Sexual Health Flashcards
When should you do Hep C serology on MSM ?
Once a year
When should you do Hep C serology on high risk patients?
Every 3 months
At what stage of syphillis will the vDRL blood test level be the highest?
In secondary syphillis
What are the 3 STIs that there is worry about anti microbial and viral resistance in?
Gonorrhoea
HIV
Mycoplasma Genitalum
How many anti retrovirals are use in post exposure prophylaxis?
3 anti-retrovirals
How many anti-virals are used in pre exposure prophylaxis?
You use 2 anti-retrovirals
Who can discuss and assess the benefits of PREP, PEP for a patient ?
ANYONE
What are some disease complications associated with HIV?
- Hodgkin’s Lymphoma
- PJP
- Shingles
- Kaposi Sarcoma
- Cervical Cancer
What is classed as a late diagnosis of HIV?
CD4 count of less than 350
Why do untreated HIV patients have a higher than average level of protein in their blood?
Due to excess levels of immunoglobulin
What organism causes thrush?
Candida Albicans
What are 3 RF for candida?
Diabetes
Antibiotics
Pregnancy
What are some symptoms of candida?
Thick cottage cheese white vaginal discharge
Superficial dyspareunia
Itchy genital pain, erythema and Balanitis
What swab would you do on someone with suspected Candida?
Amies Swab
What is the management of candida ?
Fluconazole
What ulcers does the following HSV viruses cause?
HSV 1
HSV 2
HSV 1: mouth ulcers
HSV 2: genital ulcers
What are 3 triggers of HSV?
- Sexual intercourse
- Stress
- Menstruation.
What are some of the symptoms of HSV infection?
Inguinal Lymphadenopathy
Flu like symptoms
Vulvitis and pain
Ulcer formation
What is the treatment of HSV ulcers?
Acyclovir
When is a C section indicated in a patient who has HSV infection?
Still active lesions 6 weeks pre labour. Need a C Section
What antibiotic are most gonorrhoea strains resistant to?
Ciprofloxacin
What are some of the symptoms of gonorrhoea?
Green watery discharge Pharyngitis Proctitis PID Epididymal-orchitis
What are 3 diagnostic tests for gonorrhoea?
Endocervical swab (Amies Swab)
Urethral swabs
Rectal + Pharyngeal Swabs
What are the antibiotics you use to treat gonorrhoea?
- IM ceftriaxone + Azithromycin
What are 3 complications of Gonnorhoea?
PID
Tubal infertility
Septic arthritis
What investigations would you do in a patient with suspected trichomonas vaginalis?
Amies Swab
Wet smear and microscopy
What is the management of patients with trachoma vaginalis?
Metronidazole STAT PO
What is seen on examination of a patient with Trichoma?
What is the clinical presentation of someone with trichomonas ?
Strawberry Cervix
Clinical Presentation: frothy discharge, vulval itching and dysuria
If you see Clue Cells on microscopy.. what do you diagnose?
Bacterial vaginosis
What criteria do you sue when diagnosing bacterial vaginosis?
Amsel’s Criteria
Is bacterial vaginosis a sexually transmitted disease?
NO
What is the pathophysiology of bacterial vaginosis?
How is it treated?
You get a proliferative of anaerobic bacteria and decreased lactobacilli
Management is via metronidazole
What type of microorganism is chlamydia?
Intracellular Parasite
Gram Negative
What is the treatment for chlamydia infections?
Doxycycline
What structures are affected in pelvic inflammatory disease?
- Uterus
- Fallopian Tubes
- Ovaries
How does PID present?
You get bilateral lower abdo pain
Fever
Abnormal cervical discharge and vaginal bleeding
Normally see mucopurulent cervical discharge and have cervical motion tenderness
What are 4 complications of PID?
Ectopic
Infertility
Chronic Pelvic Pain
Reactive Arthritis
How do you manage PID?
Mild
Moderate to Severe ?
Mild: you give the patient IM ceftriaxone and PO doxycycline
Moderate to Severe: give above and keep the patient in hospital
What are the 4 stages of Syphillis?
Primary: 1-90 days post infection. Single painless chancre on the genitals, cervix or mouth. Alongside inguinal lymphadenopathy.
Secondary: occurs within 2 years of infection. You get a generalised pink rash on the palms or the soles. You get generalised lymphadenopathy, fever and malaise. Can also get uveitis with wart like lesions on the mucous membranes.
Latent: no new changes
Tertiary: dementia, stroke. Aortitis and visual loss . Normally > 2 years post infection.
What is the diagnostic test for syphillis?
VDRL carbon antigen test
How do you treat syphillis?
IM Benzyl Penicillin
What are 3 complications of syphillis in pregnancy?
Still Birth
Congenital Syphillis
Preterm Delivery
What are 5 STDs that you can transmit from male partner to pregnant female?
Ebola
Zika
Syphillis
HIV
HSV , gonorrhoea and chlamydia
How does Zika virus present in an infected mother?
Conjunctivitis
Joint pain
Rash
Fever
What are two signs of Zika Virus in a child?
Microencephaly
Heart Defects
Miscarriage
Still Birth
What are two tropical STDs?
Donovanosis
Chancroid:
Symptoms same for the above: lymphadenopathy, ulcerative lesions that bleed easily in perianal region
In a patient who has MSM and is recently positive for chlamydia . What condition should you take a sample to check for?
LGV (lymphogranuloma venereum)
More expansive lesions and lymphadenopathy
What is the pathogen behind syphillis?
Treponema Pallidum
