Sexual Health Flashcards
Neisseria gonorrhoea
GN coffee bean shaped diplococci
GN coffee bean shaped diplococci
Neisseria gonorrhoea
PID symptoms in females
lower abdo pain, dyspareunia, fevers, vaginal discharge, IMB, PCB
lower abdo pain, dyspareunia, fevers, vaginal discharge, IMB, PCB are symptoms of
PID in females
PID causative organisms
Chlamydia trachomatis, Neisseria gonorrhoea (most common two), Gardnerella vaginalis, Haemophilus influenzae
Chlamydia trachomatis, Neisseria gonorrhoea (most common two), Gardnerella vaginalis, Haemophilus influenzae causes of
PID
Fitz-Hugh-Curtis S
complication of PID where infection tracks up to the liver from the pelvis, RUQ pain + perihepatitis, adhesions between liver capsule and abdo wall
complication of PID where infection tracks up to the liver from the pelvis, RUQ pain + perihepatitis, adhesions between liver capsule and abdo wall
Fitz-Hugh-Curtis S
Chlamydia trachomatis
GN intracellular coccoid/rod shaped pathogen
GN intracellular coccoid/rod shaped pathogen
Chlamydia trachomatis
condyloma acuminatum
benign genital warts
primary syphilis
2-3/52 post infection, painless, solitary, genital/perianal ulcer, may resolve spontaneously (can be multiple + painful)
painless genital ulcer, may resolve spontaneously
primary syphilis
secondary syphilis
4-8/52 post 1’ lesion, generalised illness, lymphadenopathy, diffuse macular papular rash (trunk + extremities, w/o sparing palms/soles, symmetrical, not itchy)
generalised illness, lymphadenopathy, diffuse macular papular rash (trunk + extremities, w/o sparing palms/soles)
secondary syphilis
tertiary syphilis
v rare, years post initial infection, granulomatous DZ, CVS DZ, neurological DZ
years post initial infection, granulomatous DZ, CVS DZ, neurological DZ
tertiary syphilis
trichomoniasis
Trichomonas vaginalis, frothy green discharge, pruitit, vaginitis, PCB, punctate haemorrhages (strawberry cervix)
frothy green discharge, pruitit, vaginitis, PCB, punctate haemorrhages (strawberry cervix)
trichomoniasis
candidiasis risk factors
DM, immunosuppression, recent ABx
DM, immunosuppression, recent ABx are risk factors of
candidiasis
vaginal discharge differentials
BV, gonorrhoea, chlamydia, candida, tricomonas
male urethral discharge differentials
gonorrhoea (2-5/7 incubation), chlamydia (1-3/52 incubation)
genital ulceration differentials
syphilis, herpes, Bechet’s S, LGV, chancroid
genital rash differentials
psoriasis, eczema, scabies
genital lesions differentials
lichen planus, lichen sclerosis, VIN, SCC, basal cell carcinoma, Paget’s DZ, malignant melanoma, Bartholin cyst/abscess, 2’ syphilis (condylomata lata), warts, molluscum contagiosum
dysuria differentials
chlamydia, gonorrhoea, UTI, non-specific urethritis
epididymitis
infection of the upper GU tract from an STI
infection of the upper GU tract from an STI
epidymitis
LGV
lymphogranuloma venereum = long term chronic infection of the lymphatic system, cause by Chlamydia trachomatis
Chlamydia strains
L1, L2, L3 = LGV
A-K = oculogenital chlamydia
contraception options
COCP, POP, IUD, IUS, implant, injection, withdrawal method, ovulation method, cap, diaphragm, condom, femadom, patch, ring
PID complications
chronic pain, infertility
chronic pain, infertility are complications of
PID
PID O/E
lower abdo pain, adenexal tenderness, cervical excitation, fever, dyspareunia, discharge
lower abdo pain, adenexal tenderness, cervical excitation, fever, dyspareunia, discharge O/E are indicative of
PID
PID DD
apendicitis, ectopic pregnancy, UTI, ovarical cyst torsion/rupture, endometriosis, IBS
PID investigations
pregnancy test, gonorrhoea + chlamydia NAATS, WCC, ESR, CRP, laproscopy, TVUS
PID management
analgesia, protected sex, ABx, partner notification
IUD
spermicidal + prevents implantation, effective immediately, periods heavier, longer, more painful, 2/1000 perforation, ectopic, infection, expulsion
spermicidal + prevents implantation, effective immediately, periods heavier, longer, more painful, 2/1000 perforation, ectopic, infection, expulsion
IUD
IUS
prevents endometrial thickening, effective after 7/7, periods lighter, 2/1000 perforation, ectopic, infection, expulsion
prevents endometrial thickening, effective after 7/7, periods lighter, 2/1000 perforation, ectopic, infection, expulsion
IUS
chlamydia investigations
urine/swab NAATS (nucleic acid amplification test)
chlamydia management
- azithromycin single dose
- doxycycline 7/7
pregnancy use: azithromycin, erythromycin, amoxicillin
