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PHASE 3A > Sexual health and Contraception > Flashcards

Sexual health and Contraception Flashcards

1
Q

What is the mechanism of an IUD?

A

contains copper which is toxic to the egg and sperm thus preventing implantation

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2
Q

How long can an IUD remain effective?

A

10 years

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3
Q

When is the IUD contraindicated for use?

A

Abnormal cervix
Unexplained bleeding
Repeated History of STIs
Currrent pelvic infection
Distorted uterus

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4
Q

What is the most effective emergency contraception?

A

IUD- can be used 120 hours after UPSI (5 days)

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5
Q

What is the only suitable contraceptive option for a patient w/ Hx of breast cancer?

A

IUD

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6
Q

What is the mechanism of the IUS?

A

releases progesterone thus interfering with ovulation as it thickens cervical mucus and thins the lining of the uterus

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7
Q

How long can the IUS be used for?

A

5 years

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8
Q

What are the common SE of using the IUS ?

A

Irregular bleeding, spotting, amenorrhoea, ovarian cysts

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9
Q

When would the IUS be a useful contraceptive device?

A

useful for women who get heavy and painful periods

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10
Q

When are IUS use CI?

A

Breast cancer, PID, Unexpalined bleeding, Abnormal uterus/cervix anatomy

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11
Q

What is the mechanism of the implant and how long can it be used for?

A

releases progesterone thus interfering with ovulation as it thickens cervical mucus and thins the lining of the uterus.

Can be used for 3 years

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12
Q

SE of implants?

A

periods may stop, become longer, or become irregular + ACNE

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13
Q

What is the mechanism of Combined Hormonal Contraception (CHC)?

A

Contains oestrogen (inhibits ovulation) and progesterone

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14
Q

What are the different ways the CHC can be administerd?

A

Oral
Transdermal
Intravaginal

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15
Q

What are the different types of COCP?

A

1) Monophasic- each pill contains the same doe of hormones

2) Phasic- pills contain differing amounts of hormones which must be taken in the correct order

3) Everyday pills- usually contains 21 hormone pills and 7 hormone free pills

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16
Q

List 5 CI of using CHC?

A

Less than 6wks postpartum and breastfeeding
RF of VTE
Previous VTE, IHD, Cerebrovascular incident, AFib
Current Breast Cancer
Being age 35+ and smoking >15 cigarettes
Migraine with aura
Liver cirrhosis, hepatocellular adenoma/carcinoma

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17
Q

What are the 4 different regimens for taking CHC?

A

TRADITIONAL- Takes one pill per day/one patch per week/one vaginal ring for 3 weeks followed by 7 day HFI

EXTENDED USE- Continuous use for 9 weeks followed by 7 day HFI

CONTINUOUS USE- continuos use w/o HFI

FLEXIBLE EXTENDED USE- user uses the method until bleeding and when bleeding occurs 4 day HFI

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18
Q

If the COCP is started on the 1st day of the natural period cycle, is extra contraception required to protect from pregnancy?

A

No, the suer will be protected form pregnancy immediately

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19
Q

If the COCP is started on anytime during cycle, is extra contraception required to protect from pregnancy?

A

Yes, user will need to use additional precautions (condoms) for 7 days

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20
Q

Give a name for oral progesterone only contraceptive?

A

Desogestrel

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21
Q

How long does the OCP need to be taken for in order to be effective?

A

7 days

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22
Q

What is the scoring metric used for the potential cautions and CI of COPC use?

A

UKMEC

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23
Q

What are the two ways in which HRT can be used?

A

1) CYCLICALLY- for perimenopausal women who still continue to have periods

2) CONTINUOUSLY- for postmenopausal women who do not have periods

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24
Q

List 3 benefits of HRT?

