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year 3 > Sexual Medicine > Flashcards

Sexual Medicine Flashcards

1
Q

What spirochete causes syphilis

A

Treponema Pallidum

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2
Q

Transmission routes of syphillis

A
  1. Sexual
  2. Accidental infection
  3. Blood bourne
  4. Transplacental
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3
Q

Describe the three types of stages that occur with syphilis

A
  1. Regional lymphadenopathy - resolves in 3-8 weeks
  2. If untreated, virus spreads

LATENT:
1. Asymptomatic

LATE:
1. Spreads to MSK, mucosa, CV and neurosyphilis

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4
Q

Presentation of early syphilis (primary)

A
  1. Painless papule at inoculation site
  2. Spreads and ulcerates (painful chancre with clear margins, moist base and serous exudate on pressure
  3. Bilateral painless regional lymphadenopathy
  4. Oral sex =oropharyngeal ulceration
  5. Balanitis
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5
Q

Where else are chancre sites found

A
  1. Lips
  2. Tongue
  3. Tonsils
  4. Pharynx
  5. Anal margin
  6. Rectum
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6
Q

What is secondary syphilis

A
  1. Heamatogenous dissemination of infection
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7
Q

Clinical features of secondary syphilis

A

1, Macular, papular and hypo-pigmented lesions

  1. Lymphadenopathy
  2. Mucous membrane lesions (white/grey border may coalesce oral cavity, larynx, nasal mucosa, genitalia, anus and rectum)
  3. Alopecia (telogen effluvium)
  4. Periostitis, bursitis (bone pain)
  5. Hepatitis
  6. Glomurulonephirits/nephrotic syndrome
  7. Meningism
  8. Iritis/ anterior uveitis/ optic atrophy
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8
Q

Differentials of secondary syphilis

A
  1. Measles
  2. Rubella (cervical lymphadenopathy)
  3. Psoriasis (papular rash)
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9
Q

What is gummatous syphilis

A
  1. Gumata is syphilitic granulation tissue, nodules with central scarring
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10
Q

Where are gummatous syphilis found

A
  1. Skin
  2. Bones
  3. Mouth and throat
  4. Liver, testis
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11
Q

Clinical features of late syphilis

A
  1. Gummata
  2. CV: Aortic aneurysm, regurgitation
  3. Neurosyphilis: Meningovascular, general paralysis, rabes dorsals
    Tabes Dorsalis: degenration of posterior columns and posterior root(difficulty walking etc)
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12
Q

Clinical features of babies with suyphilis

A
  1. Failure to thrive
  2. Skin lesions around mouth and body orifices
  3. Sparse hair and brittle, atrophic nails
  4. Hepatosplenomegaly
  5. Oesteochondritis and later periostitis
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13
Q

How is syphilis diagnosed

A
  1. Serum from chancres
  2. Cardiolipin antigen test
  3. Treponema pallidum PCR
  4. CSF test if neurosyphilis
  5. X-ray
  6. CT angio
  7. Ophthalmic slit lamp examination
    NEUROIMAGING
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14
Q

What is seen on a syphilis serological test

A
  1. EIA positive, TPPA positive, VDRL positive, IgM positive
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15
Q

How i early syphilis treated

A
  1. Benzathine benzylpenecillin
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16
Q

treatment of late, latent, CV or gummatous syphilis

A
  1. Banzethine benzyl penicillin
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17
Q

Treatment of neurosyphilis

A
  1. Procaine benzylpenecilin
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18
Q

Histology of neisseria gonorrhoea

A
  1. Grame negative

2. Diplococci

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19
Q

Clinical features of n.gonnorheoa in males

A

Incubation: 2-5 days

  1. Urtehral discharge
  2. Dysuria
  3. Yellow/green discharge
  4. Erythema of the urethral meatus + oedema
  5. Anterior uveitis
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20
Q

Clinical features of n.gonnorheoa in females

A
  1. Asymptomatic
  2. Vaginal discharge
  3. Syduria without frequency
  4. lower abdo pain
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21
Q

Complications of n/gonnorhea

A

Male:

  1. Urethral stricture/fistula
  2. Prostatitis
  3. Epididymitis

Inflammation of scene’s glands in women
Pelvic inflammatory disease

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22
Q

Clinical features of disseminated gonococcal infection (systemic spread of infection)

