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ICM/FCM > Sexual Health - ICM > Flashcards

Sexual Health - ICM Flashcards

1
Q

How do you test for gonorrhoea?

A

Urethral / vaginal swab with gram staining

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2
Q

Beside Gonorrhoea, what other STI can NAAT testing check for?

A

Chlamydia

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3
Q

Besides NAAT, what two other investigations can you do to check for Gonorrhoea if a male presents with symptoms?

A

Urethral Microscopy & Gram Staining

Urine testing - first void (or 1 hour)

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4
Q

A patient gets the following results for their gonorrhoea equivocal test:

Screening test - positive
Confirmatory test - negative

Have they got gonorrhoea?

A

The person is negative for gonorrhoea

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5
Q

What must you do before treating gonorrhoea after doing a NAAT test and what would it tell you?

A

Cultures

  • Causative bacteria
  • Antibiotic resistance
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6
Q

What is a complication of untreated gonorrhoea in women?

A

Pelvic inflammatory disease

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7
Q

What is a complication of untreated gonorrhoea in males? (2 marks)

A

Epididymitis

Prostatitis

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8
Q

What is the first line treatment for someone positive for gonorrhoea?

A

Ceftriaxone 500mg IM stat & Azithromycin 1g PO

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9
Q

What else would you prescribe to a patient who has also tested positive for chlamydia alongside gonorrhoea?

A

Doxycycline 100mg BD 7 days

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10
Q

If a patient has gonorrhoea but is allergic to penicillin, what alternative antibiotic would you give?

A

Azithromycin 2g

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11
Q

What is the first line treatment for chlamydia?

A

Doxycycline 100mg BD 7 days

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12
Q

If a patient is pregnant/breastfeeding and has chlamydia, what would you prescribe her?

A

Azithromycin 1g STAT
THEN
Azithromycin 500mg OD 2 days

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13
Q

What is the first line investigation for trichomonas?

A

NAAT on vaginal/urethral swab

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14
Q

What type of sample would you take for a vaginal swab to test for trichonomas?

A

Wet mount sample

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15
Q

How does a patient present with trichonomas and what would you see on inspection of the cervix?

A

Frothy/bubbly yellow/green discharge with fishy smell

Itching and dysuria

Strawberry looking cervix

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16
Q

What is the treatment for trichomonas?

A

Metronidazole 400-500mg BD for 7 days

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17
Q

How would a patient present with bacterial vaginosis?

A

Grey/white discharge

Fishy smell

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18
Q

How would you investigate for BV?

A

Charcoal swab for microscopy

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19
Q

What would you see under the microscopy for BV? (2 marks)

A

Clue cells

Reduce lactobacilli and increased Gardnerella

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20
Q

What is the treatment for BV?

A

Metronidazole 400mg BD 5-7 days

21
Q

What pH would you expect for trichomonas and BV?

A

> 4.5

22
Q

What pH would you expect for vaginal candidiasis?

A

<4.5

23
Q

What is the treatment for vaginal candidiasis?

A

Clotrimazole 500mg Pessary STAT

Fluconazole 150mg STAT oral (not if pregnant)

24
Q

How soon after treatment should you do a test of cure for trichonomas?

A

1 week after treatment?

25
Q

After a test of cure for trichonomas, the patient still has the infection present, what do you do next and what do you advise the patient?

A

Re-start the abx and then do another test of cure until the patient has no symptoms

Advise no sexual intercourse

26
Q

What is the first line investigation for testing HIV, what does it look for and when should it be done?

A

Antibody testing (blood test)

Detection of HIV-1 p24 antigen and HIV antibodies (depending when done)

Antibodies can take up to 12 weeks to be made post infection

27
Q

What other investigations besides a blood test can you do to detect HIV and what does it look for?

A

Fingerprick & Oral test

Mostly only detects HIV antibodies

28
Q

What is the normal CD4 count?

A

500-1200

29
Q

What CD4 count would you expect to see in someone with end stage HIV?

A

<200

30
Q

What is the treatment for HIV?

A

Anti-retroviral treatment

31
Q

In hepatitis B, what does HbsAg represent and what would it mean if it was positive/negative?

A

Represents if there is active infection

Positive = patient has hepatitis B
Negative = patient doesn't have active hepatitis B
32
Q

What does HbcAB represent and what does it mean if its positive or negative?

A

HbcAB = core antibody made in response to active or past infection (tells you someone has been in contact with hep B)

Positive = either had a past / current infection 
Negative = no past / current infection
33
Q

What does HbsAB represent and what does it mean if its positive or negative?

A

Represents if someone is vaccinated against Hepatitis B

Positive = vaccinated against hep B
Negative = not vaccinated against hep B
34
Q

What do the below results show and what two other things would you test for and what do they show?

HbsAg - Positive
HbcAB - positive
HbsAB - negative

A

Results show that the patient is unvaccinated against hep B, but currently has an active infection

Would want to test for HbeAg and HBV-DNA to check for viral replication and viral load

35
Q

How is hepatitis B treated?

A

Combination therapy of interferon A & lamivudine

36
Q

What investigation would you do to detect if a patient has been in contact with hepatitis C?

A

Antibody test - HCV Igg

37
Q

What investigation would you do to test if someone has a current infection of hepatitis C?

A

Viral load test - HCV RNA

38
Q

How long can it take for the HSV-Igg (hep C) test to become positive if a patient has an acute HCV infection?

A

6-24 weeks

39
Q

How long can it take for HSC-RNA (hep B) to become detectable if someone has an acute hep C infection?

A

1-2 weeks

40
Q

What is the treatment for hepatitis C?

A

Combination therapy - pegylated interferon and ribavirin

41
Q

What does syphilis look like under a dark ground microscopy?

A

Spiral shaped coils

42
Q

What investigations would you do for syphilis and what do they mean? (2 marks)

A

Serology

  • IgG –> if they have been in contact / 12 weeks
  • IgM –> detect early infection
43
Q

What is the treatment for syphilis?

A

Primary, Secondary, Early Latent:
Benzathine Penicillin G 2.4MU single dose
Doxycyline 100mg BD 14 days

Late Latent:
Benzathine Penicillin 2.4MU weekly for 3 week

44
Q

What is the investigation for herpes and how would you collect it?

A

Viral PCR –> rub swab onto wart and gain the fluid to determine what type of HSV

45
Q

What is the treatment for herpes?

A

Aciclovir 400mg TDS 5 days

46
Q

How do you investigate for genital warts/molloscum?

A

You don’t - visual

47
Q

How do gential warts differ to molloscum?

A

Warts - cauliflower appearance

Molloscum - umbilicated lesions

48
Q

What is the treatment for genital warts or molloscum?

A

0.5% podophyllotoxin solution gel/cream

ICM/FCM (16 decks)

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