partner notification (1/52 partners if symptomatic male, 6/12 of partners if asymptomatic or female)
chlamydia presentation
often asymptomatic, discharge, bleeding, dysuria, epididymoorchitis
chlamydia complications
epididymitis, PID, endometriosis, ectopic pregnancies, infertility, reactive arthritis, perihepatitis (Fitz-Hugh-Curtis S)
chlamydia screening
opportunistic e.g. freshers’ week, registering with a GP
urine/swab NAATS (nucleic acid amplification test)
chlamydia/gonorrhoea
- azithromycin single dose
- doxycycline 7/7
pregnancy use: azithromycin, erythromycin, amoxicillin
partner notification (1/52 partners if symptomat ic male, 6/12 of partners if asymptomatic or female)
chlamydia management
epididymitis, PID, endometriosis, ectopic pregnancies, infertility, reactive arthritis, perihepatitis (Fitz-Hugh-Curtis S)
chlamydia complications
opportunistic e.g. freshers’ week, registering with a GP
chlamydia screening
gonorrhoea presentation
discharge, dysuria
gonorrhoea complications
urethral strictures, epididymitis, salpingitis, PID, infertility, disseminated gonococcal infection, gonococcal arthritis, perihepatitis
DIG disseminated gonococcal infection
tenosynovitis, migratory polyarthritis, dermatitis, later complications: septic arthritis, endocarditis, perihepatitis
tenosynovitis
inflammation of the fluid filled sheath surrounding tendons
inflammation of the fluid filled sheath surrounding tendons
tenosynovitis
tenosynovitis, migratory polyarthritis, dermatitis, later complications: septic arthritis, endocarditis, perihepatitis
disseminated gonococcal infection
gonorrhoea management
ceftriaxone 500 mg IM single dose + azithromycin 1g PO single dose
ceftriaxone 500 mg IM single dose + azithromycin 1g PO single dose
gonorrhoea management
urethral strictures, epididymitis, salpingitis, PID, infertility, disseminated gonococcal infection, gonococcal arthritis, perihepatitis
gonorrhoea complications
causatie agent of syphilis
Treponema pallidum
transmission of Trepomena pallidum
sexually, ertically during pregnancy
description of ulcer in syphilis
macule to papule to ulcer, round, clean, indurated base, defined edges, heals w/i 3-10/52
in warm oppsed areas e.g. anus, labia the maculopapular rash of 2’ syphilis can
coalesce to form large fleshy masses - condyloma lata
if 2’ syphilis is left untreated
will resolve, may have recurrent episodes of 2’ syphilis
latent syphilis
when s/o has untreated syphilis w/o signs/symptoms
early stage latent syphilis
DZ present for <2 years
late stage latent syphilis
DZ present for >2 years
latent syphilis aka
3’ syphilis
neurosyphilis definition
10-20 years post-infection, asymptomatic, meningovascular/parenchymatous (general paresis + tabes dorsalis)
tabes dorsalis process
slow degeneration of dorsal column neural tracts, leading to loss of proprioception, vibration + discriminative touch
meningovascular syphilis presentation
early (part of 2’)/late (2-20 years post-infection) stages of syphilis, acute meningeal involvement (during 2’ syphilis), headache, papilloedema, Argyll Robertson pupils
Argyll Robertson pupil
sm, unequal pupils, react to accommodation, not to light (ARP = accommodation reflex present)
parenchymatous syphilis describes
general paresis, tabes dorsalis
early symptoms of general paresis
irritability, fatiguability, personality change, headaches, impaired memory, tremor
late symptoms of general paresis
lack of insight, depression/euphoria, confusion, disorientation, delusions, seizures, transient paralysis, aphasia
signs of general paresis
expressionless facies, tremor of lips/tongue/hands, dysarthria, impairment of handwriting, hyperreflexia, pupillary abnormalities, optic atrophy, convulsions, extensor plantar responses
tabes dorsalis symptoms
increasing ataxia, failing vision, sphincter disturbances, attacks of severe pain (lightening), paraesthesiae, deafness, ED
asymptomatic neurosyphilis
no neuro signs/symptoms, diagnosis based on serum/SCF
paraesthesiae
abnormal sensation, tingling/pricking, caused by P + damage of n
tabes dorsalis signs
Argyll Robertson pupil, absent refleces, Romberg’s sign, impaired vibration/proprioception/touch/pain sensation, optic atrophy, ocular palsies, Charcot’s joints
Romberg’s sign
close eyes, stand still, tests proprioception
Charcot’s joint
neuropathic arthropathy
CVS syphilis most commonly affects
large vessels, aorta
symptoms of CVS syphilis
are that of an aneurysm affecting the arch of the aorta putting P on mediastinal structures
gummata
3-12 years post infection, granulomatous lesions, painless, 3’ syphilis