Sexual Health Flashcards
what is the treatment for chlamydia?
Doxycycline BD 100mg for & days (not safe in pregnancy)
or
Azithromycin 1g STAT dose
(safe in pregnancy)
what proportion of patients are asymptomatic for chalmydia?
Women = 75% Men = 50%
in Bacterial vaginosis what will the pH of the vaginal discharge be?
pH>4.5
what proportion of men are asymptomatic for gonorrhoeaa?
5-10%
what does gonorrhoea look like under a microscope?
Gram negative diplococci
what is the treatment of gonorrhoea?
STAT: Ceftriaxone 500mg IM single dose + Azithromycin 1g PO
when is the highest risk for HIV transmission in pregnancy?
At delivery
*unless mother seroconverts during pregnancy
Seroconversion: where you become HIV +ve and develop antibodies.
what is reiter’s syndrome/reactive arthritis?
Can occur in <1% of chlamydia cases - sterile inflammation of synovial membranes, tendons, fascia triggered at a distant site
Triad of redness, joint swelling and pain
what are the pregnancy/neonatal complications of chlamydia?
IUGR
PROM
Pre-term delivery
Low birth weight
what are the pregnancy/neonatal complications of gonorrhoea?
Low birth weight
Pre-term delivery
what is a LARC?
long acting reversible contraception
what criteria are used to determine suitability of contraception?
UK MEC (medical eligibility criteria)
1: No restriction
2: Advantages outweigh risks
3: Risks outweigh advantages
4: Unacceptable health risk
what oestrogen is used in Combined oral contraceptive pill?
ethinyl oestradiol
what are the absolute contra-indications to Combined oral contraceptive pill?
Breastfeeding <6wks Postpartum (severe) Smoking >15cigs/d & >35y Multiple risk factors for Arterial CVD BP >160/100 Current or past VTE Major Surgery with Immobilisation IHD CVA Valvular Heart Disease Focal Migraine Breast Ca Complicated DM Severe liver cirrhosis Liver tumours
what is the time window for taking the progesterone only pill?
12 hours (older generation = 3 hours)
which classes of drugs interact with the COC?
Antibiotics - rifampicin, rifabutin Antidepressants - St Johns Wort Antiepileptics - carbamazepine, phenytoin etc Antifungals - Griseofluvin, imidazoles Anti-retrovirals
when starting the COC within how many days of your period must you start it to be protected immeadiately?
Days 1-5 - do not have to use condom
*if started after this use condom for 7 days
when starting the progesterone only pill, if not started on days 1-5 of the cycle, for how many days should you use condoms?
For 2 days
7 days with COC
what are the common oestrogenic side effects?
Breast enlargement Bloating Nausea Non-infective vaginal discharge Headaches Cholasma Photosensitivity
what are the common progestogenic side effects?
Acne Greasy hair Hirsuitism Depression loss of libido Vaginal dryness
In what situations should the POP be considered over the COC?
Risk of VTE
Smokers
Migraine with aura
High BP
For how long is a nuva ring left in?
21 days
What hormone/s does a nuva ring contain?
Oestrogen + progestogen
what is the mode of action of progesterone only contraceptives? (including mirena)
Thickens cervical mucus
Endometrial atrophy
Prvention of ovulation in some women’s cycles
what is the treatment of syphillis?
Benzathine Penicillin G IM single dose
what is the average time for seroconversion to take place in HIV infection?
4 weeks (2-6 weeks after exposure, antibody takes 4-8 weeks to develop) retest as some can take longer
which morning after pill interferes with other hormonal contraception?
ellaone
ullipristal
in which morning after all does efficacy reduce with time?
Levonelle
how many days after unprotected sex can the copper coil be inserted as emergency contraception?
5 days
what is AIDs and how is it defined?
acquired immunodeficiency syndrome
CD4 count <200 x 106 / L
in HIV how long does it take for the p-24 antigen to be detected?
2-4 weeks
in HIV how long does it take for the HIV antibody to be detected?
4-8 weeks
what is the recommended 1st line assay test for his?
4th generation assay tests for HIV antibody and p24 antigen
what is the disadvantage of POCT (prick testing) for HIV?
Reduces specificity & sensitivity
*dvantage = good for when venipuncture is not available
which neoplasms are more common in those with HIV?
Cervical cancer
Non-Hodgkin’s lymphoma
Kaposi’s sarcoma
what are the two methods used in routine practice for HIV testing?
1) Venepuncture - 4th generaion assay tests for HIV antibody and p24 antigen simultaneously
2) rapid POCT (point of care testing)
what are the symptoms of PID?
Lower abdominal pain bilateral generalised
Deep dyspareunia
Abnormal vaginal bleeding
Abnormal vaginal or cervical discharge(usually purulent)
In suspected PID - what does the triple swab investigation refer to?
Vulgovaginal swab - NAAT testing gonorrhoea, chlamydia
High vaginal swab - Candida, BV, TV, group B strep
Endocervical swab - Gonorrhoea culture
what is a complication of chalmydia screened for during laparoscopy?
Fitz-Hugh Curtis syndrome
rare complication of pelvic inflammatory disease (PID) involving liver capsule inflammation leading to the creation of adhesions
how many people are asymptomatic for gonorrhoea?
Women - 50%
Men - 10%
