Sexual health Flashcards

1
Q

When may confidentiality between a Dr and a young person be breached?

A

Child abuse

Serious crime

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2
Q

Factors which affect young people’s perception of a confidential service?

A

Severity of the condition
Proximity of the service provider to a young person’s familiar environment e.g. neighbour
Previous experience
Attendance with a parent
Relationship between service provider and other people known to the patient e.g friends/parents

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3
Q

Risks to babies born to teenage mothers

A

More likely to have:
Low birth weight
Be born prematurely
Have a higher risk of dying during infancy

as they grow up they are at a greater risk of educational failure, juvenile crime and becoming a teenage parent

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4
Q

Factors associated with increased risk of teen pregnancy

A

Low socio-economic group
Lack of expectation of being in education at 20
Expectation of being a parent at 20
Belief that over 50% of peers are sexually active
Intention to skip school
Being drunk more than once a month at 13

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5
Q

Types of post-coital contraception

A

Emergency hormonal contraception within 3-5 days

Emergency insertion of IUCD if intercourse happened more than 5 days before consultation

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6
Q

Types of pregnancy termination

A

Early medical terminations (drugs induce uterine contractions which expel contents - up to 9 weeks)

Suction termination 6-13 weeks

Dilation and evacuation 13-20 weeks

Late medical terminal 13-23

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7
Q

Medical criteria for an abortion

A

Continuing the pregnancy risks the life of the pregnant woman

Termination would prevent permanent injury to the physical or mental health of the pregnant woman

Substantial risk that if the child were born it would suffer from a physical or mental abnormality that would make it seriously handicapped.

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8
Q

Social criteria for termination

A

Pregnancy has not exceeded 24 weeks and continuing the pregnancy would involve increased risk of injury to the physical or mental health of the pregnant woman

Pregnancy has not exceeded 24 weeks and continuing pregnancy would involve increased risk of injury to the health of any existing children.

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9
Q

Name 5 asymptomatic STIs

A
Chlamydia
Genial warts
Genital herpes
Hepatitis
HIV
Syphilis
Trichomonas
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10
Q

Major differences between healthcare in a GUM clinic vs. primary care

A

GUM attenders perceive themselves at risk
GUM attenders expect questions about sex
Primary care attenders do not expect questions about sex
Testing in GUM is anonymous, in a GP it will be in the patient’s notes
Treatment in a GUM clinic is free

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11
Q

Advantages of providing sexual healthcare service in GP practice

A

People who are asymptomatic are unlikely to present at a GUM clinic (do not know they have STI)

The GP practice may be closer to where the patient lives and may be more accessible

The patient may prefer to talk about her/his sexual health with someone he/she knows rather than attending a GUM clinic

Patients may feel that they would be better supported in GP practice

It is possible to test for STIs at the same time as providing other care e.g. cervical smears

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12
Q

Factors affecting access to healthcare in young people

A

Knowledge of services

Confidentiality

Being able to overcome barrier to healthcare
Skills to become an active participant in healthcare rather than passive

Issues of consent

Independence from parents

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13
Q

Reasons why STI diagnosis may by increasing

A
Social reasons: increased sexual activity
People are more aware of STIs
Easier to access services
Better diagnostic tests
Artefact
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14
Q

Approach to GUM clinic consultation

A
Provide reassurance
Establish rapport
Take a sexual history
Identify if the person is at risk
Explain tests for STIs and offer tests
Offer a separate test for HIV
Offer counselling
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15
Q

4 approaches to introducing sexual history into a consultation

A

Introduce sex with a statement, then ask question.

Ask the patient what he/she thinks about risk of STI based on symptoms

Normalise “we ask all young people questions about their sexual health”

Offer resources e.g. condoms then ask about sexual health

Share knowledge of incidence and prevalence. “A lot of people your age have STis, could I ask you a few questions?”

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16
Q

Why is partner notification required for some STIs?

A

Protect patient from re-infection
Offer sexual partners tests for STIs
Offer sexual partners treatment
Inhibit further spread to the community

17
Q

Name 4 STIs where use of a condom gives protection

A
HIV
Chlamydia
Gonorrhoea
Syphillis
Hepatitis B
18
Q

Name 2 STIs where use of a condom does not prevent transmission

A

Hepatitis A

Pubic lice

19
Q

What influences sexuality

A

Sexuality - who one has sex whith, what way, why, under what circumstances and with what outcomes. Influenced by:

Rules imposed by society
Gender
Age
Economic status
Ethnicity
20
Q

Components of sexuality

A

Practices
Partners
Pleasure/pressure/pain
Procreation

Balance of power in a sexual interaction determined outcome

21
Q

Factors which affect Women’s vulnerability re: sex

A

Culture of silence around sex

Dictates good women are expected to be ignorant about sex and passive in sexual interactions

Makes it difficult for women to be informed about risk reduction

Makes it difficult for them to be proactive in negotiating safer sex

Women’s economic dependency means they could accept risky sex for money

Women tend to discuss testing with their partners before accessing sexual health service, creates a barrier to access

22
Q

Factors which affect Men’s vulnerability re: sex

A

Men are expected to be more knowledgeable and experienced about sex

Do not seek information or admit lack of knowledge about sex or protection

Experiment with sex in unsafe ways and at a young age to improve their manhood

Believe it is essential to men’s nature to seek multiple partners for sexual release

23
Q

Questions to ask in a sexual history

A
Sexual experiences (what, who, how)
Partner's sexual history
Assessment of condom use
Past STIs
Symptoms
24
Q

Give 4 examples which indicate a patient may have no apparent risk of an STI

A

Never had sexual intercourse
First sexual relationship for both him and his partner
Always used condoms perfectly
No risks since last test for an STI

25
Q

Risk factors for contracting an STI

A

Unprotected sex
Multiple sexual partners
Early onset sexual activity
Drug/alcohol abuse