Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 3a - GP > Sexual Health + Urology > Flashcards

Sexual Health + Urology Flashcards

1
Q

Define urge incontinence

A

aka overactive bladder - caused by overactivity of the detrusor muscle of the bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define stress incontinence

A

Weakness of the pelvic floor and sphincter muscles. This allows urine to leak at times of increased pressure on the bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RF for urinary incontinence (4)

A

Increased age
Postmenopausal status
Increase BMI
Previous pregnancies and vaginal deliveries
Pelvic organ prolapse
Pelvic floor surgery
Neurological conditions, such as multiple sclerosis
Cognitive impairment and dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What modifiable lifestyle factors that contribute to urinary incontinence/

A

Caffeine consumption
Alcohol consumption
Medications
Body mass index (BMI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ix for urinary incontinence

A
  1. Bladder diary - track fluid intake, urination episodes and incontinence over 3 days
  2. Urine dipstick
  3. Post-void residual bladder volume - bladder scan to assess for incomplete emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stress incontinence management

A

Avoid caffeine, diuretics, excessive or restricted fluid intake

Supervised pelvic floor exercises

Surgery i.e. Tension-free vaginal tape (TVT)

Duloxetine is an SNRI antidepressant used second line where surgery is less preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Urge incontinence management

A

Bladder retraining (gradually increasing the time between voiding) for at least six weeks is first-line

Anticholinergic medication, for example, oxybutynin

Mirabegron - alternative anticholinergic medications

Invasive procedures - i.e. botox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define retention

A

Inability to pass urine even when bladder is full usually caused by obstruction i.e. stones, BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What nerve is responsible for somatic control of micturition? and what part of the bladder does this nerve control?

A

Pudendal nerve (S2-S4)

Provides voluntary control over the external urethral sphincter - helps maintain continence during storage phase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What nerve is responsible for autonomic control of micturition? and what part of the bladder does this nerve control?

A

Hypogastric nerve (T10 - L2)

Provides sympathetic innervation to the internal urethral sphincter and the detrusor muscle (bladder wall)

During storage phase:
1. Causes relaxation of detrusor muscle
2. Maintains tone of the internal urethral sphincter - to prevent unintentional leakage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe micturition reflex during storage phase and voiding phase.

A

Storage phase:
1. sympathetic dominance inhibits bladder contraction
2. maintains sphincter tone
3. allowing the bladder to fill

Voiding phase:
1. parasympathetic activation leads to detrusor contraction
2. inhibition of the sphincters
3. facilitating urine expulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

LUTS - storage phase Sx

A

F - frequency
U - urgency
N - nocturia
I - incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

LUTS - voiding phase Sx

A

S - straining
H - hesitancy
I - intermittency
P - poor stream
D - dribbling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is cystitis?

A

Inflammation of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is UTIs more common in women?

A

Urethra is much shorter, making it easy for bacteria to get into the bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sx of lower UTI

A

Dysuria (pain, stinging or burning when passing urine)
Suprapubic pain or discomfort
Frequency
Urgency
Incontinence
Haematuria
Cloudy or foul smelling urine
Confusion is commonly the only symptom in older and frail patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is pyelonephritis and how does it occur as a result of lower UTIs?

A

Inflammation of the kidney. Lower UTIs can spread up to the kidneys and cause pyelonephritis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Difference in Sx from px with pyelonephritis compared to lower UTI?

A

Fever
Loin/back pain
Nausea/vomiting
Renal angle tenderness on examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ix for UTIs

A
  • Urine dipstick:
    Presence of nitrites or leukocytes + RBCs = px likely to have UTI.
  1. Nitrites – gram -ve bac break nitrates (normal urine waste) to nitrites
  2. Leukocyte esterase - WBCs
  3. RBCs - haematuria
  • Midstream urine (MSU):
    microscopy, culture and sensitivity testing will determine the infective organism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cx of UTI

A

MC - Escherichia coli

Other -
Klebsiella pneumoniae
Enterococcus
Pseudomonas aeruginosa
Staphylococcus saprophyticus
Candida albicans (fungal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx of UTI (cystitis)

A

Trimethoprim (avoid in patients in 1st trimester)
Nitrofurantoin (avoid in patients in 3rd trimester)
Amoxicillin or cefalexin used instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why is nitrofurantoin avoided in third trimester?

A

Risk of neonatal haemolysis (destruction of the neonatal red blood cells).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is trimethoprim avoided in first trimester?

A

Folate antagonist → cause congenital malformations, particularly neural tube defects (e.g., spina bifida).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What bacteria causes chlamydia? What kind of bacteria is it? Intra or extra cellular?

