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Phase 3a - Obs & Gynae > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

Sx of chlamydia in women?

A

Abnormal vaginal discharge
Pelvic pain
Abnormal vaginal bleeding (intermenstrual or postcoital)
Painful sex (dyspareunia)
Painful urination (dysuria)

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2
Q

Examination findings of chlamydia in females?

A

Pelvic or abdominal tenderness
Cervical motion tenderness (cervical excitation)
Inflamed cervix (cervicitis)
Purulent discharge

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3
Q

Complications of chlamydia in pregnancy?

A

Preterm delivery
Premature rupture of membranes
Low birth weight
Postpartum endometritis
Neonatal infection (conjunctivitis and pneumonia)

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4
Q

What is trichomoniasis infection caused by?

A

Flagellated protozoan parasite

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5
Q

Sx of trichomoniasis infection?

Both females and males.

What colour is the discharge?

A

Females:
* Profuse, frothy, yellow discharge
* Vulval irritation
* Dyspareunia
* Strawberry cervix

Males:
* Non-gonococcal urethritis

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6
Q

Tx of trichomoniasis infx?

A
  • Oral metronidazole
  • Abstain from sexual activity 1 wk
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7
Q

What’s balanitis?

A

When head of penis (glans) becomes inflamed

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8
Q

What is chancroid typically caused by?

A

STI of genital skin caused by gram-negative bacillus Haemophilus ducreyi (H. ducreyi)

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9
Q

Sx of chancroid

A
  • Painful genital lesion - may bleed on contact
  • Painful lymphadenopathy a.k.a bubo - may rupture + discharge pus
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10
Q

Tx of chancroid

A

Abx:
Ceftriaxone
Azithromycin

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11
Q

What is Lymphogranuloma Venereum and what is it caused by?

A

LGV is a STI caused by L1, L2 or L3 serovars of chlamydia trachomatis.

MC - MSM

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12
Q

Sx of Lymphogranuloma Venereum?

A
  • Painless genital ulcer
  • Inguinal lymphadenopathy
  • Proctitis - rectal pain + discharge
  • Systemic sx - fever
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13
Q

Tx of Lymphogranuloma Venereum?

A

Abx:
Oral doxycycline
Oral erythromycin
Oral tetracycline

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14
Q

What are genital herpes caused by?

A

Caused by infx w/ HSV-1 or HSV-2

HSV-1 : Associated w/ oral herpes + MC cause of genital herpes
HSV-2 : Previously MC

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15
Q

Genital herpes sx

A
  • Multiple painful genital ulcers
  • Dysuria
  • Vaginal/urethral discharge
  • Crusting + healing of lesions
  • Systemic sx - fever
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16
Q

Tx of genital herpes

A

Antivirals:
Aciclovir
Valaciclovir

17
Q

What is syphilis and which bacteria causes it? How is it transmitted?

A

A STI caused by spirochete bacterium Treponema pallidum.

Transmission:
* Primarily transmitted through direct contact with syphilis sores or rash during vaginal, anal, or oral sex.
* Can also be transmitted from an infected mother to her unborn child, resulting in congenital syphilis.

18
Q

Difference between primary, secondary and tertiary syphilis?

A

Primary = Occurs 3 wks post exposure. Highly contagious during this stage.

Secondary = Develops wks to mths and still highly contagious through skin membrane contact.

Tertiary = Occurs years to decades after initial infx if untreated. Less contagious but can cause severe health problems.

19
Q

Sx present in the following:
1. Primary syphilis
2. Secondary syphilis (manifests 4-10 weeks post-primary infection)
3. Tertiary syphilis (may occur 20-40 years after primary infx in untreated patients)
4. Congenital syphilis

A
  1. Single painless lesion (chancre) - round and heals spontaneously within 3-8 wks + painless regional lymphadenopathy.
  2. Symmetrical maculopapular rash involving palms, soles and face + mucosal ulcers and lymphadenopathy + malaise, fever, hep and glomerulonephritis.
  3. Gummatous, CVD complications, neuro complications (i.e. dementia, paresis)
  4. Infant presents with rash on palms/feet soles, mucous patches/lesions in mouth/nose/genitals, fever, hepatosplenomegaly, anaemia, bone developmental abnormalities

Gummatous = a tusmor of gummy or rubbery consistency that is characteristic of the tertiary stage of syphilis

20
Q

Ix for syphilis?

A

Dark field microscopy - samples from primary lesions or secondary rash but not oral lesions (false +ve)

PCR testing - oral lesions

Serological tests - treponemal tests (most sensitive for 2 or latent stages)

21
Q

Tx of syphilis in:
1. Primary, secondary and early latent syphilis
2. Tertiary and late latent syphilis
3. Neurosyphilis

A
  1. Single dose IM penicillin G (benzathine benzylpenicillin)
  2. Longer course IM penicillin G for 2-3 weeks
  3. IV penicillin G for 10-14 days
22
Q

What is a Jarisch-Herxheimer reaction?

A

On initial tx of syphilis this reaction may occur. This is an acute febrile illness which is self-resolving within 24 hours. Generally, patients can be reassured and given antipyretics for the fever.

23
Q

What is trichomonas vaginalis?

A

Trichomoniasis is a sexually transmitted infection (STI) caused by the flagellated protozoan parasite, Trichomonas vaginalis.

24
Q

Sx of trichomonas vaginalis

A

In women:
Profuse, frothy, yellow vaginal discharge
Vulval irritation
Dyspareunia
Rare ‘strawberry cervix’ sign may be observed in some cases

In men:
Non-gonococcal urethritis

25
Q

Ix for trichomonas vaginalis?

A

Direct microscopy and culture of the causative organism, Trichomonas vaginalis.

Other:
pH testing of vaginal discharge: a pH of >4.5 suggests trichomonasis

26
Q

Tx of trichomonas vaginalis?

A

Oral metronidazole
Abstain from sexual activity for at least one week

27
Q

What are genital warts caused by?

A

HPV (human papillomavirus) especially 6 and 11.

28
Q

How do genital warts look like?

A

Small (2 - 5 mm) fleshy protuberances which are slightly pigmented
May bleed or itch

29
Q

Mx of genital warts?

A

1st line: Topical podophyllum (if multiple non-keratinised wart) or cryotherapy (if solitary keratinised wart)

2nd line: imiquimod (topical cream)

30
Q

How is HIV transmitted?

A
  • Predominantly - sexual contact
  • Parenteral exposure (e.g., injection drug use, needlestick injury)
  • From mother to child during childbirth or breastfeeding
31
Q

Mx of HIV in pregnancy?

A

Start mother on combination antiretroviral therapy (cART) as soon as a diagnosis is confirmed.

If mother’s viral load <50 = vaginal delivery recommended
If viral load >50 = elective c-section recommended

Baby recommended infant post exposure prophylaxis (PEP) with either zidovudine monotherapy or cART.

Safest way to feed infants born to women with HIV = formula milk (but if women has low viral load on cART can choose to breastfeed as they are aware if risk)

Phase 3a - Obs & Gynae (7 decks)

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