sexual health

Question 1

when is IUD contraindicated

Answer 1

in people with active chlamydia

Question 2

risks with depo

Answer 2

fertility can take 12 months to come back, weight gain, risk of osteoporosis

Question 3

when can you restart COCP after emergency contraception

Answer 3

-take straight away if levonorgesterel
-take after 5 days if on ulipristal acetate (ella one)

Question 4

when is smoking an absolute contraindication to COCP

Answer 4

if >35

Question 5

how long does POP take to become effective

Answer 5

48 hours

Question 6

how long is additional contraception needed after female sterilisation

Answer 6

7 days (but should not engage in sex or physical activity for 1 week)

Question 7

under what age is sex always non consensual

Answer 7

13

Question 8

missed pill rules

Answer 8

first week, emergency contraception for 7 days, second week - covered, third week - skip pill free break

Question 9

what needs to happen after vasectomy

Answer 9

post vasectomy semen analysis at 12 weeks (additional contraception needs to be used up until this point)

Question 10

when is dose of levonorgestrel doubled

Answer 10

when over 70kg

Question 11

reasons to admit someone with PID

Answer 11

systemic illness with N+V, high fever or pregnant

Question 12

what happens in partner notification in someone with PID

Answer 12

treat current partner with 7 days of 100mg doxycycline

Question 13

what’s a double vs triple vaginal swab

Answer 13

double = NAAT (one endocervix and one vulvovaginal) and one charcoal which is ths HVS
triple = one NAAT (endocervic and vulvovaginal), one HSV and one endocervical using charcoal

Question 14

how long does the POP take to work

Answer 14

2 days

Question 15

how long does the implant, IUS, injection, COCP take to work

Answer 15

7 days

Question 16

when switching from POP to COCP what is needed

Answer 16

7 days barrier contraception

Question 17

apart from painful blisters, what other symptoms would someone with HSV present with

Answer 17

-lymphadenopathy
-dysuria
-discharge
-pyrexia

Question 18

MX of HSV

Answer 18

aciclovir 400mg TDS for 5 days (reduce the severity and the duration of the episode but will not sure the patient)

Question 19

what are some conservative Mx options for HSV

Answer 19

saltwater baths, topical petroleum jelly, oral analgesia, topical lidocaine

Question 20

what are the complications of herpes

Answer 20

urinary retention (due to autonomic neuropathy)
proctitis
psychological distress
recurrence
HSV keratitis
herpetic whitlow
disseminated herpes in fiction in the newborn

Question 21

what’s the other name for genital warts

Answer 21

condyloma acuminata

Question 22

2 topical mx options for warts

Answer 22

1) podophyllotoxin (wart icon) –> this is anti mitotic
2) imiquimod (immune modifier)

(smoking increases the chance of recurrence)

Question 23

when can you treat genital warts with topical Tx

Answer 23

when they are non keratinised

Question 24

is the HPV vaccine effective at treating EXISTING warts

Answer 24

no

Question 25

then do you refer someone with warts

Answer 25

if you are unsure on diagnosis, if someone is immunosuppressed or if someone has internal lesions

Question 26

What Tx is appropriate for genital warts in pregnancy

Answer 26

no topical treatments only cryoablation

Question 27

what symptoms do you get with mycoplasma

Answer 27

dysruria, PCB due to cervicitis, lower abdo pain/PID

Question 28

how do you test for mycoplasma

Answer 28

NAAT

Question 29

Mx of mycoplasma

Answer 29

1) doxy BD 7 days 2) moxifloxacin if complicated -test of cure at 5 weeks

Question 30

MX of gonorrhoea

Answer 30

cerftriaxone 1g IM and test of cure at 14 days

Question 31

what antibiotic is used to Tx chlamydia in pregnancy

Answer 31

azithromycin

Question 32

how is LGV (lymphogranuloma venereum) treated

Answer 32

21 days abx

Question 33

what is the incubation period for primary syphilis

Answer 33

21 days

Question 34

what is secondary syphilis

Answer 34

occurs in 25% untreated syphilis. Get widespread non pruritic symmetrical maculopapular rash -RASH -HEPATITS -SPLENOMEGALY -CONDYLOMA LATA

Question 35

what are the tertiary syphilis features

Answer 35

1) cardiovascular - ascending aortic aneurysm or aortic regurg 2) granulomatous inflammatory lesions 3) neurological involvement --> get dementia or tabes dorsal, Argyll-Robertson pupil

Question 36

when should syphilis be tested for

Answer 36

12 weeks from exposure (PCR swab from base of ulcer)

Question 37

how do we test for syphilis

Answer 37

-PCR swab from the base of the ulcer -dark ground microscopy -serology - antitreponemal IgM test for primary (VDRL monitor disease activity)

Question 38

what is tabes dorsalis

Answer 38

degeneration of the dorsal column in syphilis

Question 39

Mx of syphilis

Answer 39

benzathine penicillin I<

Question 40

for 4+ cases of candidiasis a year, what should you do

Answer 40

may need longer term Tx with fluconazole, check CBG

Question 41

what is the amsel criteria for BV

Answer 41

clue cells, discharge, pH >4.5, whiff test (3/4 of these indicates BV)

Question 42

Tx for BV

Answer 42

treat symptomatic people with metronidazole

Question 43

what kind of organism is trichomonas vaginalis

Answer 43

flagellated protozoan

Question 44

symptoms of trichomoniasis

Answer 44

frothy, discharge, strawberry cervix

Question 45

Dx of trichomoniasis

Answer 45

HVS - wet mount,

Question 46

MX of trichomoniasis

Answer 46

remember treat TV in the same way you treat BV -metronidazole 400mg BD for 5-7 days

Question 47

causes for NGU in males

Answer 47

1) Chlamydia trahomatis 2) Mycoplasma genitalium

Question 48

IX for NGU

Answer 48

microscopy of the urethral discharge reveals > 5 polymorphonuclear lymhocytes

Question 49

Tx for NGU

Answer 49

doxy for 7 days

Question 50

what does IgM vs IgG indicate when it comes to hepB infection

Answer 50

IgM = recent in last 6 months IgG = persists for life