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Phase 3A Revision > Sexual Medicine > Flashcards

Sexual Medicine Flashcards

1
Q

What is bacterial vaginosis?

A

Caused by loss of healthy bacteria in the vagina, that normally secrete lactic acid to keep the pH low, meaning that the pH rises and other bacteria can grow
Not sexually transmitted

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2
Q

What are the risk factors for bacterial vaginosis?

A

Excessive vaginal cleaning
Recent antibiotics
Smoking
Copper coil

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3
Q

What is the presentation of bacterial vaginosis?

A

Fishy-smelling grey/white discharge
Half of women are asymptomatic
NOT typically associated with itching or pain

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4
Q

What is the management of bacterial vaginosis?

A

Asymptomatic = no management
Metronidazole
Rule out other STis

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5
Q

What is the most common causative organism of vaginal candidiasis?

A

Candida albicans

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6
Q

What are the risk factors for thrush?

A

Increased oestrogen (pregnancy) (lower pre-puberty or post-menopause)
Poorly controlled diabetes
Immunosuppression
Broad-spectrum antibiotics

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7
Q

What are the symptoms of vaginal candidiasis?

A

Thick, white discharge that does not typically smell
Vulval and vaginal itching

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8
Q

What is the management of uncomplicated thrush?

A

Single dose intravaginal clotrimazole cream/pessary
Single dose of fluconazole

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9
Q

What is the causative organism of chlamydia?

A

Chlamydia trachomatis

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10
Q

What is the presentation of chlamydia in women?

A

Abnormal vaginal discharge
Pelvic pain
Abnormal vaginal bleeding
Dyspareunia
Dysuria

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11
Q

What is the presentation of chlamydia in men?

A

Urethral discharge/discomfort
Dysuria
Epididymo-orchitis
Reactive arthritis

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12
Q

How do you diagnose chlamydia?

A

NAAT (First catch urine sample or urethral swab)

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13
Q

What is the management of chlamydia?

A

Doxycycline BD for 7 days

Doxycycline contradicted in pregnancy so consider azithromycin, erythromycin or amoxicillin

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14
Q

What is the causative organism in gonorrhoea?

A

Neisseria gonorrhoeae

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15
Q

What is the presentation of gonorrhoea in women?

A

Odourless purulent discharge, possibly green or yellow
Dysuria
Pelvic pain

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16
Q

What is the presentation of gonorrhoea in men?

A

Odourless purulent discharge
Dysuria
Testicular pain or swelling

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17
Q

What is the management of gonorrhoea?

A

Single dose IM ceftriaxone if sensitivities not known
Single dose oral ciprofloxacin if sensitivities known

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18
Q

What is the presentation of trichomonas vaginalis infection?

A

Frothy, yellow-green, fishy smelling discharge
Itching
Dysuria
Dyspareunia
Balanitis
Cervicitis

19
Q

What is the management of trichomoniasis?

A

Refer to GUM
Metronidazole

20
Q

What is the presentation of genital herpes?

A

Ulcers/blistering lesions around genital area
Neuropathic pain
Flu-like symptoms
Dysuria
Inguinal lymphadeopathy

21
Q

What is the management of genital herpes?

A

Aciclovir
Paracetamol
Topical lidocaine

22
Q

What is the causative organism of syphilis?

A

Treponema pallidum

23
Q

What is the presentation of primary syphilis?

A

Painless genital ulcer (chancre), usually resolving over 3-8 weeks
Local lymphadeopathy

24
Q

What is the presentation of secondary syphilis?

A

Occurs after chancre has healed
Maculopapular rash
Condylomata lata (grey warts around genitals and anus)
Low-grade fever
Lymphadeopathy
Alopecia
Oral lesions

25
Q

What is the standard treatment for syphilis?

A

Single IM benzathin benzylpenicillin

26
Q

How long does an IUD (copper coil) take to become effective contraception?

A

Instantly

27
Q

How long does the POP take to become effective contraception?

A

2 days

28
Q

How long does an IUS (Mirena) take to become effective contraception?

A

7 days

29
Q

How long does the COCP take to become effective contraception?

A

7 days

30
Q

How long does the implant (Nexplanon) take to become effective contraception?

A

7 days

31
Q

How long does the contraceptive injection take to become effective?

A

7 days

32
Q

How does the COCP prevent pregnancy?

A

Preventing ovulation
Thickening of cervical mucosa (progesterone)
Inhibition of endometrial proliferation (progesterone)

33
Q

What are three common regimes for taking the COCP?

A

21 days on and 7 off
63 days on and 7 off (tricycling)
Continuous use

34
Q

What are the side effects and risks of the COCP?

A

Unscheduled bleeding –> common in first 3 months but settles with time
Breast pain/tenderness
Mood changes
Headaches
Hypertension
VTE
Breast and cervical cancer
MI and stroke

35
Q

What are the benefits of the COCP?

A

Effective contraception
Rapid return of fertility
Improvement in premenstrual symptoms, menorrhagia and dysmenorrhoea
Reduced risk of endometrial, ovarian and colon cancers
Reduced risk of benign ovarian cysts

36
Q

What are the UKMEC4 contraindications for taking the COCP?

A

Uncontrolled hypertension
Migraine with aura
History of VTE
Age over 35 and smoking more than 15 per day
Major surgery with prolonged immobility
Vascular disease or stroke or ischaemic heart disease
Liver cirrhosis/tumours
SLE

37
Q

What is the UKMEC4 contraindication for taking the POP?

A

Active breast cancer

38
Q

How is the POP taken?

A

Continuously

39
Q

What are the side effects and risks of taking the POP?

A

Changes to bleeding schedule (1/3 have amenorrhoea or less regular bleeds, 1/3 have regular bleeds and 1/3 have unscheduled heavier or prolonged bleeds)
Breast tenderness
Headaches
Acne
Ovarian cysts
Ectopic pregnancy
Breast cancer

40
Q

What are the side effects and risks of the progesterone depot injection?

A

Weight gain (unique to injection)
Acne
Reduced libido
Mood changes
Headaches
Flushes
Hair loss
Skin reactions
Osteoporosis (unique to injection)
Breast and cervical cancer

41
Q

How long does a contraceptive implant last before it needs replacing?

A

3 years

42
Q

How long after unprotected sex can the copper coil be used as emergency contraception?

A

5 days

OR 5 days after estimated ovulation date

43
Q

How long after unprotected sex can levonorgestrel be used as emergency contraception?

A

Within 72 hours

44
Q

How long after unprotected sex can ulipristal be used as emergency contraception?

A

120 hours

Phase 3A Revision (23 decks)

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