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Phase 3a conditions list flashcards > Sexual health > Flashcards

Sexual health Flashcards

1
Q

What are some risk factors for STIs (8)?

A
  • < 25 years
  • UPSI
  • IVDU
  • Immunosuppression
  • Men who have sex with men (MSM)
  • Lower socioeconomic status
  • Multiple partners
  • Sexually active
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2
Q

What are the important STIs to how about (9)?

A
  • Chlamydia
  • Gonorrhoea
  • Trichomonas vaginalis
  • HSV
  • HPV
  • Syphilis
  • Mycoplasma genitalium
  • HIV
  • Chancroid
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3
Q

What investigations are typically done to investigate for STIs in men (3)?

A
  • Men = first catch urine + MC&S = usually first line
  • Urethral swab
  • Bloods
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4
Q

What investigations are typically done to investigate for STIs in women (4)?

A
  • Vulvovaginal swab (done by themselves) = usually first line
  • Endocervical or high vaginal swabs
  • First catch urine
  • Bloods
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5
Q

What are the different types of swab that can be used to investigate STIs and what are they for (2)?

A
  • Charcoal swab = MC&S
  • Nucleic acid and amplification test (NAAT) swab = identification of DNA/ RNA
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6
Q

Who is eligible for the sexual health screening programme?

A

Sexually active 16-24 year olds

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7
Q

How frequently should 16-24 year olds be screened for STIs?

A

Annually or when they change partner

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8
Q

What is typically tested for if someone attends a GUM clinic for an STI screen (4)?

A
  • Chlamydia
  • Gonorrhoea
  • Syphilis (blood)
  • HIV (blood)
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9
Q

How far back should the contacts of those with chlamydia and gonorrhoea be traced and what should they be offered?

A
  • Chlamydia = 6 months
  • Gonorrhoea = 2 months
    offer them tests
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10
Q

What is the most common STI in the UK?

A

Chlamydia

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11
Q

What is the full name for chlamydia?

A

Chlamydia trachomatis

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12
Q

What type of bacteria is chlamydia trachomatis?

A

Gram negative cocci

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13
Q

What are the signs/ symptoms of chlamydia (4)?

A
  • Dysuria
  • Purulent (pus) discharge
  • Abnormal vaginal bleeding
  • Proctitis - discomfort, discharge, bleeding (inflam in rectum)
    often asymptomatic in women
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14
Q

How is chlamydia diagnosed?

A

NAAT
first catch urine or vulvovaginal swab

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15
Q

What are some examination finding of those with chlamydia (3)?

A
  • Pelvic/ abdo pain
  • Cervical motion tenderness
  • Purulent discharge
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16
Q

What additional swabs should be taken considered for chlamydia in certain patient groups (2)?

A
  • Rectal
  • Pharyngeal
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17
Q

How should chlamydia be treated?

A

100mg doxycycline BD for 7 days

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18
Q

What are some contraindications to doxycycline (2)?

A
  • Pregnant
  • Breastfeeding
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19
Q

What does doxycycline do if a pregnant woman takes it?

A

Can cause foetal teeth discolouration

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20
Q

How should chlamydia be treated in pregnancy/ breastfeeding?

A

Azithromycin 1g stat, then 500mg OD for 2 days

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21
Q

What are some complications of chlamydia (7)?

A
  • PID
  • Lymphogranuloma venereum
  • Infertility
  • Reactive arthritis
  • Neonatal infection (conjunctivitis/ pneumonia)
  • Pregnancy comp (low birth weight, pre-term, ectopic, PROM)
  • Fitz Hugh cutis
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22
Q

What is lymphogranuloma venereum?

A

Ulceration of genital area due to chlamydia infection

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23
Q

What are the signs/ symptoms of lymphogranuloma venereum (3)?

A
  • Ulceration of genital area
  • Proctitis (inflame of rectum)
  • Inguinal lymphadenopathy
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24
Q

Where else in the body does chlamydia commonly infect?

A

The eye causing conjunctivitis

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25
Q

What is the full name for gonorrhoea?

A

Neiserria gonorrhoea

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26
Q

What type of bacteria is neiserria gonorrhoea?

A

Gram -ve diplococci

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27
Q

What are the signs/ symptoms of gonorrhoea (3)?

A
  • Dysuria
  • Odourless green discharge
  • Pelvic pain
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28
Q

How is gonorrhoea diagnosed?

A

First catch urine or vulvovaginal NAAT

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29
Q

What is important to do before commencing antibiotics for gonorrhoea?

A

Charcoal swab (urethral or endocervical) for MC&S
to determine Abx resistance

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30
Q

How is gonorrhoea typically managed if the sensitivities are not known?

