Sexual hx Flashcards
overall structure
WIPE
confidentiality
HPC
PMH + previous STIs
DHx + allergies + FHx
(women = menstrual cycle, contraception, pregnancy, smear)
sexual hx
domestic violence check
risk assessment
vaccination hx
offer leaflet & condoms
HPC male/female/both
male: dysuria // discharge // testicular pain/swelling
female: change to discharge (colour, smell, amount) // IMB/PCB // UTI sx // PID sx
both: blisters // rashes // ulcers // lymph nodes
partner symptoms
sexual hx template
when, who, gender, time
what, condoms, extras, and 3 months time
chlamydia mx
NAAT // doxycycline
abstinence // PN // contraception
gonorrhoea mx
NAAT & CULTURE // ceftriaxone
PN // test of cure // superG
genital herpes mx
https://www.nhs.uk/conditions/genital-herpes/
standard STI screen
chlamydia, gonorrhoea NAAT
HIV/syphillis bloods
tailored screening STIs
standard &
MSM: 3-site testing
HepB&C: sexual/endemic risk
symptom-based STI tests
vaginal infections (BV, TV, candida): microscopy
urethritis: microscopy
TV: VVS NAAT
gonorrhoea: microscopy & culture from infected site
herpes & tropenems: PCR
mycoplasma genitalium: NAAT
tests on male presenting with small penis ulcer
Viral swab for HSV / TP, CT/GC urine, HIV/syphilis blood
female testing after a new partner
CT/GC VVS, HIV/syphilis blood
female with itchy vaginal discharge
CT/GC VVS plus TV, microscopy of vaginal wall (gram stain and wet mount), HIV/syphilis blood
male with pain on passing urine
Microscopy of endo-urethral sample (Gram stain), Gonorrhoea culture, CT/GC urine, HIV/syphilis blood
male with testicular pain
Microscopy of endo-urethral sample (Gram stain), Gonorrhoea culture, CT/GC urine, Mid-stream urine dip and culture, HIV/syphilis blood
female with PCB
CT/GC VVS plus TV, microscopy of vaginal wall (Gram stain and wet mount), microscopy of endocervix (Gram stain), Gonorrhoea culture endocervix, HIV/syphilis blood