for cure for gonorrhoea

A

Asymptomatic - NAAT
- 7 days after tx for RNA NAAT
- 14 days after treatment for DNA NAAT

Symptomatic - cultures
- 72 hours after treatment

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29
Q

GONORRHOEA

Name 5 complications associated with gonorrhoea

A

PID
Infertility
Conjunctivitis
Disseminated gonococcal infection
Septic arthritis
Endocarditis
Epidiymo-orchitis
Prostatitis

30
Q

GONORRHOEA

What is disseminated gonococcal infection

A

complication of untreated gonococcal infection - bacteria spreads to skin and joints

non-specific skin lesions - dermatitis
Polyarthralgia
Migratory polyarthritis
Tenosynovitis
Systemic symptoms - fever and fatigue

31
Q

SYPHILIS

What is the causative organism

A

Treponema pallidum

32
Q

SYPHILIS

How can syphilis be transmitted

A

Oral / vaginal / anal sex
Vertical transmission
IVDU
Blood transfusions

33
Q

SYPHILIS

Describe the primary stage

A

Painless chancre
Painless lymphadenopathy

34
Q

SYPHILIS

Describe the secondary stage

A

Maculopapular rash - palms and soles of feet

Low grade fever

Lymphadenopathy

Oral lesions

Alopecia

Condylomata lata

35
Q

SYPHILIS

Describe the tertiary stage

A

Gummatous lesions - granulomatous lesions with necrotic centre affecting skin, organs and bones

Aortic aneurysms

Aortic regurgitation

Neurosyphilis

36
Q

SYPHILIS

Describe neurosyphilis

A

Headache

Dementia

Paralysis

Sensory impairment

Tabes dorsalis - demyelination of posterior columns of spinal cord

Argyll Robertson pupil

37
Q

SYPHILIS

Describe the Argyll-Robertson pupil

A

Constricted pupil that accommodates when focussing on a near object but does not react to light

Irregular shape

38
Q

SYPHILIS

What is latent syphilis

A

Occurs after secodnary syphillis - patient is asymptomatic despite still being infected

39
Q

SYPHILIS

What is the difference between early latent and late latent syphilis

A

Early latent - within 2 years of initial infection

Late latent - from 2 years after initial infection

40
Q

SYPHILIS

Describe the testing required for syphilis

A

Syphilis serology

Non-treponemal tests: Not sepcific for syphilis so high rate of FP
Rapid plasma reagin - PRP
VDRL
Assess the quantity of antibodies being produced
Negative following treatment

Treponemal specific tests: Specific for syphilis
TP-IEA
TPHA
Qualitative only

41
Q

SYPHILIS

What are the causes of false positivies in non treponemal tests - cardiolipin

A

Pregnancy
SLE
TB
Malaria
HIV

42
Q

SYPHILIS

What is the management of syphilis

A

Single dose of IM Benpen

43
Q

TRICHOMONAS

What is the causative organism

A

Trichomonas vaginalis

44
Q

TRICHOMONAS

What can trichomonas increase the chances of

A

Contracting HIV - Damaging vaginal mucosa

Bacterial vaginosis

Cervical cancer

PID

45
Q

TRICHOMONAS

How does trichomonas present

A

Vaginal discharge - frothy green
Ithcing
Dysuria
Dysparerunia

46
Q

TRICHOMONAS

What signs are present in a patient with trichomonas

A

strawberry cervix

vaginal pH > 4.5

47
Q

TRICHOMONAS

How is trichomonas diangosed

A

women
- Charcoal swab with microscopy of posterior fornix or self taken vulvovaginal swab

wet mount - mobile trophitizes

men
- 1st catch urine

48
Q

BACTERIAL VAGINOSIS

What is the causative orgaism

A

Gardenella vaginalis

49
Q

BACTERIAL VAGINOSIS

What is BV

A

Overgrowth fo anaerobic bacteria and Loss of lactobacilli
Increase risk of developing an STI

