Sexual Medicine Flashcards
What serology may you conduct in a suspected Hepatitis B patient?
HBsAg (production of anti-HBs, suggestive of infection) - present for <6 months
Anti-HBs (immunity through exposure either infection or innoculation)
Anti-HBc (previous or current infection)
LFTs
And a full liver screen:
ANA
SMA
Copper
Ceraluplasmin
Ferritin
Transferrin saturation
AFP
AAT1
What is the risk of transmission of Hepatitis C during a needlestick injury in the UK?
2%
What investigations would show Hepatitis C virus?
HCV RNA with anti-HCV Abs
How is Hepatitis C treated?
Combination of protease inhibitors
How is Hepatitis B treated?
Interferon-alpha
How does HIV seroconversion present?
Glandular fever type illness 3-12 weeks after infection consisting of sore throat, lymphadenopathy, malaise and arthralgia and diarrhoea
What tests are used in diagnosis of HIV?
Combination tests HIV p24 antigen and HIV antibody
Make sure to test asymptomatic patients 4 weeks after possible exposure and then 12 weeks repeat test
What potential complications of HIV may exist?
Oral thrush
Shingles
Hairy leukoplakia
Kaposi sarcoma
Cryptosporidiosis
Cerebral toxoplasmosis
Progressive multifocal leukoencephalopathy
Pneumocystis jirovecii pneumonia
HIV dementia
Aspergillosis
Oesophageal candidiasis
Cryptococcal meningitis
Primary CNS lymphoma
CMV retinitis
What are the main symptoms of Chlamydia in males or females?
Women: Cervitis - discharge and bleeding
Men: Urethral discharge, dysuria
How do you test for Chlamydia?
Men: NAATs from first-void urine
Female: Vaginal swab
What is the management of Chlamydia?
Doxycycline 7/7
If pregnant, Azithromycin or Erythromycin
What are the main symptoms of Chlamydia in males or females?
Women: Cervitis - discharge and bleeding
Men: Urethral discharge, dysuria
What is the main treatment of Gonorrhoea?
Ceftriaxone 1g IM
What are the key features of disseminated gonococcal infection?
Tenosyvitis
Migratory polyarthritis
Dermatitis
What are the main features of Syphilis?
Primary:
Chancre
Tender lymphadenopathy
Secondary:
Fever
Rash
Condylomata lata (painless, warty lesions on the genitalia)
Tertiary:
Gummas
Ascending aortic aneurysms
Paralysis
Argyll-Robertson pupil
How do you manage Syphilis?
IM Benzyl Penicillin
What may occur following treatment of Syphilis?
Jarisch-Herxheimer reaction - destruction of bacteria results in endotoxin release which causes fever, rash, tachycardia after dose of antibiotic
What is the criteria for Bacterial Vaginosis?
Amsel criteria
pH > 4.5
Positive Whiff test
Thin, white discharge
Clue cells on microscopy
How do you manage bacterial vaginosis?
Oral metronidazole 5/7
What are the clinical features of Trichomonas?
Frothy yellow-green discharge
Strawberry cervix
Motile trophozoites
How do you screen for Cervical cancer?
HPV screening
Screen from 25-64
30s = 3 years; 50s = 5 years
Negative = no FU
Positive
+ Cytology abnormal (dyskariosis)
- Colposcopy
+ Normal cytology
- Repeat at 12 months
- If repeat +ve at 24 months, Colposcopy
If sample is inadequate, repeat in 3 months
How is cervical cancer managed?
LLETZ