A

IM ceftriaxone 1g stat

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31
Q

What are some complications of gonorrhoea (5)?

A
  • Septic arthritis
  • Disseminated gonococcal infection
  • Conjunctivitis
  • Neonatal infections (ophthalmia neonatorum)
  • Infection of nearby organs (proctitis, prostatitis, epididymo-orchitis)
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32
Q

Does chlamydia or gonorrhoea more commonly cause reactive and septic arthritis?

A
  • Chlamydia = reactive
  • Gonorrhoea = septic
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33
Q

What is ophthalmia neonatorum and how is it managed?

A

Neonatal conjunctivitis
it is a medical emergency when caused by gonorrhoea and can lead to blindness

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34
Q

What are the signs/ symptoms of disseminated gonococcal infection (3)?

A
  • Polyarthralgia (migratory)
  • Systemic Sx e.g. fever, fatigue
  • Various non-specific skin lesions
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35
Q

What is the most common STI worldwide?

A

Trichomonas vaginalis

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36
Q

What sort of organism is trichomonas vaginalis?

A

Flagellated protazoa

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37
Q

What are the signs/ symptoms of trichomonas vaginalis (5)?

A
  • Dysuria
  • Yellow frothy offensive discharge
  • Itching
  • Strawberry cervix
  • Balantitis (inflammation of penis glans)
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38
Q

How is trichomonas vaginalis diagnosed (2)?

A
  • Charcoal high vagina swab + microscopy
  • Men = first catch urine + microscopy
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39
Q

What is an additional finding in women with trichomonas vaginalis?

A

High vaginal pH
like in BV

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40
Q

How is trichomonas vaginalis managed?

A

Metronidazole

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41
Q

What else is important to do/ tell in those diagnosed with trichomonas vaginalis (2)?

A
  • Do not drink alcohol - reacts with metronidazole and can induce hypotension
  • Contact trace
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42
Q

What can cause ulcers in the genital region?

A

HSV 2

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43
Q

How is HSV 2 diagnosed?

A

PCR (swab)

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44
Q

How is HSV 2 treated?

A

Aciclovir

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45
Q

What causes genital warts?

A

HPV 6 and 11

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46
Q

What is the presentation of genital warts?

A

Painless warts on genitals

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47
Q

How can genital warts be prevented?

A

HPV vaccines

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48
Q

How are genital warts treated?

A

Podophyllotoxin cream/ imiquimod cream

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49
Q

What bacteria causes syphilis?

A

Treponema pallidum

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50
Q

What type of bacteria is treponema pallidum?

A

-ve spirochete

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51
Q

What are the stages of syphilis (4)?

A
  • Primary syphilis
  • Secondary syphilis
  • Latent syphilis
  • Tertiary syphilis
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52
Q

How long is syphilis incubation period?

A

21 days

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53
Q

What is the presentation of primary syphilis?

A

Painless ulcer at infection site (chancre)

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54
Q

What are the signs/ symptoms of secondary syphilis (5)?

A
  • Maculopapular rash
  • ‘Snail track’ ulcers
  • Alopecia
  • Low grade fever
  • Lymphadenopathy
    typically last 3-12 weeks
55
Q

What is the presentation of tertiary syphilis?

A

Gummatous lesions - granulomas that can develop in multiple organs throughout the body

56
Q

What is a complication of tertiary syphilis (3)?

A
  • Neurosyphilis
  • A^3 (abdominal aortic aneurysm)
  • Higher risk of HIV transmission
57
Q

What are the symptoms of neurosyphilis (4)?

A
  • Headache
  • Altered behaviour
  • Sensory impairment
  • Argyll-robertson pupil (accommodates but no light reflex)
58
Q

How is syphilis diagnosed (2)?

A
  • Serology testing
  • Infection site swabs + NAAT
59
Q

What serology tests are done for syphilis (2)?

A
  • Rapid plasma reagin (RPR)
  • Venereal disease research laboratory (VDRL)
60
Q

How is syphilis managed?

A

IM Benzathine benzylpenicillin (benzathine pen g)

61
Q

What is a complication of treatment for syphilis?

A

Jarisch-herxheimer reaction
contents of bacteria spilling in blood - a bit like tumour lysis syndrome

62
Q

What STI is known for resistance to an increasing number of antibiotics?

A

Mycoplasma genitalium

63
Q

What is the typical presentation of MG?

A

Urethritis

64
Q

What are the signs/ symptoms of urethritis (2)?

A
  • Dysuria
  • Discharge
65
Q

How is MG investigated?

