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Women's and Mens health > Sexual health investigations > Flashcards

Sexual health investigations Flashcards

1
Q

List of risk factors for HIV. (8 things)

A
  1. From an area with high prevalence
  2. MSM (men who have sex with men)
  3. Female sexual contacts of MSM
  4. Multiple sexual partners
  5. History of injecting drug use
  6. Been raped
  7. Blood transfusions in less developed countries
  8. Occupational exposure (needle stick injury)
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2
Q

In a person with suspected HIV what would you look for on examination ? (4 things)

A
  1. Rash (maculopapular)
  2. lymphadenopathy
  3. Signs of immunocompromised (e.g candida)
  4. More serious conditions
    - Pneumocystis pneumonia (fever, cough, dyspnoea etc)
    - Lymphoma
    - Kaposi’s sarcoma (purplish spots on legs, feet +/or face)
    - TB
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3
Q

Who would you offer HIV testing to? (5 things)

A
  1. Newly registered to the medical practice
  2. Those who request it
  3. Have RF’s for HIV
  4. All pregnant women
  5. Unexplained illnesses

Note: it doesn’t have to be a venous sample. You can offer swab tests or offer a home kit (www.freetesting.hiv)

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4
Q

How do you manage someone with a new diagnosis of HIV? (4 things)

A
  • If there’s no need for urgent admission then refer to HIV clinic within 48 hours or 2 weeks max
  • Give written details
  • Promote safe sex
  • Arrange a follow up within a few days to give more information/ support

websites:
- www.bashh.org
gov.uk/hiv
terence Higgins trust

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5
Q

What must you always check when considering prescribing in those with HIV?

A
  • Drug interactions with their ART’s
  • you must seek specialist advice to find out if its safe to prescribe (Antidepressants, abx, erect dysfunction drugs etc)
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6
Q

What investigations would you do for Chlamydia and Gonorrhoea ?
(discuss Ix for men and women)

A

In women:

  1. Vulvo- vaginal or endocervical swab
  2. Alternatively, first catch urine (FCU) sample (held in bladder for at least 1 hour before testing. Collect 20ml of this)

In men:

  1. FCU
  2. Urethral swab
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7
Q

How do you confirm a diagnosis of Chlamydia and Gonorrhoea ?

A

NAAT testing

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8
Q

How is Syphilis investigated?

A

Refer to the GUM Clinic for them to investigate

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9
Q

How would you investigate Trichomoniasis ? on exam what would you see? (5 things for women and 3 things for men)

A

Women:

  1. History
  2. Speculum exam
    - Green frothy discharge
    - Fishy odor
    - Vulval/ vaginal inflammation
    - Cervicitis (strawberry cervix)
  3. Vaginal pH
    - >4.5 suggests Trich
  4. High vaginal or self low vaginal swab
  5. offer STI test

Men:

  1. History
  2. Urethral swab and/ or First void urine for culture and microscopy
  3. offer STI tests

Note you would always treat the partner for Trich

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10
Q

What is Trichomoniasis ?

A

It is a sexually transmitted infection caused by a bacteria (flagellated protozoan Trichomonas vaginalis)

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11
Q

What is a wet mount sample?

A

A sample of vaginal discharge is put on a glass slide and mixed with saline solution for microscopy

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12
Q

What conditions would you look for when taking a black charcoal swab in a woman? (2 things)

A
  1. Bacterial vaginosis
  2. Thrush
  • Raised pH will indicate likely infection.
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13
Q

What does the Hepatitis core antibody tell us?

A

Whether you have ever been in contact with the virus

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14
Q

What does the Hepatitis surface antigen tell us?

A

Whether the virus is present in the blood

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15
Q

What does the Hepatitis surface antibody tell us?

A

This is tested to see if people have been vaccinated against Hepatitis B

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16
Q

If a patient has the core antibody and surface antibody for Hepatitis B, do they need the vaccine?

A

No

17
Q

What does it mean if a patient has a negative HBsAg, HBsAb and HBcAb?

A

They don’t have hepatitis B, never had it and have not been vaccinated against it.

18
Q

What does it mean if a patient has a negative HBsAg but a positive HBsAb & HbcAb ?

A

It means the patient has been in contact with the infection and the body has cleared it because the surface antigen is negative (meaning theres no active virus)
AND they are immune because they have the surface antibody

19
Q

If a patient has a positive HbsAb, would you vaccinate them and why?

A

No because their body has formed surface antibodies against Hepatitis B and so they are immune

20
Q

What does it mean if a patient has a negative HBsAg and HbcAb but a positive HBsAb ?

A

The patient does not have Hepatitis B and has never had it but is vaccinated against it

21
Q

What does it mean if a patient has a negative HBsAb but a positive HBsAg & HbcAb ?

A

It means the patient currently has hepatitis (chronic hepatitis)

22
Q

What does it mean if a patient has a negative HBsAb and HbsAg but a positive HbcAb ?

A

The patient does not have the virus currently and has not been vaccinated against the virus BUT has been in contact with the virus

23
Q

If a patient has a negative HBsAb and HbsAg but a positive HbcAb would you offer the vaccine and why ?

A

Yes- because although they are not infectious and have previously been in contact with the virus, they are not immune.

24
Q

What 2 tests are usually done to detect Hepatitis C?

A
  1. The antibody test (HCV Antibody)

2. The PCR test (HCV RNA)

25
Q

What tests would you request if you think someone may have syphilis?

A

Syphilis IgM-
Help detect early infection.
Request if early symptoms such as painless ulcers on genitals and mouth, rash on hands and feet

or IgG -
will tell you if the patient has been in contact with the infection.
Request this in a routine screening for sexual health
Takes 12 weeks

26
Q

How do you differentiate between genital molluscum and warts? (5 things)

A

Genital molluscum:
Glossy and fluid filled
Centrally umbilicate lesions (doughnut shaped)
Not always sexually transmitted

Genital warts:
More cauliflower shaped
Always sexually transmitted

27
Q

What test tells us if the patient is immune from hepatitis ?

A

HBsAb

Women's and Mens health (6 decks)

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