Sexual Health Flashcards
Candidiasis more common in?
Diabetes
Immunosuppressed patients
Presentation of candidiasis?
Itchy
Thick, white discharge
Vulval and vaginal irritation
Management of candidiasis?
Clotrimazole cream
One off clotrimazole pessary
One off fluconazole dose (150mg)
Presentation of bacterial vaginosis (BV)?
Fishy smelling, watery, grey discharge
Dysuria
High vaginal pH
“clue cells” on microscopy
Management of BV?
Metronidazole (1st line)
Vaginal swabs to rule out chlamydia/ gonorrhoea
Avoid vaginal irrigation that might disrupt natural flora
Cause of gonorrhoea?
Neisseria gonorrhoeae, gram negative diplococcus
Presentation of gonorrhoea?
More often symptomatic Odourless green, purulent discharge Dysuria Pelvic pain Testicular pain
Diagnosis of gonorrhoea?
Nucleic acid amplification testing of endocervical swabs or urine
Endocervical swab for culture and sensitivity prior to antibiotics
Management of gonorrhoea?
Single dose of ceftriaxone 500mg IM and azithromycin 1g oral
Contact tracing for partners
Education to prevent further infection
Cause of chlamydia?
Chlamydia trachomatis, gram negative bacteria
Chlamydia presentation?
Often asymptomatic PV discharge Pelvic pain Abnormal bleeding Dyspareunia
Examination findings in chlamydia?
Cervical excitation
Fever
Purulent discharge
Pelvic/abdominal tenderness
Diagnosis of chlamydia?
Vulvovaginal swab in females
First void urine in males
PCR
Treatment of chlamydia?
Doxycycline for 7 days
Single dose of 1g azithromycin
Contact tracing for partners
Education to prevent future infection
Cause of genital herpes?
HSV-2 (can be HSV-1)
Presentation of genital herpes?
Labial ulceration/ vesicular lesions
Pain
No discharge
(ask about sexual contacts)
Diagnosis or genital herpes?
Clinical diagnosis
Swab can be taken for viral PCR
Management of genital herpes?
Oral acyclovir
Topical for cold sores
Cause of syphilis?
Treponema pallidum
Primary syphilis?
Local ulcer (canker) No pain
Secondary syphilis?
Symmetrical rash, mucosal ulceration, neuro symptoms
Diagnosis of syphilis?
Serology for TP IgGEIA
Ulcer sample PCR
Treatment for syphilis?
Benzathine penicillin IM or doxycycline 100mg 2 weeks (28 days if late latent)
Complications of gonorrhoea?
Male - epididymitis
Female - pelvic inflammatory disease
Both - monoarthritis, disseminated gonococcal infection