A

Relief of vasomotor sx
Relief of urogenital sx
Decreases risk of osteoporosis

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25
List 3 risks of using HRT?
Increases risk of breast cancer Increases risk of endometrial cancer Increases risk ok VTE
26
What annual check is recommended to women who use the OCP?
Blood pressure
27
What haemantic tests are required in IDA and what would they show?
Total Iron Binding Capacity- HIGH Ferritin- LOW
28
Cases of Microcytic anaemia?
Thalassemia Anaemia of chronic disease IDA Lead poisoning Sideroblastic Anaemia
29
What is the immediate primary treatment for suspected meningial septicaemia?
IM Benzylpenicillin
30
What criteria is used in GP for dianosis of acute tonsillitis, and what are they?
ModifiedCENTOR Criteria (requires 3 out 4 to reach diagnosis of acute bacterial tonsillitis) -Age 3-14 -History of fever -Tonsillar exudates -No cough -Tender anterior cervical lymphadenopathy
31
What is the treatment given to patients presenting with otitis externa?
Topical acetic acid (combined antibiotic/steroid drops)
32
What is a common side effect of IUDs?
Long and heavier periods
33
What is a side effect of the depopovera injections and the oral progesterone pills?
Weight gain
34
Which contraceptive is well known for improving the regularity of period cycles and may improve acne?
Combined oral contraceptive pill
35
Which virus can cause slapped cheek syndrome?
Parovirus b19
36
What virus causes a rash in children which tends to start at the face, moves down to trunk and spares the limbs?
Rubella
37
What virus causes hand foot and mouth disease?
Cocksackievirus A16
38
Describe the rash associated with rosella infantum?
Macular erythemous rash on trunk following high fever and Coryzal illness
39
What is the spirometery measurements expected in obstructive lung disease?
FEV1 - decreased Normal FVC FEV1/FVC ratio <70% Increase in TLC and RV
40
What spirometry measurements would you expect in restrictive lung disease?
FEV1- decrease FVC- decrease FEV1/FVC ratio normal or increase Decrease in TLC and RV
41
What is the first line treatment in diabetic neuropathy?
Amitryptiline, duloxetine, gabapentin, pregabalin
42
What is the management of asthma in adults according to NICE guidelines?
1st- SABA 2nd- LD ICS 3rd- Add LTRA 4th- Add LABA 5th- MART therapy
43
What is the causative agent in chlamydia?
Chlamydia trachomatis
44
What is the PEFR in the BTS asthma classification of moderate, severe, and life threatening?
Moderate- PEFR 50-75% Severe- PEFR 33-50% Life threatening- PEFR <33%
45
What medications must be ceased in someone with AKI?
NSAIDS Aminoglycosides ACEI Diuretics Angiotensin II receptor antagonist
46
Which cancers is the COCP pill; A) increases risk against B) protective against
A) breast and cervical B) ovarian and endometrial
47
Which contraception is a associated with weight gain?
Depo provera
48
What is the most common side effect of the POP?
Irregular vaginal bleeding
49
What kind of organism causes a Trichomonasis infection?
Flagellated protozoan
50
What Sx and signs can be found when a person has trichiomonaisis infection?
Profuse yellow vaginal discharge Strawberry cervix Dysparenuia Itching Post coital bleeding
51
What is the management of Trichomonasis infection?
Oral metronidiazole Abstain from sex for at least a week or until screening has been completed Contact tracing
52
What is the synonymous finding in chancroid?
Painful lesion that bleeds on contact
53
What is the Sx of genital candidiasis and is management?
White cottage cheese discharge + itchiness + soreness Tx- oral fluconazole, vaginal pessary Topical azoles for vuvlal symptoms
54
What are the signs and symptoms in the different stages of syphyllis infection?
Primary- single painless lesion/ulcer Secondary- Manifests 4-10 weeks after infection Symmetrical maculopapular rash (soles, palms and feet) Mucosal ulcers and lymphadenopathy Malaise, fever, hepatitis, glomerulonephritis Tertiary- occurs 20-40 years after primary infection
55
What is the causative organism if syphyllis?
Treponema palladium (bacteria)
56
What is the treatment of syphyllis?
IM benzathine benzylpenicillin
57
When should ellaone be cautioned for use?
In patients with asthma controlled with steroids
58
What is the description for mollascum contagiosum and what's its management?
Small domed shaped flesh colour/pink papules with central indentation Tx- generally self resolves within 18 months Can have cryotherapy for aesthetics
59
Management of chlamydia?
Oral doxycycline BD 7 days
60
What is the causative organism in genital warts and list sx?
HPV 6 + 11 Painless flesh coloured bumps in genital area + itching + burning
61
What is the causative organism of genital herpes?
HSV1 and HS2
62
What is Ix and tx of genial herpes?
Ix- NAAT/viral PCR IV acyclovir and analgesia
63
What is the causative organism in Chancroid?
Haemophillus Ducreyi
64
What is the tx of chancroid?
Ceftriaxone, Azithromycin and Ciprofloxacin
65
What is the causative organism in bacterial vaginosis?
Gardnella vaginalis
66
List the ix in bacterial vaginosis?
Positive whiff test clue cells on wet mount ph >4.5
67
Tx for bacterial vaginosis
Metronidazole
68
Tx for genital warts
Podophiltoxin ointmnet Inquuimod crema Trichloracetic acid Cryotheraphy
69
Odourless prulent discharge is indicative of what?
N. Gonorrhoea
70
What is the most common caustaive organism in PID?
Chlamydia
71
What is first line Mx for thrush?
Fluconazole oral 150mg single dose
72
How long does it take for the Progesterone-only pill to become effective?
48 hours
73
In terms of emergency contraceptive use of Levonorgestrel what changes for patients with a BMI over 26kg/m² or over 70kg
Double the dose
74
At what time post partum can an IUD or IUS be inserted?
