Sexual health Flashcards
What percentage of chlamydia is asymptomatic
50% in men
70% in women
Symptoms of chlamydia in men
Urethral discharge
Dysuria
Urethral itch or discomfort
Rectal discharge and bleeding
Symptoms of chlamydia in women
Vaginal discharge Dysuria Pelvic pain Post-coital and intermenstrual bleeding Rectal discharge and bleeding
Investigations for chlamydia
Men = first catch urine for NAAT (nucleic acid amplification) Women = vaginal swab for NAAT
1st line treatment for chlamydia
Doxycycline 100mg BD 7/7`
Complications of chlamydia in women
PID (leads to): Tubo-ovarian abscess Ectopic pregnancy Perihepatitis Chronic pelvic pain Infertility
Complications of chlamydia in men
Epididymitis
What percentage of gonorrhoea is asymptomatic
10% (penis) in men
93% (rectum) in men
50% in women
Symptoms of gonorrhoea in men
Urethral discharge
Dysuria
Urethral itch or discomfort
Rectal discharge and bleeding
Symptoms of gonorrhoea in women
Vaginal discharge Dysuria Pelvic pain Post-coital and intermenstrual bleeding Rectal discharge and bleeding
Investigations for gonorrhoea
Men = first catch urine for NAAT Women = vaginal swab for NAAT
How does gonorrhoea appear on a gram stain
Gram-negative intracellular diplococci within polymorphonuclear cells
1st line treatment for gonorrhoea
Ceftriaxone 1g IM stat with 3.5ml lidocaine
No sexual intercourse for 1 week and symptoms resolved
Which antibiotic is having resistance issues with gonorrhoea
Azithromycin
Complications of gonorrhoea in women
Bartholin’s abscess
PID leading to: tubo-ovarian abscess, ectopic, infertility, perihepatitis, chronic pelvic pain
Complications of gonorrhoea in men
Epididymitis
Urethral strictures
Signs of disseminated gonococcal infection
Arthritis
Tenosynovitis
(Rare) endocarditis, hepatitis, meningitis
Aetiology of PID
60% = idiopathic, BV related (anaerobes) 20% = chlamydia 10% = mycoplasma genitalium 1-3% = gonorrhoea
Symptoms of PID
Lower abdo pain Abnormal vaginal discharge Intermenstrual bleeding (painful) Post-coital bleeding Dyspareunia
Signs of PID
Lower abdo tenderness
Cervical excitation
Uterine/adnexal tenderness
Temp +/-
Differentials for PID
Ectopic UTI Haemorrhagic ovarian cyst Torsion ovarian cyst Appendicitis Constipation/IBS
Treatment for PID
Must cover chlamydia and anaerobes
1st line = ceftriaxone 1g IM + doxycycline 100mg BD 2/52 + metronidazole 400mg BD 10-14/7
