Sexual health Flashcards
What would you see on MC and S high vaginal swab if candida thrush?
Oval spores and budding hyphae
What class of drug do you treat thrush with?
Imidazoles
Which drugs do you use to treat thrush with?
Intravaginal Clotrimazole or micanazole
If vulval symptoms then topical clotrimazole or micanazole pessary
Oral fluconazole
What organisms involved in BV and what is pH?
ph>4.5
Gardanella vaginalis and atopium vaginae
How do you diagnose BV, what criteria? What will microscopy show?
- pH >4.5
- Positive whiff test
- Microscopy- will show clue cells
Amsels criteria (3/4 including thin white grey discharge)
How do you treat BV?
Oral 400mg Metranadizole
Intravaginal Metranadizole
Intravaginal clindamycin
How do do you treat BV during pregnancy and what is it associated with?
Oral clindamycin
preterm labour (give before 20 weeks to prevent) and chorioamnionitis
What should be avoided when taking metranadizole?
Alcohol
What type of organism is trichomonas vaginallis?
Flagellated protozoan
What are the features of trichomonas? in female and male
Female- green/grey discharge which is offensive
Vulvovaginitis- itchy, superficial dyspaeurenia, dysuria
Strawberry cervix
Male- purulent urethral discharge, dysuria, urtheral irritation, frequency
How do you diagnose trichomonas and what would you seen on microscopy?
- HVS- microscopy- motile trichomonads
- Gold standard- NAATs
- In males do culture of first void urine
How do you treat trichomonas and how long should they abstain from sex?
Metranadizole
1 week until contract tracing and until partner has completed follow up
How do you investigate gonorrhoea? What will micscopy show
Microscopy culture and sensitivity- endocervical swab or urethral swab- gram negative diplococcus
NAATS
Management of gonorrhoea?
Contact tracing?
Anogenital disease- IM ceftriaxone single dose with Azithromycin
if male symptomatic urehtritis- tracing from 2 weeks previous
All other- 3 months previous
How is chlamydia trochomanis treated?
In pregnancy?
Doxycline- 7 days and Azithromycin single dose
Oral Azithromycin
What are genital herpes caused by and how do you investigate?
HSV1- oral HSV2- recurrent (primary and latent infection in dorsal root ganglia)
Viral swab from base ulcer for NAATs and PCR
Or HSV serology- HSV1 IgG antibidoes and HSV2 IgG antibodies
Conservative and pharmacological management of genital herpes?
C: saline bath, analgesiae, topical anaesthetic, analgesia
Pharamcological: Aciclovir
What are genital warts caused by and how are they treated?
HPV 6 & 11
If not regressed or recurrent then Imiqioud cream and cryotherapy
What is the organism causing syphilis?
Spirochoaete: Treponema pallidum
What is IX and TX of syphillis?
EIA and serological tests
IM benzylpenicillin
What clade of HIV virus is repsonsible for HIV infection in Europe?
HIV 1 virus- clade B
What are three phases of HIV?
Primary infeciton- seroconversion at 6 weeks- most infectious
Latency periods- lasts 6-7 years
ARDC or AIDS- <200 CD4 and oppurtunistic infection, constituinal symptoms, persistent generalized lymphoadenopathy
What are the IX for HIV?
- Serum/salivary HIV antibody using ELISA and confirm with Western blot
if negative… - PCR for HIV RNA
Monitor progression with HIV RNA, and CD4 cell count
How often should you conduct smear tests in HIV positive women?
Every year because progression to disease is faster
What drugs are included in HAART therapy (Clue reverse transcriptase inhibitors all together 5)
2 nucleoside reverse transcriptase inhibitors
1 non-nucleoside reverse trasncriptase inhibitor
2 protease inhibitors
lesion colour in lichen planus and lichen sclerosus
Lichen planus- purple flat papular lesions
Lichen sclerosus- pink white papules with fissures and thin skin, and vaginal inflammatory adhesions (have severe pruiritis)
