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OBGYN > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

Chlamydia incubation + S+S

A

Incubation: 4 weeks in men, unknown for women

S+S: thin + watery discharge, dysuria, PCB, IMB, dyspareunia

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2
Q

Complications of STIs + STI risks in pregnancy

A

Complications: PID, perihepatitis (Fitz-Hugh-Curtis), Reiters syndrome (arthritis, uveitis, conjunctivitis), tubal infertility, increased risk of ectopic

For men: epididymo-orchitis

STI risks in pregnancy: PROM, prematurity, low birth weight, postpartum endometriosis

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3
Q

Chlamydia investigations + treatment

A

Vulvovaginal swab, urine for PCR Azithromycin 1g single dose (safe in pregnancy) Doxycycline 100mg for 7 days

Obligate intracellular parasite

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4
Q

Gonorrhoea S+S + incubation

A

Incubation = 2-5 days S+S: green discharge (from cervical os, urethra, Skene’s or Bartholin’s glands) Dysuria, urethritis, IMB/ PMB

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5
Q

Gonorrhoea investigations + treatment

A

VVS for NAAT testing ECS for culture + sensitivity Ceftriaxone IM single dose + azithromycin 1g oral single dose (safe in pregnancy)

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6
Q

Herpes incubation + pathology

A

5-14 days Enters distal processes of sensory neuron + stays dormant in root ganglion. Periodically reactivates + travels down axon into basal skin layers

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7
Q

Herpes S+S

A

Primary infection: flu like symptoms, inguinal lymphadenopathy, vulvitis, ulcers = lasts 3 weeks

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8
Q

Herpes complications

A

Meningitis Sacral radiculopathy Transverse myelitis Myalgia Erythema multiforme

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9
Q

Herpes implications in pregnancy

A

Primary infection = miscarriage or labour Neonatal risks = transmission high with NVD if during primary maternal infection

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10
Q

Herpes management

A

Treatment with acyclovir helpful in first 5 days Delivery by CS if labour within 6 weeks of primary infection

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11
Q

Genital warts (causes, S+S, management)

A

HPV 6 + 11 S+S: tiny flat patches on vulval skin, may affect cervix Manage with podophyllin solution applied daily, cryotherapy

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12
Q

Syphilis primary infection (incubation, S+S)

A

10-90 days post infection Solitary, painless ulcer (chancre) + inguinal lymphadenopathy

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13
Q

Secondary syphilis presentation

A

Occurs within first 2 years of infection (usually 4-8 weeks after) Generalised polymorphic rash on palms + soles, non-itchy Macular lesions on trunk + arms Generalised lymphadenopathy Condyloma lata (wart lesions on genitals + mouth) Anterior uveitis

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14
Q

Latent syphilis

A

Disease present but asymptomatic

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15
Q

Tertiary syphilis presentation

A

Over 2 years Neurosyphilis, cardiovascular + gummata (nodular plaques in skin or bone, firm + coppery red)

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16
Q

Neurosyphilis presentation

A

Headache, 3/6/8 CN involvement, papilloedema, hemiplegia Paranchymatous (ataxia, lightening pain, absent reflexes)

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17
Q

Cardiovascular syphilis presentation

A

Aortic regurgitation, aortitis

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18
Q

Investigations for syphilis (+ microscopy findings)

A

NAAT or bloods Smear from primary lesion = spirochaetes

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19
Q

Management of syphilis

A

Ben-penicillin + procaine penicillin

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20
Q

Balanitis (who, causes, S+S, management)

A

Commonly affects boys under 4 y/o + uncircumcised males Causes: candida, bacterial infection, STI, poor hygiene, psoriasis S+S: redness, irritation, soreness, dysuria Management: treat underlying cause, avoid soaks

21
Q

Acute HIV S+S

A

Influenza like illness, rash Fever, myalgia, lymphadenopathy, pharyngitis

22
Q

Investigations for HIV

A

Ab to the core = deeloped in 2-6 weeks Repeat test after 3 months due to delayed seroconversion

