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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?

22
Q

What pH would you expect for vaginal candidiasis?

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
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?
Re-start the abx and then do another test of cure until the patient has no symptoms Advise no sexual intercourse
26
What is the first line investigation for testing HIV, what does it look for and when should it be done?
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
What other investigations besides a blood test can you do to detect HIV and what does it look for?
Fingerprick & Oral test Mostly only detects HIV antibodies
28
What is the normal CD4 count?
500-1200
29
What CD4 count would you expect to see in someone with end stage HIV?
<200
30
What is the treatment for HIV?
Anti-retroviral treatment
31
In hepatitis B, what does HbsAg represent and what would it mean if it was positive/negative?
Represents if there is active infection ``` Positive = patient has hepatitis B Negative = patient doesn't have active hepatitis B ```
32
What does HbcAB represent and what does it mean if its positive or negative?
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
What does HbsAB represent and what does it mean if its positive or negative?
Represents if someone is vaccinated against Hepatitis B ``` Positive = vaccinated against hep B Negative = not vaccinated against hep B ```
34
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
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
How is hepatitis B treated?
Combination therapy of interferon A & lamivudine
36
What investigation would you do to detect if a patient has been in contact with hepatitis C?
Antibody test - HCV Igg
37
What investigation would you do to test if someone has a current infection of hepatitis C?
Viral load test - HCV RNA
38
How long can it take for the HSV-Igg (hep C) test to become positive if a patient has an acute HCV infection?
6-24 weeks
39
How long can it take for HSC-RNA (hep B) to become detectable if someone has an acute hep C infection?
1-2 weeks
40
What is the treatment for hepatitis C?
Combination therapy - pegylated interferon and ribavirin
41
What does syphilis look like under a dark ground microscopy?
Spiral shaped coils
42
What investigations would you do for syphilis and what do they mean? (2 marks)
Serology - IgG --> if they have been in contact / 12 weeks - IgM --> detect early infection
43
What is the treatment for syphilis?
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
What is the investigation for herpes and how would you collect it?
Viral PCR --> rub swab onto wart and gain the fluid to determine what type of HSV
45
What is the treatment for herpes?
Aciclovir 400mg TDS 5 days
46
How do you investigate for genital warts/molloscum?
You don't - visual
47
How do gential warts differ to molloscum?
Warts - cauliflower appearance Molloscum - umbilicated lesions
48
What is the treatment for genital warts or molloscum?
0.5% podophyllotoxin solution gel/cream

ICM/FCM (16 decks)

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