A
  1. Gonococcal dermatitis
  2. Tenosynovitis
  3. Endocarditis
  4. Hepatitis
  5. Meningitis
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23
Q

Diagnosis of n.gonorrhoea

A

VUlvovaginalr, urethral smear for NAAT

Endocervical smear microscopy

Mid-stream microscopy: urethrl sample

Swab from area that seems infected basically

Blood culture

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24
Q

Treatment of n.gonnorheoa

A
  1. Ceftriaxone 1g IM single dose
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25
Q

Clinical Features of c.trachomatis

A

ONLY 60% have signs

  1. INCREASED vaginal discharge
  2. Dysuria without frequency

MALE:

  1. Urethral discharge
  2. Dysuria
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26
Q

Complications of c.trachomatis in males

A
  1. Reiter’s syndrome
  2. Prostatitis/urethritis

Pelvic inflammatory disease

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27
Q

Diagnostics of c.tracheomatis

A
  1. NAAT
  2. Light microscopy
  3. Sterile pyuria in MSM
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28
Q

Treatment of c.tracheomatis

A
  1. Doxycycline
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29
Q

What can cause orgasmic dysfunction and low arousal

A
  1. Partner conflict
  2. Ignorance
  3. Anxiety/depression
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30
Q

Management of orgasmic dysfunction

A
  1. Sensate focus

2. Testosterone gel when both ovaries removed

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31
Q

What is dyspareunia

A

1, Genital pain just before or after sexual intercourse

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32
Q

What is vaginismus

A
  1. Learned response secondary to dyspareunia - involuntary contraction of muscular of OUTER THIRD of vagina cueing distress
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33
Q

Factors that contribute to vaginismus

A
  1. Pregnancy
  2. Loss of control
  3. Sexual abuse
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34
Q

Management of vaginismus

A
  1. Encourage inserting finger in vagina
  2. Proceed to more fingers and use librication
  3. Kegel escercise
  4. Suggest partner involvement
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35
Q

What score system is used for erectile dysfunction

A
  1. IIEF-5
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36
Q

How does the IIEF-5 work

A

Confidence in getting and keeping an erection (1->5)

Erections on sexual stimulation hard enough for
penetration (1->5)

Maintaining erection after penetration

Maintaining erection to completion of intercourse

Satisfactory intercourse

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37
Q

Main causes of ED

A
  1. Lifestyle factors
  2. Trauma and Iatrogenic
  3. Drugs
  4. Vascular
  5. Endocrine
  6. Neuro: MS, Parkinson’s
  7. Psychogenic (depression/anziety
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38
Q

First line management for ED

A
  1. Psychosexual therapy
  2. Sildenafil (PDE 5 inhibitor)
  3. Tadalafil
  4. Prostaglandin E1 agent: Alprostadil
  5. Implants and vacuum devices
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39
Q

What can cause premature ejaculation

A
  1. Anxiety, deep sexual concerns, sexual assault
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40
Q

Primary vs secondary premature ejacultation

A
  1. Primary: ALWAYS been problem

SECONDARY: Performance anxiety, previous control

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41
Q

How is Premature EJ work

A
  1. Ejaculation 1-2 hours before
  2. Deep breath before ejacultaion (reduce stimulation)
    3/ Distraction techniques
  3. Reduce sensation
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42
Q

What is delayed ejaculation

A
  1. Difficulty having an orgasm
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43
Q
  1. What can cause delayed ejaculation
A
  1. Decreased sensitivity
  2. Prostatectomy
  3. MS
  4. Alcohol
  5. DM
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44
Q

Management of delayed ejaculation

A
  1. Reduce masturbation
  2. Resolve underlying anxiety
    3.
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45
Q

What is retrograde ejaculation

A
  1. Semen enter the bladder instead of through the penis during orgasm (dry orgasm)
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46
Q

What can cause retrograde ejaculation

A
  1. Dysautonomia

2. Operation on prostate - transurethral resection of the prostate

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47
Q

How is retrograde ejaculation diagnosed

A
  1. Urinalysis
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48
Q

What is vulvodynia

A
  1. Affects vulvar area, chronic pain syndrome (burning)
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49
Q