Within 48 hours of childbirth or after 4 weeks
75
For emergency contraception, when must Levonorgestrel be taken?
Within 72 hours of UPSI
76
Post-partum when do women require contraception?
21 days after giving birth
77
How long does it take for the combined oral contraceptive pill to become effective?
7 days
78
You can provide contraception, abortion and STI advice/treatment without parental knowledge or consent to people under 16 provided that. (5)
1) Understand all aspects and its implications 2) You can't persuade them to tell their parents or allow you to tell them 3) Young person likely to have sex with or without treatment 4) Their physical or mental health is likely to suffer 5) Best interest of young person to receive treatment without parental knowledge
79
For emergency contraception, up to how long after UPSI can Ulipristal acetate be taken?
120 hours post-UPSI
80
What are the guidelines for stopping non-hormonal contraception before and after 50 years old
<50 years old - Stop contraception after 2 years of amenorrhoea >=50 years old - Stop contraception after 1 years of amenorrhoea
81
What are the guidelines for stopping COCP before and after 50 years old
<50 years old - Can be continued to 50 years >=50 years old - Switch to non-hormonal or progestogen only
82
What are the guidelines for stopping Depo-Provera before and after 50 years old
<50 years old - Can be continued to 50 years >=50 years old - Switch to non-hormonal (stop after 2 years amenorrhoea) OR Switch to progestogen-only method
83
What are the guidelines for stopping Implant, POP and IUS before and after 50 years old
<50 years old - Can be continued to 50 years >=50 years old - Continue, If amenorrhoeic check FSH and stop after 1 year if FSH >= 30u/l or stop at 55 years old
84
Under what conditions is lactational amenorrhoea a reliable method of contraception
Amenorrhoeic Baby <6 months Breastfeeding exclusively
85
For patients using the COCP, If 1 pill is missed at any time in the cycle, what is the advice?
Take the last pill even if it means taking two pills in one day and then continue taking pills daily, one each day No additional contraceptive protection needed
86
For patients using the COCP, If 2 or more pills are missed, what is the advice?
Take the last pill even if it means taking two pills in one day, leave any earlier missed pills and continue one a day Women should use condoms abstain from sex until pills taken for 7 days in a row
87
For patients using the COCP, what is the emergency contraception guidance if 2 or more pills are missed in week 1?
Emergency contraception should be considered if she had unprotected sex in the pill-free interval or in week 1
88
For patients using the COCP, what is the emergency contraception guidance if 2 or more pills are missed in week 2?
After seven consecutive days of taking the COCP there is no need for emergency contraception
88
For patients using the COCP, what is the emergency contraception guidance if 2 or more pills are missed in week 3?
She should finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval
89
What is the contraceptive advice when switching from a traditional POP to COCP?
7 days of barrier contraception is needed
90
After how many hours of missing taking the POP is action required?
3 hours Due to short window of acting
91
What does UKMEC1 mean?
No restriction to use of contraceptive
92
What does UKMEC2 mean?
Advantages of contraception generally outweigh the disadvantages
93
What does UKMEC3 mean?
Disadvantages of contraception generally outweigh the advantages
94
What does UKMEC4 mean?
Unacceptable health risk
95
What is the Mx of Gonorrhoea?
IM Ceftriaxone If injection refused use Oral Cefixime 400mg and 2g Azithromycin Single Dose
96
What two pathogens most commonly cause Urethritis?
Chlamydia trachomatis Mycoplasma genitalium
97
What are the features of epidiymo-orchitis?
Unilateral testicular pain and swelling Ureteral discharge
98
Name the important differential diagnosis epididymo-orchitis?
Testicular torsion
99
What is the Ix for epididymo-orchitis?
Sexually active younger adults: NAAT for STIs Older adults with a low-risk sexual history: MSSU
100
What would a Positive non-treponemal and Positive treponemal test mean
Consistent with active syphilis infection
101
What would a Positive non-treponemal and Negative treponemal test mean
Consistent with a false-positive syphilis result
102
What would a Negative non-treponemal and Positive treponemal test mean
Consistent with successfully treated syphilis
103
What is the Mx for occupational exposure to HIV?
Immediate washing of wound Refer to A+E Post-exposure prophylaxis (PEP) within 72 and taken for 4 weeks
104
If a pregnant person is positive for Chlamydia what is the Mx?
Azithromycin or Erythromycin or Amoxicillin The SIGN guidelines suggest azithromycin 1g stat
105
What are the features of herpes simplex virus infection?
Malaise Fever Extensive painful oral ulceration Submandibular lymphadenopathy
106
What type of drug is Tamoxifen?
A SERM (Selective Oestrogen Receptor Modulators) acts as a oestrogen receptor antagonist and partial agonist. Used in the management of oestrogen receptor positive breast cancer
107
What are the adverse effects of Tamoxifen use?
Menstrual disturbance Hot flushes VTE Endometrial cancer
108
Give an example of 2 aromatase inhibitors
Anastrozole and Letrozole
109
What are aromatase inhibitors?
Reduces peripheral oestrogen synthesis
110
What are the adverse effects of aromatase inhibitors?
Osteoporosis Hot flushes Arthralgia, Myalgia Insomnia
111
What is the main factor influencing the longevity of a copper IUD?
Amount of copper on the device

PHASE 3A (11 decks)

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