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PHAY0010 > Sexual Health Workshop [completed] > Flashcards

Sexual Health Workshop [completed] Flashcards

1
Q

What is the causative organism for chlamydia?

A

Chlamydia trachomatis (gram positive)

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2
Q

What population is chlamydia prevalent in?

A

Sexually active people under 25

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3
Q

Are people with chlamydia often symptomatic or asymptomatic?

A

Asymptomatic

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4
Q

What are some symptoms that men may experience if they have chlamydia?

A

Pain when urinating (dysuria) caused by urethritis
Discharge
Testicular pain and swelling
Fever
Perineal fullness due to prostatis
Pain and discharge from anus

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5
Q

What are some symptoms that women may experience if they have chlamydia?

A

Pain on urination
Pus in the urine
Lower abdominal pain
Fever
Dyspareunia - pain during sex
Bleeding between periods or after sex
Changes in vaginal discharge
Pain and discharge from anus

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6
Q

What signs may be found on examination of men with chlamydia?

A

Testicular tenderness
Mucoid/mucopurulent discharge

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7
Q

What signs may be found on examination of women with chlamydia?

A

Friable inflamed cervix with a follicular/cobblestone appearance
Cervix bleeds on contact/cervical excitation
Discharge
Pelvic tenderness on palpitation

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8
Q

What are some ways to diagnose chlamydia?

A

Cell culture
Antigen detection/enzyme immunoassays
Nucleid Acid Amplification Test (HIGHEST SENSITIVITY)
Serology
Swab is vulvovaginal, cervical, urethral, or rectal.
Or men may have first-catch urine sample.

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9
Q

What is the first line treatment for chlamydia?

A

ORAL
Doxycycline 100mg bd for 7 days OR azithromycin 1g on day 1 then 500mg od for 2 days

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10
Q

What addition counselling should be given to patients with chlamydia?

A

NO SEX until doxycline course completed or 7 days after azithromycin
Test for other STIs
Partner notification
Follow up
Use of barrier methods of contraception

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11
Q

Which partners should be notified in chlamydia?

A

Partners from
4 weeks back: symptomatic men
6 months back: women and asymptomatic men

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12
Q

What are the health implications of not treating chlamydia?

A

Pelvic inflammatory disease
Infertility
Ectopic pregnancy
Ophthalmia neonatorum - if passed on to neonate
Issues with Labour and delivery
Urethral stricture and scarring in men
Reiter’s syndrome (reactive arthritis)

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13
Q

When will the symptoms of chlamydia be relieved?

A

2-4 weeks - improvements seen after a few days

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14
Q

What is the causative organism for Gonorrhoea?

A

Neisseria gonorrhoeae (gram negative)

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15
Q

What population is gonorrhoea prevalent in?

A

Young people under the age of 25.

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16
Q

What percentage of men with gonorrhoea are symptomatic?

A

90/95%

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17
Q

What symptoms may men with gonorrhoea experience?

A

mucopurulent/purulent urethral discharge
dysuria
balanitis
epididymal tenderness and swelling

18
Q

What percentage of women with gonorrhoea have no symptoms?

A

50%

19
Q

What symptoms may women with gonorrhoea experience?

A

Mucopurulent discharge/increase in discharge
Easily induced bleeding
Bleeding between periods
Cystitis/dysuria
Pelvic/lower abdominal pain

20
Q

What sign may be found on examination of men with gonorrhoea?

A

Epididymal tenderness - pain on palpation of the testes

21
Q

How is gonnorhea diagnosed?

A

Swab taken of vagina, cervix or penis –> presence of Neisseria gonorrhoeae detected through cell culture or Nucleic Acid Amplification test

22
Q

What is the first line treatment for gonnorhea?

A

Oral ciprofloxacin 500mg as a single dose if susceptibility is known OR
Ceftriaxone 1g IM if susceptibility is not known

23
Q

What additional counselling should be given to patients with gonnorhea?

A

Avoid sexual activity until 7 days after they and any partners have treatment
Partner notification
Test for other STIs
Advice on safe sex - e.g. barrier methods such as condoms and dental dams
Follow up and test of cure is recommended

24
Q

Which partners should be notified in gonorrhoea?

A

All partners from the last 3 months or TWO WEEKS in symptomatic men

25
Q

What are the health implications of not treating gonorrhoea?

A

Epididymo-orchitis - painful condition of testicles
Spread to womb - PID can lead to infertility and pain

26
Q

What is the national chlamydia screening programme? Who is eligible?

A

Anyone who is sexually active, aged 15-24 and has a womb and ovaries may be invited

Anyone can go to a pharmacy or gum clinic and ask for a test

27
Q

What is provided in a chlamydia screening kit?

A

Blood test
Urine test (men)
Vaginal
Rectal

28
Q

What is an IUD?

A

Copper coil inserted into the uterus - copper stops egg implanting or being fertilised
Can cause heavy bleeds and uncomfortable to put in
>99% effective
Lasts a long time (5-10 years)
Fertility goes back to normal as soon as its taken out
can also be used as emergency contraception if over 5 days

29
Q

What is a diaphragm or cap?

A

silicon discs put inside vagina just before intercourse to stop the sperm entering the womb
92-96% effective if used correctly
Caps are smaller diaphragms

30
Q

What are progestogen only pills (POPs)

A

Contain progestogens such as levenorgestrol, norethistone, desogestrel
Prevents egg release
over 99% effective if used correctly

31
Q

What are lovima and Hana?

A

POPs - contain desogestrel 75mcg and can be supplied as P medicines

32
Q

What are some contraindications for Lovima and Hana?

A

Active thrombosis
Active or history of liver disease or liver cancer
Active or suspected sex-steroid sensitive cancer - breast, uterine or ovarian
Undiagnosed vaginal bleeding
Pregnancy
Allergic to ingredients such as lactose, soya, or peanut (soybean oil in lovima)

33
Q

When is the best time to take the POP?

A

Days 1 to 5 of cycle (Day 1 = first day of period)

34
Q

If you start a POP after day 5, why do you still have to use other methods of contraception?

A

Protection only starts after taking for 2 days

35
Q

What is the window to take a missed POP?

A

3 hours except desogestrol which is 12 hours

36
Q

Is there a seven day pill free period with POPs

A

No

37
Q

what drugs can affect efficacy of CHCs and POPs when they are taken orally ?

A

Enzyme inducers - carbamazepine, eslicarbazepine acetate, efavirenz, nevirapine, oxcarbazepine, phenytoin, phenobarbital, primidone, rifabutin, rifampicin, ritonavir, St John’s wort, and topiramate

38
Q

If combined oral contraceptives are used correctly do condoms need to be used during the pill free period?

A

No

39
Q

What are some side effects of CHCs?

A

depression
weight gain
mood swings
changes in libido
headches

THROMBOSIS
CANCER

40
Q

What is natural family planning?

A

Tracking the menstrual cycle to see when most fertile and not having sec during this 6 day window.
Can be figured out using basal temperature, changes in mucus and ovulation test but need to know cycle really well.
If done correctly then 91-99% effective

41
Q

What is the implant?

A

Small plastic rod inserted under the skin of the arm that releases progestogen
Lasts for 3 years
99% effective if replaced as needed.
Can make periods lighter but can also make them heavier

42
Q

What is male sterilistion?

A

Vasectomy - sperm ducts are sealed, blocked or cut so sperm is not released on ejaculation
Over 99% effective
Not always reversible if you change your mind

PHAY0010 (27 decks)

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