How is vulvodynia diagnosed

A

Symptoms must last 3 months

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50
Q

Clinical features of vulvodynia

A
  1. Burning at entrance to vagina that happens when touched (tampons etc)
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51
Q

Causes of vulvodynia

A
  1. Sjogren syndrome
  2. Neuropathy
  3. SLE
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52
Q

How is vulvodynia treated

A
  1. Lubricant during sex
  2. Cotton underwear
  3. Counselling
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53
Q

What is peyronie’s disease

A
  1. disease causes plaques to form after chronic inflammation of tunica albuginea
  2. Causes abnormal curvature of penis
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54
Q

Diagnosis of peyronie’s disease

A
  1. penile ultrasonography
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55
Q

Clinical features of peyrnoie’s disease

A

Sexual intercourse is painful

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56
Q

What causes aspermia

A 
Retrograde ejaculation 
Alpha blockers (tamsulosin)
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57
Q

What is hypospadias

A
  1. Congenital where urethra does no open in its usual location
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58
Q

Clinical feature of hypospadias

A
  1. Foreskin less developed (hooded)
  2. Chordee (downward bending of penis)
  3. Undescended testicles
  4. Pain on ejculation or weak ejaculation
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59
Q

Treatment of hypospadias

A
  1. Urethroplasty
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60
Q

What can cause anejaculation

A
  1. Spinal cord injury
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61
Q

What is female sexual arousal disorder

A
  1. Inability to attain sexual arousal
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62
Q

Diagnosis of female sexual arousal disorder

A
  1. Inadequate lubrication swelling response normally present during arousal
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63
Q

Diagnosis of female sexual arousal disorder

A
  1. Little interest in sex
  2. Few thought related to sex
  3. Decreased start and rejecting of sex
  4. Little genital sensations during sex MOST OF THE TIME
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64
Q

Treatment of female sexual arousal disorder

A
  1. Flibanserin
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65
Q

What is hypoactive sexual desire disorder

A
  1. Lack of sexual fantasies and desire for sexual activity in MALES
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66
Q

How is hypoactive sexual desire disorder treated

A 
COUNSELLING 
FLIBANSERIN (this increases libido
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67
Q

What is sexual aversion disorder

A

IN FEMALES

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68
Q

What is a paraphilia

A
  1. INTENSE sexual arousal to atypical objects, situations fantasies or individuals
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69
Q

What causes pelvic inflammatory disease

A
  1. C.trachomatis
  2. N.gonnroheoa
  3. M.genitalium
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70
Q

What factors can facilitate ascending infection of PID

A
  1. Uterine contractions
  2. Loss of cervical mucus plug
  3. Carriage of bacteria by spermatozoa
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71
Q

Risk factors for PID

A
  1. YOUNG
  2. NEW PARTER within 3 months
    3 .Past history of PID
  3. Vaginal douching
  4. SMOKING
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72
Q

Symptoms of Acute PID

A
  1. Lower abdo pain
  2. Deep dyspareunia
  3. Menstrual regularity
  4. Vaginal discharge
  5. Nausea
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73
Q

Signs of Acute PID

A
  1. Lower abdo tenderness with guarding
  2. Fever
  3. Adnexal mass
  4. Abdo distention
74
Q

Complications of chronic PID

A
  1. Peri-Appendicitis
  2. Infertility
  3. Ectopic pregnancy
  4. Perihepatitis
75
Q

What is Fitz-Hugh-Curtis syndrome

A
  1. Violin string adhesions between anterior surface of liver and abdo wall
76
Q

Investigations of PID

A
  1. SWABS
  2. FBC, CRP, ESR, chlamydial antibody
  3. MSSU
  4. Pelvic Imaging
  5. Lapsoscopy GOLD STANDARD
77
Q

Differentials of PID

A
  1. Ectopic pregnancy
  2. Appendicitis
  3. Ovarian cyst
  4. IBS
78
Q

Management of PID

A
  1. AVOID sexual intercourse and give CEFTRIOXONE + doxycycline
79
Q

Symptoms of Acute prostatitis

A
  1. Prostatic pain
  2. LUTS
  3. Pyrexia, arthralgia
80
Q

Diagnosis of prostatitis

A
  1. MSSU
  2. DRE
  3. BLOOD TESTS
  4. Prostatic specific antigen
  5. MRI of pelvis and lumbar spine
  6. STI screening
81
Q