A
  • First catch/ vaginal swab NAAT
  • Charcoal swab + MC&S (for macrolide resistance)
66
Q

How is MG treated (2)?

A
  1. Doxycycline + azithromycin
  2. Moxifloxacin
67
Q

What causes chancroid?

A

Bacteria (haemophilus ducreyi)

68
Q

What are the signs/ symptoms of chancroid (3)?

A
  • Painful genital ulceration
  • Discharge
  • Lymphadenopathy
69
Q

How is chancroid treated?

A

Azithromycin
chancroid = azythromycin

70
Q

What are two STI-like conditions that are not sexually transmissible?

A
  • Bacterial vaginosis
  • Thrush
71
Q

What is bacterial vaginosis?

A

Overgrowth of bacteria, especially anaerobes, in the vagina

72
Q

What is usually the cause of BV?

A

Loss of lactobacilli ‘the friendly bacteria’

73
Q

What is the most common anaerobe causing BV?

A

Gardnerella vaginalis
overgrown garden??

74
Q

What are some risk factors for BV (4)?

A
  • Multiple partners
  • Excessive PV cleaning
  • Recent Abx
  • Smoking
75
Q

What reduces the risk of getting BV (2)?

A
  • COCP
  • Condom use
76
Q

What is the typical presentation of BV?

A

Fishing smell watery grey discharge

77
Q

What criteria can be used to diagnose BV?

A

Amstel criteria
amsterdam because they have lots of sexual partners there

78
Q

What are the Amstel criteria for diagnosis of BV (4)?

A
  • pH > 4.5
  • White/ grey discharge
  • Clue cells on microscopy
  • +ve whiff test
    3/4 for diagnosis
79
Q

What are clue cells?

A

Epithelial cells of vagina with Gardnerella vaginalis stuck in them

80
Q

How is BV managed (2)?

A
  • Conservative advice (e.g. stop smoking, stop douching/ cleaning)
  • Metronidazole
81
Q

What are some complications of BV (4)?

A
  • Increased risk of STIs
  • Miscarriage/ preterm
  • PROM
  • Postpartum endometritis
82
Q

What causes thrush?

A

Candida infection

83
Q

What are some risk factors for thrush (4)?

A
  • Increased oestrogen (pregnancy, fertile, COCP)
  • Poorly controlled diabetes
  • Immunosuppression
  • Recent Abx
84
Q

What are the signs/ symptoms of thrush (2)?

A
  • Thick white ‘cottage cheese’ discharge that does not smell
  • Itchy
85
Q

How is thrush investigated (3)?

A
  • Clinical diagnosis
  • pH < 4.5
  • Charcoal swab + microscopy (if in doubt)
86
Q

How is thrush managed (2)?

A
  • Oral fluconazole stat
    or
  • Clotrimazole cream
87
Q

What is important to inform women treated for thrush about?

A

Antifungal creams can damage condoms/ prevent spermicides working so alternative contraception needed for 5 days

88
Q

What is pelvic inflammatory disease?

A

Infection and inflammation of the organs of the pelvis caused by infection ascending through the cervix

89
Q

Which structures can become inflamed in PID (3)?

A
  • Endometritis
  • Salpingitis (Fallopian tubes)
  • Oophoritis (ovaries)
    peritonitis can occur
90
Q

What causes PID most commonly (3)?

A
  • Chlamydia = MC
  • Neiserria gonorrhoea
  • MG
    can be caused by others such as H. influenzae, E. coli
91
Q

What are the signs/ symptoms of PID (6)?

A
  • Pelvic/ lower abdo pain
  • Deep dyspareunia
  • Abnormal vaginal bleeding
  • Discharge
  • Fever
  • Dysuria
92
Q

What are some risk factors for PID (5)?

A
  • Coil
  • No barrier contraception
  • Multiple partners
  • Younger age
  • Previous PID
93
Q

What are some examination finding of PID (4)?

A
  • Abdo/ pelvic tenderness
  • Cervical motion tenderness
  • Discharge
  • Fever
94
Q

How is PID investigated (4)?

A
  • High vaginal swabs + MC&S (often negative)
  • Pregnancy test (ectopic)
  • Bloods (HIV, syphilis)
  • TVUSS
95
Q

How is PID treated with antibiotics?

A
  • Ceftriaxone
  • Doxycycline
  • Metronidazole
96
Q

When should PID be referred to hospital (2)?

A
  • Pregnant woman
  • Signs of sepsis
97
Q

What are some complications of PID (5)?

A
  • Infertility
  • High risk for ectopic pregnancy
  • Chronic pelvic pain
  • Sepsis
  • Fitz-hugh-curtis syndrome
98
Q

What is Fitz-hugh-curtis syndrome?