A

Chlamydia trachomatis = gram-negative bacteria.
Intracellular organism = enters + replicates within cells before rupturing the cell and spreading to others.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
RF for developing chlamydia?
Young Sexually active Multiple partners
26
What programme has Public Health England set out to detect chlamydia?
National Chlamydia Screening Programme (NCSP) - aims to screen every sexually active person under 25 years of age for chlamydia annually or when they change their sexual partner.
27
Sx of chlamydia in women?
Abnormal vaginal discharge Pelvic pain Abnormal vaginal bleeding (intermenstrual or postcoital) Painful sex (dyspareunia) Painful urination (dysuria)
28
Sx of chlamydia in men?
Urethral discharge or discomfort Painful urination (dysuria) Epididymo-orchitis Reactive arthritis
29
Examination findings of chlamydia in females?
Pelvic or abdominal tenderness Cervical motion tenderness (cervical excitation) Inflamed cervix (cervicitis) Purulent discharge
30
Ix of chlamydia?
Nucleic acid amplification tests (NAAT) are used to diagnose chlamydia: Vulvovaginal swab Endocervical swab First-catch urine sample (in women or men) Urethral swab in men Rectal swab (after anal sex) Pharyngeal swab (after oral sex)
31
Tx of chlamydia?
1st line - Doxycycline 100mg BD for 7 days. If contraindicated use: Azithromycin Erythromycin Amoxicillin
32
When is doxycycline contraindicated?
In pregnancy and breastfeeding.
33
Complications of chlamydia? (3)
Chronic pelvic pain Infertility Ectopic pregnancy Conjunctivitis Lymphogranuloma venereum If pregnant: Preterm delivery Premature rupture of membranes Low birth weight Postpartum endometritis Neonatal infection (conjunctivitis and pneumonia)
34
What is lymphogranuloma venereum?
Cdtn affecting the lymphoid tissue around the site of infection with chlamydia.
35
RF for LGV (lymphogranuloma venereum)?
Men who have sex with men (MSM).
36
Describe 3 stages of LGV?
Primary stage - Painless ulcer (penis, vaginal wall or rectum) Secondary stage - Lymphadenitis (swelling + pain in lymph nodes infected i.e. inguinal or femoral nodes) Tertiary stage - inflammation of the rectum (proctitis) + anus → change in bowel, tenesmus
37
Tx for LGV?
1st line - Doxycycline
38
What is chlamydial conjunctivitis?
Conjunctival infection when genital fluid comes in contact with eye.
39
What kind of bacteria is Neisseria gonorrhoeae?
Gram-negative diplococcus bacteria
40
How does gonorrhoea spread? Where are the infected areas?
STI that spreads via contact with mucous secretions from infected areas such as endocervix in women, urethra, rectum, conjunctiva and pharynx.
41
Sx of gonorrhoea?
Female: Odourless purulent discharge, possibly green or yellow Dysuria Pelvic pain Male: Odourless purulent discharge, possibly green or yellow Dysuria Testicular pain or swelling (epididymo-orchitis)
42
Ix for gonorrhoea?
Nucleic acid amplification testing (NAAT) - detect the RNA or DNA of gonorrhoea. Standard charcoal swab for microscopy, culture and sensitivities - to choose abx If genital infx - endocervical, vulvovaginal or urethral swabs, or in a first-catch urine sample. MSM - rectal and pharyngeal swab
43
Tx of gonorrhoea?
IM ceftriaxone - if unknown sensitivities Oral ciprofloxacin - if sensitivities known Other tx: abstain from sex for 7 days do a follow up test of cure due to high abx resistance
44
What are some conditions that HSV is responsible for causing?
Cold sores (herpes labialis) Genital herpes Herpes keratitis (infl of cornea in eye) Herpetic whitlow (painful skin lesion on finger)
45
How is HSV spread?
Through direct contact with affected mucous membranes or viral shedding in mucous secretions.
46
What are the different strains of HSV?
HSV-1 HSV-2
47
Describe sx of herpes labialis (oral herpes) and genital herpes?
Herpes labialis: Tingling and burning followed by development of vesicular then ulcerative lesions involving the oropharynx and perioral mucosa. Genital herpes: Asymptomatic to tingling and burning without lesions, to recurrent genital ulcerations.
48
Typical tx used for HSV outbreak?
Antivirals - Aciclovir, famciclovir, and valaciclovir
49
What kind of virus in influenza?
RNA virus
50
What are the 3 types of influenza?
A, B and C A and B - MC
51
Typical sx of influenza
Fever Lethargy and fatigue Anorexia (loss of appetite) Muscle and joint aches Headache Dry cough Sore throat Coryzal symptoms
52
Difference between common cold and flu (influenza)?
Flu - abrupt onset, fever, “wiped out” with muscle aches and lethargy Common cold - gradual onset, no fever, can usually continue many activities
53
Tx of someone at risk of complications of influenza?
Oral oseltamivir Inhaled zanamivir Otherwise self-care measures
54
What is infectious mononucleosis (IM) also known as and what virus is it caused by?
aka glandular fever - infection with the Epstein Barr virus (EBV).
55
How is IM (glandular fever) spread?
Virus found in saliva of infected person therefore spread by kissing or by sharing cups, toothbrushes and other equipment that transmits saliva.
56
What does an adolescent presenting with a sore throat and then develops an itchy rash after taking amoxicillin have?
IM - Mononucleosis causes an intensely itchy maculopapular rash in response to amoxicillin or cephalosporins.
57
Sx of IM
Fever Sore throat Fatigue Lymphadenopathy (swollen lymph nodes) Tonsillar enlargement Splenomegaly
58
1. What antibodies does the body produce in response to IM? 2. How long does it take for these antibodies to be produced? 3. What 2 tests are done to find these antibodies?
1. heterophile antibodies 2. takes up to 6 weeks 3. Monospot test - uses RBC's from horses and Paul-Bunnell test - uses RBC's from sheep
59
Tx of IM
Self-limiting Patients are advised to avoid alcohol, as EBV impacts the ability of the liver to process the alcohol. Patients are advised to avoid contact sports due to the risk of splenic rupture.
60
What is Lyme disease and how is it transmitted?
An infectious disease transmitted to humans through the bite of infected ticks.
61
Sx of Lyme disease?
Erythema migrans: Typical rash that occurs 1 to 2 weeks after a tick bite Central clearing + Constitutional sx: Fever, headache, myalgias, fatigue, or arthralgias
62
Tx of Lyme disease?
Single dose abx prophylaxis i.e. doxycycline

Phase 3a - GP (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions