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FINALS > SEXUAL HEALTH > Flashcards

SEXUAL HEALTH Flashcards

1
Q

what are the clinical features of lymphogranuloma venereum?

A
  • Inguinal lymphadenopathy
  • Non-specific symptoms of proctocolitis (anorectal pain, rectal bleeding, mucopurulent discharge and tensesmus
  • Groove sign of Greenblatt (femoral and inguinal node involvement)
  • Genital elephantiasis, saxophone penis, esthiomene
  • Fever, malaise, arthralgias
  • Lower abdominal or lower back pain
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2
Q

how is lymphogranuloma venereum diagnosed?

A
  • clinical features

- positive NAAT for chlamydia

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3
Q

how is lymphogranuloma venereum managed?

A
  • oral doxycycline
  • oral erythromycin in pregnant women
  • pus aspiration from bubonuli to prevent rupture and sinus tract formation
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4
Q

what are the risk factors for developing syphilis?

A
  • Unprotected sex.
  • Multiple or anonymous sexual partners.
  • Substance use.
  • Transactional sex.
  • Social vulnerability.
  • Needle-sharing contact.
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5
Q

what are the clinical features of primary syphilis?

A

-painless genital chancre

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6
Q

what are the clinical features of secondary syphilis?

A
  • A maculopapular rash.
  • Condylomata lata (moist wart-like lesions).
  • Buccal ulceration.
  • Generalised lymphadenopathy
  • Fever, headache and malaise.
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7
Q

what are the clinical features of tertiary syphilis?

A
  • Loss of proprioception and vibration sensation
  • Tabes dorsalis
  • Argyll-Robertson pupil (accommodation but absent pupillary light reflex).
  • Abdominal aortic aneurysm.
  • Gummatous lesions.
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8
Q

what are the clinical features of congenital syphilis?

A
  • Blunted upper incisor teeth (Hutchinson’s teeth) and mulberry molars.
  • Keratitis.
  • Saddle nose.
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9
Q

how is syphilis diagnosed?

A
  • dark-field microscopy
  • specific serological tests: EIA/TPHA/TPPA (stay positive after treatment)
  • non-specific serology: VDRL/RPR (negative after treatment
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10
Q

how is syphilis treated?

A
  • Offer full screening for other STIs (including HIV).
  • Perform contact tracing to help limit ongoing transmission.
  • Offer benzathine benzylpenicillin intramuscularly as first line management:
  • Given as a single dose for primary and secondary syphilis.
  • Given as three doses over 2 weeks (day 0, 7, 14) in latent late syphilis.
  • Offer doxocycline for 14 days as first line treatment in patients with a penicillin allergy.
  • Offer intravenous aqueous benzylpenicillin sodium for suspected neurosyphilis.
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11
Q

what are the clinical features of gonorrhoea in men?

A
  • Mucopurulent or purulent urethral discharge.
  • Dysuria.
  • Tender epididymis in epididymitis.
  • Anal discharge.
  • Perianal and anal pain.
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12
Q

what are the clinical features of gonorrhoea in women?

A
  • Increased or altered vaginal discharge.
  • Lower abdominal and pelvic pain.
  • Dysuria.
  • Intermenstrual bleeding.
  • Painful intercourse (dyspareunia) if the infection spreads to the endocervix.
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13
Q

how is gonorrhoea diagnosed?

A
  • NAAT
  • vulvovaginal swab in women
  • first pass urine sample in men
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14
Q

how is gonorrhoea managed?

A
  • Offer intramuscular ceftriaxone and oral azithromycin as single doses.
  • Offer oral cefixime instead of intramuscular ceftriaxone if the patient refuses intramuscular injection.
  • metronidazole if history of sexual abuse
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15
Q

what are the clinical features of genital herpes?

A
  • Painful bilateral blisters on the external genitalia.
  • Fever and malaise.
  • Dysuria.
  • Inguinal lymphadenopathy.
  • Tingling and burning symptoms (recurrent)
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16
Q

what are the clinical features of oral herpes?

A
  • Cold sores.
  • Sore throat.
  • Fever.
  • Cervical lymphadenopathy.
17
Q

how are genital herpes treated?

A
  • Prescribe oral aciclovir (400 mg three times daily for 5 - 10 days) as first line treatment of primary genital herpes.
  • Prescribe topical lidocaine and recommend sitz baths for pain relief.
  • Advise abstinence from sexual intercourse until the lesions have cleared.
  • Offer episodic antiviral treatment (oral aciclovir) for infrequent episodic attacks.
  • Offer suppressive antiviral treatment (oral aciclovir) for frequent episodic attacks.
18
Q

how is oral herpes managed?

A
  • Recommend paracetamol and ibuprofen to treat symptoms of pain and fever.
  • Prescribe oral aciclovir (200 mg five times daily for 7 - 10 days) for severe, frequent or persistent disease.
19
Q

how is genital herpes treated in pregnant women?

A
  • oral acyclovir

- c-section delivery

20
Q

what are the risk factors for developing chlamydia?

A
  • A new sexual partner.
  • More than one sexual partner in the last year.
  • Lack of consistent condom use.
  • Social deprivation.
21
Q

what are the clinical features of chlamydia in women?

A
  • Increased vaginal discharge.
  • Post-coital or intermenstrual bleeding.
  • Purulent vaginal discharge.
  • Mucopurulent cervical discharge.
  • Deep dyspareunia.
  • Dysuria,
  • Pelvic pain and tenderness.
22
Q

what are the clinical features of chlamydia in men?

A
  • Dysuria.
  • Mucoid or mucopurulent urethral discharge.
  • Urethral discomfort.
  • Epididymo-orchitis.
23
Q

how is chlamydia diagnosed?

A

-NAAT: first pass urine in men, vulvovaginal swab in women

24
Q

how is chlamydia treated?

A
  • Prescribe oral doxocycline (100 mg twice daily for 7 days) as the first line treatment.
  • Prescribe azithromycin (1 g orally for one day, then 500 mg one daily for two days) as the first line treatment in pregnant women (doxycycline causes foetal tooth discolouration)
25
Q

what are the clinical features of genital warts?

A
  • Asymptomatic.
  • Pruritus is uncommon.
  • Urinary symptoms are uncommon and are caused by lesions in the distal urethra and meatus.
  • Bleeding is uncommon and is due to local trauma.
26
Q

how are genital warts treated?

A
  • Offer topical podophyllotoxin or imiquimod for non-keratinised warts.
  • Offer cryotherapy for keratinised or internal warts (urethral meatus or vaginal warts).
27
Q

when should levonorgestrel be given for emergency contraception?

A

-within 72 hours of UPSI

28
Q

when should ulipristal acetate be given for emergency contraception?

A

-within 120 hours of UPSI

29
Q

when should Cu-IUD be given for emergency contraception?

A
  • to 120 hours after first UPSI

- up to 5 days after the earliest expected date of ovulation

FINALS (18 decks)

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