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Phase 3A > Sexual Medicine > Flashcards

Sexual Medicine Flashcards

1
Q

What are the four stages of the sexual response cycle?

A
  1. Desire (libido)
  2. Arousal (excitement)
  3. Orgasm (climax)
  4. Resolution
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2
Q

What is a sexual disorder?

A

Difficulty, either by an individual or a couple, during any stage of normal sexual activity.
It must cause the individual/couple extreme distress, and be persistent for a minimum of 6 months.

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3
Q

For something to be classed as a sexual disorder what 2 things does it need to be to be?

A
  1. It must cause the individual/couple extreme distress

2. Be persistent for a minimum of 6 months.

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4
Q

What is erectile dysfunction?

A

The inability to develop or maintain an erection of the penis during sexual activity

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5
Q

List two psychological causes of ED

A

Any 2 of the following;

  • Stress
  • Depression
  • Performance anxiety
  • Relationship issues
    Script issues
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6
Q

List two medical conditions that can cause of ED

A

Any 2 of the following;

  • ATHEROSCELROSIS - obesity, smoking
  • DIABETES MELLITUS
  • Cardiovascular disease
  • Kidney failure
  • Hormone imbalance
  • Neurological problems such as MS, trauma to the nerves
  • Peyronie’s disease
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7
Q

Name 2 investigations that you would want to do on a patient presenting with ED

A

Any of the following investigations may be appropriate;

  • Glucose / lipid profile (diabetes, obesity, cholesterol)
  • Blood pressure
  • Hormone levels (testosterone, prolactin)
  • Physical examination
  • Blood tests
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8
Q

What is the first line medication currently used to treat ED?

What is its mechanism of action?

A

Viagra (Sodenafil)

PDE 5 inihibitor

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9
Q

List 1 device that can be used to treat ED

A
  • Vacuum/penis pump

- Penile/Scrotal rings

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10
Q

Give 3 pieces of lifestyle advice to someone with ED

A
  • Exercise (increase blood flow and prevent/slow atherosclerosis)
  • Lose weight (if patient is overweight)
  • Stop smoking
  • Reduce alcohol consumption
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11
Q

What is premature ejaculation?

A
  • A sexual arousal disorder
  • An male orgasm that occurs before their partner achieves orgasm / mutually satisfactory length of time has passed during intercourse (generally ejaculation that occurs in under 2 minutes of penis insertion).
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12
Q

List 1 medical condition and one psychological condition that can cause premature ejaculation

A
  • Thyroid problem (whether this be over or underactive)
  • Depression
  • Performance anxiety
  • Relationship issues
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13
Q

What is retrograde ejaculation?

A

When semen travels back into the bladder instead of the urethra.

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14
Q

How could you test for retrograde ejaculation?

A
  • Patient history - reports little to no ejaculation during orgasms
  • Urine sample (check for semen), cloudy urine - sample should be from urine produced immediately after sex
  • Scans
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15
Q

What is the main problem caused by retrograde ejaculation?

A

Can affect the ability to have a child (does not affect the ability to orgasm or enjoy a healthy sex life).

Usually individuals do not need treatment unless they are wanting to father a child - IVF or artificial insemination.

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16
Q

What is dyspareunia?

A
  • Pain during intercourse

- Pain disorder

17
Q

List 3 medical causes of female dyspareunia (superficial)

A

Any of the following 3;

  • Episiotomies
  • Lack of sexual arousal
  • Vaginismus
  • Genital irritation – latex condoms, products
  • Vaginal Atrophy
  • Insufficient lubrication (vaginal dryness) – menopause
  • Infection: STI, thrush
18
Q

List 2 medical causes of female dyspareunia (deep)

A

Any of the following 2;

  • PID
  • Endometriosis
  • IBS
  • Constipation
19
Q

List 2 medical causes of dyspareunia in men

A

Any of the following 2;

  • Infection: STI’S, thrush
  • Urethral strictures
  • Prostatitis
  • Varicoceles
20
Q

List 2 psychological causes of dyspareunia

A

Any 2 of the following;

  • Poor partner technique
  • Anxiety / stress
  • Previous trauma e.g. bad first experience, rape
21
Q

How would you treat dyspareunia?

A

Depends on the cause!

  • Lubrication
  • Couples therapy
  • Behavioural therapy
  • Testing and treatment for STI
22
Q

What is vaginismus?

A

Involuntary spasm of the pelvic floor muscles that surround the vaginal opening.
Spasms make penile entry painful and/or impossible.

23
Q

List 1 medical cause of vaginismus

A

Any of the following;

  • Thrush
  • FGM
  • Congenital abnormalities
24
Q

List 1 psychological cause of vaginismus

A

Any of the following;

  • Previous trauma/abuse
  • First bad sexual experience
  • Fear or dislike of partner or pregnancy
25
Q

What treatment exists for vaginismus?

A
  • Vaginal trainers: objects of different sizes that can be inserted into the vagina and gradually help to widen it and allow the patient to become used to having things in the vagina
  • Pelvic floor exercises
  • Psychosexual therapy
26
Q

What is Peyronie’s disease?

A

Extreme curving of the penis during erection

27
Q

List some psychological therapies

A
  • Sensate focus

- Personal sexual growth programme

28
Q

Hormone tests

A
  • TSH
  • Oestrogen
  • Testosterone
  • Free andoregn index
  • GnRH
  • LH
  • FSH
  • Prolactin
29
Q

What are the principles of couples therapy?

A
  • Create a working alliance with the couple
  • Offer insight and understanding into their problems
  • Facilitate more effective communication
  • Chaneg dysfunctional theought patterns
30
Q

Woman presents with grey, thin, fishy smelling discharge. You take a swab and look under the microscope. What are you expecting to see? What would you expect the pH of the sample to be?

A

CLUE CELLS - BV.

pH > 4.5

31
Q

How do you treat BV?

A

Metronidazole

32
Q

How do you treat trichomonas?

A

Metronidazole

33
Q

List 4 groups at risk of HepB

A

Homosexual men

Injecting drugs

High risk areas - africa, asia, eastern europe

Commercial sex workers and their partners

34
Q

List 2 complications associated with chlamydia infection

A
  • PID

- Reiters syndrome

35
Q

A woman was diagnosed with chlamydia 2 weeks ago. She has now developed conjuncitivis and a very sore, swollen left knee. What is the most likely diagnosis?

A

Reiters syndrome

36
Q

Is HIV a notifiable disease?

A

No

37
Q

Is HIV the same as AIDs - what is the difference?

A

CD4 count < 200 = AIDs.
HIV is the virus.
AIDs is the state of the immune system.

38
Q

A lady has recently been diagnosed with pneumonia and has been taking ciprofloxacillin. She presents to you complaining of an itchy vulva. What is the most likely diagnosis?

A

CANDIDA - can follow use of broad spectrum antibitoics.

Phase 3A (17 decks)

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