50
Q

BACTERIAL VAGINOSIS

Name 5 risk factors for BV

A

Multiple sexual partners
douching
recent antibiotics
smoking
copper coil

51
Q

BACTERIAL VAGINOSIS

How does bacterial vaginosis present

A

Watery grey discharge - fishy smelling

Asymptomatic

52
Q

BACTERIAL VAGINOSIS

What are not typical features of BV

A

Pain

Itching

Irritation

53
Q

BACTERIAL VAGINOSIS

How doy you diangose BV

A

pH > 4.5

Charcoal swab
- High vaginal or vulvovaginal

Clue cells - microscopy

54
Q

BACTERIAL VAGINOSIS

What are the risks of BV infection in pregnancy

A

Miscarriage
Preterm delivery
PROM
Chorioamnionitis
Low birth weight
Post partum endometritis

55
Q

HERPES

Where does the virus lay dormant in the sensory nerve ganglia

A

HSV1 - Trigeminal nerve ganglion

HSV2 - Sacral nerve ganglia

56
Q

HERPES

How does genital herpes present

A

Painful ulcers
Painful lymphaednopathy
neuropathic pain
dysuria
flu like sx

57
Q

HERPES

How is it diangosed

A

clincal diagnosis

Viral PCR - can e taken

58
Q

PELVIC INFLAMMATORY DISEASE

Name 3 causative rognaisms

A

Chlamydia trichomatis
Neisseria gonorrhoea
Mycoplasma genitalium
Gardenella vaginalis

59
Q

PELVIC INFLAMMATORY DISEASE

Name 4 risk factors for PID

A

Not using barrier contraception
multiple sexual partners
younger age
existing STI
IUD
Previous PID

60
Q

PELVIC INFLAMMATORY DISEASE

Describe the symptoms of PID

A

Lower abdominal pain
abnormal vaginal discharge
dysparerunia
fever
dysuria
IMB / PCB

61
Q

PELVIC INFLAMMATORY DISEASE

Describe the signs of PID

A

Pelvic tenderness
Cervical motion tenderness
Cervicitis
Purulent discharge

62
Q

PELVIC INFLAMMATORY DISEASE

How do you diagnose PID

A

Pregnancy test - exclude ectopic

NAAT - Chlamydia and gonorrhoea
NAAT - Mycoplasma
HIV test
Syphilis test

High vaginal swab

Bloods - CRP

63
Q

PELVIC INFLAMMATORY DISEASE

What is the management of PID

A

IM Ceftriaxone - Gonorrhoea
Doxycycline - Chlamydia
Metronidazole - Gardenella

64
Q

PELVIC INFLAMMATORY DISEASE

What are the complications of PID

A

Sepsis
Abscess
Infertility
Ectopic pregnancy

65
Q

PELVIC INFLAMMATORY DISEASE

What is Fitz-Hugh-Curtis syndrome

A

Inflammation and infection of the liver capsule (Glisson’s capsule), leading to adhesions between the liver and peritoneum.
Bacteria may spread from the pelvis via the peritoneal cavity, lymphatic system or blood.

66
Q

HIV

Name 4 AIDS defining illnesses

A

Kaposi’s sarcoma
Pneumocystitis jirovecii penumonia
CMV infection
Candidiasis - oesphoageal or bronchial
Lymphoma
TB

67
Q

HIV

What is given prophylactically to patients with a low CD4 count

A

Co-trimoxazole - protect against pneumocystosis pneumonia

68
Q

HIV

What shoudl HIV patients avoid

A

live vaccines

69
Q

SEXUAL HEALTH

Describe triple swabs

A

Endocervical NAAT - CT
Endocervical charcoal swab - NG
HVS - CHarcoal for bacterial and fungal infections

70
Q

CANDIDIASIS

Describe the presentation

A

Cottage cheese discharge

Pruritus

Erythema

Swelling

Superficial dysparerunia

71
Q

SEXUAL HEALTH

Which sexual health conditions increase vaginal pH

72
Q

SEXUAL HEALTH

Which sexual health conditions decrease vaginal pH

A

Candidiasis

Finals revision (17 decks)

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