Management of prostatitis

A
  1. ORAL CIPROFLOXCIN or TRIMETHOPRIM

2. Paracteromal and ibuprofen

82
Q

three causes of haematospermia

A
  1. Trauma
  2. Inflammation
  3. Hypertension
  4. Warfarin
  5. Haematological disorders - laekaemia
83
Q

What classifies a UTI

A

10^5 in Urinalysis

84
Q

Management of Prostatitis

A
  1. Ciprofloxacin
  2. Tamsulosin
  3. NSAIDs
  4. Finasteride
85
Q

What class of drug is finasteride

A

5-alpha reductase inhibitor

86
Q

What causes epipidymo-orchitis

A
  1. c tract or n.gonnorheoa
87
Q

Where does infection spread from in epididymoorchitis

A
  1. urethra or bladder

2. Lymphatics or blood vessels

88
Q

Causes of UTIs

A
  1. Sex

2. Catheters

89
Q

What causes UTIs

A
  1. E coli
  2. Klebsiella
  3. Pseudomonas
  4. Shigella
  5. Salmonella
90
Q

Clinical features of epididymo-orchitis

A
  1. Pyrexia
  2. arthritis
  3. Scrotal erythema
  4. Swelling of epididymis
  5. UNILATERAL scrotal pain and swelling
91
Q

Complications of epididymo-orchitis

A
  1. Hydrocele
  2. Abscess
  3. Infertility
  4. Chronic prostatitis
92
Q

Investigation for epididymo-orhcitis

A
  1. MSSU
  2. Microscopu
  3. FBC, CRP
  4. NAAT swab
  5. Doppler ultrasonography to exclude differentials
  6. Epididymal aspiration
93
Q

Differentials for epididymo-orchitis

A
  1. Torsion
  2. Epididymitis
  3. Testicular cancer
94
Q

Management of epididymo-orchitis

A
  1. NSAID

2. Doxycycline + ceftriaxone

95
Q

What can cause reactive arthritis

A
  1. C trachematis
  2. Ureaplasma urealyticum
  3. N.gonnorheoa
  4. Shigella
  5. Salmonella
96
Q

Clinical features of reactive arthritis

A
  1. Urethritis/iritis/episcleritis
  2. Dysuria
  3. Arthritis (asymmetrical polyarthritis)/enthesistis
  4. keratodemra blennorhagica
  5. Erythema nodosum
  6. Balantis/oral lesions
97
Q

Where is arthritis seen in reactive arthritis

A
  1. Lower limbs

2. Sacroilitis

98
Q

Diagnosis for reactive arthritis

A
  1. Stool culture
  2. ESR.CRP
  3. Urinalysis
  4. Radiology for periostitis/sacrolilitis
  5. ECG
  6. Syonivial tipsy
  7. HLA-B27 test
    RF negative
    ANA test negative
99
Q

How is arthritis and enthesistis in reactive arthritis

A
  1. NCOX-2 NSAID, pred, STI antibiotics
100
Q

What organism causes bacterial vaginosis

A

g.vaginalis

101
Q

histology of g.vaginalis

A

Gram negative bacillus

102
Q

Clinical features of g.vaginalis

A
  1. Vaginal discharge
  2. Moderate volume, grey->white->yellow
    Frothy
    Irritation
103
Q

Complication of g.vaginalis

A
  1. PID

2. Pots-Hysterectomy vaginal cuff cellulitis

104
Q

Treatment of g.vaginalis

A
  1. Metronidazol e

2. Clindamycin

105
Q

How is trichomoniasis infection treated

A

ORAL metronidazole

106
Q

Histology of trichomoniasis

A
  1. Flagella, hydrogenosomes, axostyle
107
Q

Most common organism that causes genitalcandidiasis

A
  1. Candid albicans
108
Q

Pre-disposing factors to genital candidiasis

A
  1. DM
  2. CHild-bearing years: luteal phase of menstruation, 3rd trimester
  3. HIV and drugs that impair immunity
  4. Contraceptives
109
Q

Clinical features of genital candidiasis

A
  1. Vulval pruritus
  2. Burning
  3. External dysuria
  4. Dyspareunia
  5. Vulval erythema
110
Q