A

Inflammation and infection of the liver capsule

99
Q

What are some causes of balanitis (3)?

A
  • Candidia = mc
  • Trichomonas vaginalis
  • Lichen sclerosis
100
Q

How does balanitis typically present?

A

White itchy lesions with thick discharge

101
Q

What is a complication of balanitis?

A

Balanitis xerotica obliterans
long term inflammation leading to damage

102
Q

What parasite can infect the pubic area?

A

Public lice

103
Q

What is the typical presentation of pubic lice?

A

Severely itchy pubic area with visible movement

104
Q

How are pubic lice treated?

A

Permethrin

105
Q

What is it known as when you are not interested in sex but you want to be?

A

Hypoactive sexual desire disorder (HSDD)

106
Q

What are 3 ways HSDD will present itself?

A
  • Decreased sex desire
  • Decreased response to partners sexual cues
  • Don’t initiate sex
107
Q

What are some risk factors/ causes for HSDD (3)?

A
  • Depression/ anxiety
  • DM, hypothyroid
  • Meds (e.g. opioids, SSRIs)
108
Q

How can HSDD be managed (4)?

A
  • Reduce stress
  • Couples therapy
  • Exercise
  • Flibanserin
109
Q

What is failure to orgasm despite stimulation known as?

A

Anorgasmia

110
Q

What are some risk factors/ causes of anorgasmia (6)?

A
  • Depression/ anxiety
  • Performance anxiety
  • DM/ hypothyroid
  • Postmenopausal
  • Post hysterectomy
  • Dyspareunia
111
Q

How is anorgasmia managed (3)?

A
  • Sexual education
  • Clitoral vacuum (increases blood flow)
  • COCP
112
Q

What is involuntary contraction of the vaginal wall known as?

A

Vaginismus

113
Q

What are some consequences of vaginismus (2)?

A
  • No sexual penetration
  • Speculum + smear impossible/ difficult
114
Q

What are some risk factors/ causes of vaginismus (4)?

A
  • Trauma
  • Anxiety/ stress
  • Childbirth
  • FGM
115
Q

How is vaginismus treated (3)?

A
  • Sex education/ psychology
  • Keigel exercises
  • Vaginal dilation therapy
116
Q

What is pain in vulva without an identifiable cause known as?

A

Vulvodynia

117
Q

How is vulvodynia managed (4)?

A
  • Reduce friction during sex (lubricants)
  • Keigel
  • Analgesia
  • TCAs
118
Q

What can be done in sex education/ psychology to improve sex (3)?

A
  • Couples therapy
  • CBT
  • Different techniques e.g. clitoral stimulation/ sex toys
119
Q

What is erectile dysfunction known as?

120
Q

What are some causes of impotence (7)?

A
  • Peripheral vascular disease/ atherosclerosis
  • DM
  • Spinal cord damage
  • High prolactin
  • Stress/ performance anxiety
  • MS
  • Meds e.g. SSRIs
121
Q

How is erectile dysfunction managed (2)?

A
  • Keigel exercises
  • Sildenafil
122
Q

What is important to assess in men with erectile dysfunction?

A

QRISK score + do bloods
at risk of PVD + CHD

123
Q

What is premature ejaculation?

A

Ejaculation within 1 minute of sex

124
Q

What are some causes of premature ejaculation (4)?

A
  • Performance anxiety
  • Watching pornography
  • Hyperthyroid
  • Sex abuse
125
Q

How is premature ejaculation managed (5)?

A
  • Sex therapy
  • Stop, start, squeeze
  • Lidocaine cream
  • Keigel exercises
  • Dapoxetine
126
Q

What is retrograde ejaculation?

A

When the sperm is ejaculated into the bladder due to the urethral sphincter not contracting

127
Q

What are some causes of retrograde ejaculation (2)?

A
  • Transurethral resection of the prostate (TURP)
  • ACE-i
128
Q

How is retrograde ejaculation diagnosed?

A

Post ejaculatory void = lots of sperm

129
Q

How is retrograde ejaculation treated (2)?

A
  • Medications (tighten neck of bladder) e.g. TCAs
  • Surgery
130
Q

What can cause a wonky erection?

A

T3 collagen deposits in tunica albuginae

131
Q

What is it known as when you have a wonky erection due to collagen deposits?

132
Q

What condition is peyronie associated with?

A

Dupuytrens contractures

133
Q

How is peyronie diagnosed?

A

Penile USS

134
Q

How is peyronies managed (2)?

A
  • Surgical straitening
  • Injection of collagenase

Phase 3a conditions list flashcards (31 decks)

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