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GOSH > Sexual Health Serious Issues > Flashcards

Sexual Health Serious Issues Flashcards

1
Q

When can a child consent to sexual intercourse?

A

Over 14

Remind the child that sexual intercourse under 16 is illegal

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2
Q

Can a child under 14 give consent for sexual intercourse?

A

No
Even if they have capacity this is classed as rape
Must inform social services if disclosed (may inform the police)

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3
Q

How is fraser guidance applied to sexual activity & contraceptives?

A

UnProtected Sex Is Silly:

  • Understands: Young person understands the advice with sufficient maturity to understand what is involved
  • Parents: Do not need to inform parents
  • Sexual intercourse: Young person very likely to begin/continue having sex with/without contraception
  • Interest: In the young person’s interest to give treatment/advice without parental consent
  • Suffer: Without contraception advice/treatment the young person’s physical/mental health would suffer
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4
Q

What are a person’s immediate needs following sexual assault?

A
  • Safety
  • Treatment of injuries
  • Baseline screening (STIs, HIV)
  • Prevention of pregnancy (cuIUD or Levonelle)
  • Prophylaxis for STIs, HIV, Hep B (vaccination)
  • Self-harm risk assessment
  • Referral for forensic medical examination in local SARC for DNA evidence
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5
Q

What are a person’s intermediate needs following sexual assault?

A
  • Pregnancy test
  • Screening for STIs
  • Hep B vaccination
  • Assess coping abilities
  • Practical & psychosocial support
  • Identify symptoms of PTSD
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6
Q

What are a person’s long-term needs following sexual assault?

A
  • STI screen offered

- Counselling/therapy

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7
Q

What are the risks of domestic violence in pregnancy?

A

Miscarriage
Infection
Premature birth
Injury/death to the foetus

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8
Q

What tests should be offered to a woman with symptoms who requires a speculum examination?

A
  • Vulvovaginal swab (chlamydia & Gonorrhoea NAAT)
  • HSV (TV, BV, candida)
  • Endocervical swab (Gonorrhoea culture)
  • Bloods (HIV & Syphilis)
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9
Q

What tests should be offered to a woman without symptoms who doesn’t requires a speculum examination?

A

-Vulvovaginal (Chlamydia & Gonorrhoea)
Patient/clinician taken
-Bloods (HIV & Syphilis)

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10
Q

What tests should be offered to a heterosexual man with symptoms?

A
  • Urine (Chlamydia & Gonorrhoea NAAT)
  • Urethral swab (Gonorrhoea culture)
  • Bloods (HIV & Syphilis)
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11
Q

What tests should be offered to a heterosexual man without symptoms?

A
  • Urine (Chlamydia & Gonorrhoea NAAT)

- Bloods (HIV & Syphilis)

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12
Q

What tests should be offered to a homosexual man with symptoms?

A
  • Urine (Chlamydia & Gonorrhoea NAAT)
  • Urethral swab (Gonorrhoea culture)
  • Pharyngeal swab (Chlamydia & Gonorrhoea) & culture
  • Rectal swab (Chlamydia & Gonorrhoea NAAT) & culture
  • Bloods (HIV & Syphilis & Hep B)
  • Offer Hep B vaccine
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13
Q

What tests should be offered to a homosexual man without symptoms?

A
  • Urine for chlamydia & gonorrhoea NAAT
  • Pharyngeal swab for chlamydia & gonorrhoea NAAT
  • Rectal swab for chlamydia & gonorrhoea NAAT
  • Blood for HIV and syphilis and hepatitis B
  • Offer Hepatitis B vaccine
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14
Q

What are the 2 subtypes of Reiter’s syndrome?

A

GI: Salmonella, Shigella, Campylobacter
GU: Chlamydia, Gonorrhoea

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15
Q

What is the most likely diagnosis?
A 45yo HIV +ve lady w/multiple lesions on her face. Lesions are raised, swing, non-tender, non-erythematous, approx 3mm, umbilicated centres

A

Molluscum Contagiosum
Develop on face, abdomen, buttocks, genitalia
Latent period of 3-12weeks
Extensive & persistent in immunocompromised

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16
Q

Who is genital candidiasis most commonly seen in?

A

Diabetics
Pregnancy
HIV
Those on immunosuppressants

17
Q

What is the presentation of lymphogranuloma venereum?

A 
Presents between 3-21days infection
3rd develop small painless papule which ulcerates & heals after days
Unilateral lymphadenopathy 
Inguinal abscesses (buboes) 
Proctitis when rectal mucosa infected
18
Q

What are the different stages of Syphilis?

A

Primary: 10-90d post-infection, dull red papule on external genitalia forming single well-demarcated painless ulcer heals 3-10w, bilateral inguinal lymphadenopathy
Secondary: 6-8w after primary infection, malaise, mild fever, headache, pruritic skin rash, hoarseness, swollen lymph nodes, patchy diffuse hair loss, bone pain, arthralgia
Latent: No clinical evidence of disease, detectable by serology
Gummatous: Late stage, host resistance begins to fail, areas of granulation tissue on scalp, upper leg, sternoclavicular area, copper coloured lesions, can also occur internally
Neurosyphilis: Detectable in CSF, headache, CN palsy, general paralysis of the insane, tabes dorsals, trophic ulcers, Charcot’s joints, Argyll Robertson pupils

19
Q

How does Trichomoniasis present?

A 
Offensive greenish-grey discharge
vulval soreness
Dyspareunia
Dysuria
Vaginitis
vulvitis
Cervix: Punctate erythematous/strawberry appearance
20
Q

What is PID?

A

Polymicrobial infection

Spectrum of inflammatory disorders of the upper GU tract

21
Q

What are the causes of PID?

A 
N. Gonorrhoeae
Chlamydia
Anaerobes
Gardnerella vagnalis
H. Influenzae
Strep Agalactiae
22
Q

What are Sx of PID?

A 
Bilateral pelvic/abdo pain
Deep dyspareunia
Abnormal vaginal bleeding
Mucopurulent discharge
Adnexal tenderness

Pyrexia
Adnexal pain
Leukocytosis

23
Q

In PID what is RUQ associated with?

A

Fitz-Hugh-Curtis Syndrome
Peri-hepatitis
Adhesions between the liver & peritoneum

24
Q

How is PID diagnosed?

A 
Pregnancy test
Bimanual: Rule Out Ectopic!
VV swab: NAAT
EC swab & culture
High vaginal swab
Bloods: WCC, ESR, CRP, HIV
25
Q

How is PID treated?

A

Analgesia
Abx - Doxcycline & Metronidazole & Ceftriaxone
Refrain from sexual intercourse

26
Q

What are the complications of PID?

A 
Fitz-Hugh-Curtis Syndrome
Chronic pelvic pain
Infertility
Ectopic
Hydrosaphinx
Dyspareunia

GOSH (17 decks)

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