What can cause recurrent vulvovaginal candidiasis

A
  1. Hypersensitivity

2. Sex

111
Q

Clinical features of men wit genital candidiasis

A
  1. Balantis

2. Balanoposthitis

112
Q

Diagnosis of genital candidiasis

A
  1. SWABS and microscopy
  2. Latex agglutination test
  3. PCR
  4. Vaginal pH should be normal
  5. Urinalysis
113
Q

Management of genital candidiasis

A
  1. Bathing in saline or Nabicarbonate

2. Clotrimazole or oral Fluconazole

114
Q

Causes of UTI (organisms)

A
  1. Staphylococcus saprophysticus
  2. Ecoli
  3. Proteus mirabilis
  4. Enterococci
    Klebsiella and enterobacter
115
Q

Diagnostics of UTi

A
  1. CLOUDY urine
  2. leucocyte esterase
  3. Nitrate reductase
  4. Protein and haematuria
  5. MSSU (10^5)
116
Q

How are UTIs treated

A
  1. Fluids

2. Nitrofurantoin or trimethoprim

117
Q

Complicated vs uncomplicated UTI

A

1.Uncomplciated are caused by a predictable group of organisms, complicated are not

118
Q

Course of progression of HSV

A
  1. Primary infection
  2. Latency in dorsal root ganglion
  3. Reactivation upon nerve stimulation
  4. Recurrence (peripheral lesions)
  5. Viral shedding
119
Q

Clinical features of HSV

A
  1. Pain
  2. Irritation
  3. Regional node lymphadenopathy
  4. Vaginal/urethral discharge
  5. crusting
  6. Urinary retention, micturition
120
Q

Complications of HSV

A
  1. aSeptic meningiti s
  2. Sacral radiluopathy
  3. PHARYNGITIS
121
Q

Diagnosis of HSV

A
  1. PCR swabs from lesions
  2. Viral cell culture
  3. IgM and western blot serology
  4. Cervical cytology
122
Q

Treatment of HSV

A
  1. Saline washes to reduce risk of superinfection
  2. Drink plenty of flud
  3. Codeine phosphate
  4. Acyclovir (5 days)
123
Q

How to prevent HSV

A
  1. Circumcision
  2. Condom
  3. Antiviral drugs
124
Q

Clinical features of HPV

A
  1. Genital warts found in areas likely to be traumatised udirng sex (prepuce, urethral meatus, scrotum)
125
Q

Treatment of HPV

A
  1. Podophyllotoxin
  2. Cryotherapy
  3. Trichloroacetic acid
  4. Electrosurgery
126
Q

Machoism of action of combined pill, vaginal ring and patch

A

Inhabit ovulation

2. Alter cervical mucus to stop spermatozoa penetration

127
Q

ADVANTAGES of combined hormonal contraceptives

A
  1. Improve acne
  2. Protects against PID
  3. Reduces risk of ovarian cancer
  4. Reduce large bowel cancer
128
Q

DISADVANTAGES of combined hormonal contrraceptive

A
  1. Needs constant use

2. No protection against STI

129
Q

IF Combine spill is missed what should the patient do

A

Take forgotten and take next pill when due

2. If missed two,do the same but abstain for 7 days/codnoms

130
Q

First choice of COC

A
  1. Levonorgestrel
131
Q

Side effects of COC/oestrogen

A
  1. Headaches
  2. Nausea
  3. Breast tenderness
  4. Leg Cramps
132
Q

Side effects of COC/progesterone

A
  1. Mood change
  2. Bloating
  3. Greasy skin
133
Q

What should be given to women postpartum contraception

A

POP

134
Q

Prior to surgery what should be done to the oral contraceptive pill

A

Stop IMMEDIATELY and switch to POP

135
Q

How doe the UKMEC system work for COC

A
  1. More than 35 and smoking less than 15 cigs
  2. BMI >35
  3. Fmaily history of thromboembolic disease
  4. Controlled HTN
  5. Immobility
  6. Gallbladder disease

UKMEC 3

UKMEC 4:

  1. Migraine with aura
  2. Uncontrolled HTn
  3. Current breast cancer
136
Q

What is the time frame of using a copper inauterine device

A
  1. Inserted for emergency contraception within 5 days after unprotected sex
137
Q