23
Q

Management of HIV

A

HAART = combination antiretroviral regime

24
Q

Advanced HIV S+S

A

Persistent lymphadenopathy Fever, night sweats, diarrhoea, weight loss Oral candidiasis, herpes, seb dermatitis, impetigo

25
Q

Bacterial vaginosis cause + S+S

A

Overgrowth of anaerobes (Gardnerella) White grey discharge, fishy smell

pH >4.5 - 6

26
Q

BV implications in pregnancy

A

Late miscarriage Preterm birth PPROM

27
Q

BV investigations + RF

A

Increasing vaginal pH (>4.5) Clue cells on microscopy

Hay/Ison criteria gram stained vaginal smear

RF: douching, black ethnicity, smoking, STI

28
Q

BV management

A

Metronidazole oral (beware of Disulfram reaction) + clindamycin cream (can weaken condoms so don’t use during treatment)

29
Q

Trichomonas S+S

A

Frothy green offensive smelling discharge Itching + soreness

Dysuria

Strawberry cervix

Superficial dyspareunia

30
Q

Trichomonas implications in pregnancy

A

Preterm delivery Low birth weight

31
Q

Trichomonas investigations + management, what does it look like

A

Wet mount microscopy or VVS NAAT Metronidazole 2g stat dose + 400mg BD for 5-7 days (avoid in first trimester)

Sexual partners should be treated simultaneously

32
Q

Candidiasis RF

A

Antibiotics, pregnancy, COCP, DM, anaemia, high oestrogen

33
Q

Candidiasis S+S

A

Itching + soreness, satellite lesions Thick curd like white discharge Dysuria Superficial dyspareunia

34
Q

Candidiasis management

A

Clotrimazole pessary + cream (safe in pregnancy) Fluconazole oral = not safe in pregnancy

35
Q

STD swabs + what they test for

A

HVS = MC+S, candida, TV, BV Endocervical = M,C+S, gonorrhoea + chlamydia

36
Q

Complications of chlamydia

A

Reactive arthritis, urethritis, conjunctivitis

Characteristic vesicle skin lesions: keratoderma blenorrhagica

Also called Reiter’s syndrome

Lymphogranuloma venereum = lymphadenopathy

Neonatal conjunctivitis + pneumonia

37
Q

Genital warts management in pregnancy

A

Cryotherapy - podyphillin is contraindicated

38
Q

Management of cryptococcal meningitis

A

IV amphoterecin B

39
Q

What can syphilis cause in pregnancy?

A

Hutchinson teeth

40
Q

What does chlamydia look like on a swab?

A

Gram negative intracellular rods

41
Q

What is lichen planus?

A

Found around genitals, commonly on vulva

Skin hypopigmentation + atrophy, giving shiny look

White polygonal papules - can form plaques

Treat with steroids

Increases risk of vulval carcinoma

42
Q

What bug causes syphilis + what are the long term complications?

A

Treponema pallidum

Aortic regurg, dementia, tabes dorsalis, gummata

43
Q

What do the following discharges signifiy: white cottage cheese, white/ thin, green, grey/ odorous, yellow/ green + frothy

A

Cottage cheese = candida

White/ thin = chlamydia

Green = gonorrhoea

Grey + odorous = BV (Gardnerella)

Yellow/ green + frothy = TV

44
Q

Summary of vaginal infections

A
45
Q

What is disseminated gonorrhoea?

A

Fever, pustular rash, polyarthralgia

46
Q

Describe standard screening for men + women

A

Men: NAAT (urine or VVS) + serology

MSM: 3 site testing NAAT

Hep B + C for those at risk

47
Q

What extra swabs can be done + for what?

A

Microscopy HVS (gram stain + wet mount) for BV + TV

Micrscopy (gram stain of endo-urethral swab) for urethritis

Mid stream urine dip + culture for testicular pain

VVS NAAT - can do TV as well

PCR for herpes + treponemes ulcers

NAAT for mycoplasma gen

48
Q

Who is at the greatest risk of HIV?

A

MSM

OBGYN (18 decks)

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