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Finals > Sexual health > Flashcards

Sexual health Flashcards

1
Q

What is the pH of the vagina in bacterial vaginosis?

A

> 4.5

Normal is <4.5

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2
Q

Why does BV occur?

A

Loss of lactobacilli (good bacteria) in the vagina which enables other bacteria to proliferate

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3
Q

What are the risk factors for developing BV?

A

Multiple sexual partners, excessive vaginal cleaning, recent antibiotics, smoking, copper coil

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4
Q

What is the classic discharge associated with BV?

A

Fishy smelling watery grey or white vaginal discharge

There should be no itching/irritation or pain

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5
Q

What sign is seen on MC+S on those with BV?

A

Clue cells

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6
Q

What is the treatment for BV?

A

Metronidazole (as it targets anaerobes)

PO or vaginal gel

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7
Q

What is he most common infective cause of thrush?

A

Candida albicans

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8
Q

What are the risk factors for thrush?

A

Increased oestrogen, poorly controlled diabetes, immunosuppression, broad spectrum antibiotics

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9
Q

What is the presentation of thrush?

A

Thick, white discharge that does not typically smell, vulval itching or discomfort

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10
Q

What is the management for thrush?

A

Clotrimazole cream/pessary

Oral fluconazole (contraindicated in pregnancy)

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11
Q

What does the national screening survey for chlamydia aim to do?

A

Screen every sexually active person under 25 annually or when they change partner

Everyone that tests positive should re-test 3 months after treatment

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12
Q

What swabs are taken to test for all STIs?

A

Charcoal swabs (high vaginal) - BV, thrush, gonorrhoea, trichomonas

NAAT (first catch urine or vulvovaginal swab) - DNA or RNA of chlamydia or gonorrhoea

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13
Q

What is the presentation of chlamydia?

A

Abnormal vaginal discharge, pelvic pain, abnormal bleeding, dyspareunia, dysuria, cervical motion tenderness, inflamed cervix

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14
Q

What is the management of chlamydia?

A

1st line = doxycyline 100mg BD for 7 days

Other options = azithromycin, erythromycin, amoxicillin

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15
Q

When is a test of cure recommended for chlamydia?

A

Rectal cases, pregnancy or when symptoms persist

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16
Q

What counselling should be given to someone after a STI diagnosis?

A

Abstain from sex for 7 days
Contact tracing and notification
Provide advice about how to prevent
Consider safeguarding

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17
Q

What are the complications of chlamydia infection?

A

PID, chronic pelvic pain, infertility, ectopic pregnancy, conjunctivitis, lymphogranuloma venereum, reactive arthritis

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18
Q

What type of bacteria is gonorrhoea?

A

Gram negative diplococci

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19
Q

What is the presentation of gonorrhoea?

A

Odourless purulent discharge possible green/yellow, dysuria, pelvic pain

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20
Q

What is the management of gonorrhoea (sensitivities not known and known)?

A

If not know - IM ceftriaxone 1g

If known - oral ciprofloxacin 500mg (single dose)

21
Q

Is a test of cure recommended for gonorrhoea?

A

Yes for everyone - 72 hours after treatment if culture or 7 days for RNA NAAT or 14 days for DNA NAAT

22
Q

What type of infection is trichomonas vaginalis?

A

Protozoa infection

23
Q

What is the typical discharge associated with trichomonas?

A

Frothy yellow/green, may have fishy smell

24
Q

What is seen on speculum examination in women with trichomonas?

A

Strawberry cervix
Inflammation of the cervix

25
Q

What is the vaginal pH in someone with trichomonas?

A

> 4.5

26
Q

What is the 1st line investigation for trichomonas?

A

Charcoal swab from posterior fornix of vagina

27
Q

How is trichomonas managed?

A

Referral to GUM clinic
Metronidazole PO for 5-7 days

28
Q

Which strain of HSV commonly causes genital herpes?

A

HSV-2

29
Q

What is the presentation of genital herpes?

A

Painful blisters/ulcers affecting genital area, neuropathic pain, dysuria, inguinal lymphadenopathy

Initial episode is often most severe and can last 3 weeks, recurrent episodes can occur whenever

30
Q

Can you get genital herpes from someone with a cold sore?

A

Yes - via oral sex

Cold sores are usually caused by HSV-1 so will get that strain

31
Q

What is the management of genital herpes?

A

Aciclovir

Paracetamol, topical lidocaine, loose clothing, avoid intercourse when symptoms are present

32
Q

What are the complications associated with herpes infection during pregnancy?

A

Neonatal infection has high morbidity and mortality

Primary genital herpes before 28 weeks - aciclovir during initial infection + from 36 weeks onwards, c-section

Primary genital herpes >28 weeks - aciclovir followed by prophylactic aciclovir, C-section recommended

Recurrent - regular prophylactic aciclovir considered from 36 weeks

33
Q

What bacteria causes syphillis?

A

Treponema pallidum

34
Q

How can syphilis be contracted?

A

Sexual contact, vertical transmission, IVDU, blood products

35
Q

How does primary syphilis present?

A

PAINLESS solitary ulcer on penis/vulva (21 days after contracting)

36
Q

What are the symptoms of secondary syphilis?

A

Systemic symptoms particularly of skin and mucous membranes e.g. maculopapular rash, lymphadneopathy , oral lesions

37
Q

What are the features of tertiary syphilis?

A

Involvement of different organs e.g. neurological symptoms such as dementia, altered behaviour

38
Q

What investigations are done to diagnose syphilis?

A

Antibody testing and enzyme immunoassay

39
Q

What is the treatment for syphilis?

A

IM benzathine benzylpenicillin

40
Q

What is the infective cause of genital warts?

A

HPV

41
Q

How are genital warts spread?

A

Via skin to skin contact in intimate areas

42
Q

What is the treatment for genital warts?

A

Self-limiting
Topical wart treatment can be sued or cryotherapy, excision, laser etc.

43
Q

What is the presentation of PID?

A

Pelvic or lower abdominal pain, abnormal discharge, pain during sex, fever, dysuria, cervical motion tenderness, inflamed cervix

44
Q

What is seen in microscopy in PID which can help aid diagnosis?

A

Pus cells - absence of pus cells can exclude PID

45
Q

What is Fitz-Hugh-Curtis syndrome?

A

Inflammation and infection of the liver capsule leading to adhesions between liver and peritoneum

Bacteria may spread from pelvis via peritoneal cavity

46
Q

What is lymphogranuloma venereum?

A

Caused by chlamydia trachomatis

Stage 1:Leads to small painless pustule –> ulcer

Stage 2: painful inguinal lymphadenopathy

Stage 3: proctocolitis

47
Q

What are the risk factors for lymphogranuloma venereum?

A

MSM, HIV, used to be seen more in the tropics

48
Q

What is the treatment for lymphogranuloma venereum?

A

Doxycycline

49
Q

How does chancroid present?

A

Multiple painful ulcer on genitals that start off as papules and spread

Finals (21 decks)

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