Clinical features of PID

A

INFLAMMATION OF UTERUS, FALLOPIAN TUBES< OVARUES AND CERVIX
1. Lower sbdo pain
2. Post coital bleeding
Intermenstrual bleeding

Chornic:
Low grade fever
Weight Loss
ABdo pain

138
Q

Extra genital symptoms of Chlamidya and Gonnorheoa

A
  1. Contact with eyes - conjunctivitis
  2. Contact with anal or rectal mucosa - Proctitis (tenesmus, anorectal pain and bleeding, constipation)
  3. Pharyngitis
139
Q

Treatment of PID

A
  1. IV Cefoxitin -> doxycycline for 14 days
140
Q

Name three cancers caused by HPV

A
  1. Penile, anorectal, oropharyngeal

2. Carvical, vulvar, vaginal

141
Q

What serotypes of HPV cause anogenital warts

A

6 and 11

142
Q

How is HPv diagnosed

A

Appearance of warts or biopsy

143
Q

Treatment of anogenital warts

A

1, Cryotherapy or TOPICAL IMIQUIMOD

144
Q

CF of trichomona vaginalis

A
  1. Bad smelling prurulent discharge
  2. Burning
  3. Pruritus
    LRTI symptoms and lower abod pain
145
Q

DIagnosis of trichomona vaginalis

A
  1. NAAT or microsocpy of vaginal secretion
146
Q

Symptoms of Crabs (pediculosis pubis) and SCabies (sarcoptes scabiei)

A
  1. BOTH PRURITIS
    Lice and nits in crabs can be seen
    Scbaies show erythematous papules

Microsocpic examination of hair shafts or skin

147
Q

Treatment of Crabs

A
  1. Topical Permethrin

2. Nits should be removed with tweezers

148
Q

Treatment of Scabies

A

Oral Ivermectin

149
Q

Primary infection of HSV what does this mean

A 
No previous anti HSV virus antibodies 
1. Painful vesicles
Pruritus
Dysuria
Ignuinal lymphadenopathy 
Fever, headahces myaglgia
150
Q

Diagnosis of HSV

A
  1. Viral culture
  2. HSV PCR
  3. Serology - anti HSV antibodies
151
Q

Treatment of HSV

A

1, Oral acyclovir

152
Q

How does haemophilus decreyi cause infection

A

Micraabrasions in the askin -> ulcers (chancres - bleed when scraped)

153
Q

Diagnosis of haemophilus decreyi

A

PCR
Culture
Gram Stain

154
Q

Treatment of haemophilus decreyi

A

Ceftriaxone IM

155
Q

Primary vs Secondary syphilis (both early syphilis)

A

Primary: Chancres
Resolves and cause systemic infection

Secondary: Comes back but no chancre
Systemic infection: lymphadenopathy in inguinal and femoral regions and cervical
Symmetrical maculapapular rash 
Heptatitis
Oliguria
Arterial Hypertension
156
Q

What defines AIDS

A

CD4 cell count less than 200 mol /ml

Or presence of aids defining illness: pneuomocystic jiroveci

157
Q

Diagnosis of HIV

A
  1. Enzyme-linked immunoassays
  2. Western Blot
  3. HIV viral load test (RNA)

If 1 is negative and 3 is positive - early infection
If both are positive - early or established infection

158
Q

Symptoms of acute hepatitis

A

Nausea
Vomtiing
Upper RQ pain
Jaundice, puritis, dark urine

159
Q

SYmptpoms of chronic hepatiti s

A
  1. Extrahepatic symptoms:
    Arthlagia
    Skin rashes
160
Q

Blood test results in Hep B

A

HBs antigen Pos

161
Q

Blood test results in Hep C

A

Anti-HCV Igg - positive

162
Q

Treatment of Hep B

A

Pegylated INF

Tenofovor

163
Q

Treatment of Hep C

A
  1. Velpatisvir
164
Q

After what time can sexual disorders be diagnsoed

A

6 months

165
Q

Three characteristics of played ejactulation

A
  1. Marked DELAY
  2. MARKED infrequency
  3. ABSENCE
166
Q

What is Male hypoactive sexual desire disorder

A
  1. Few or no sexual thoughts

2. Low or absent desire for sexua activity

167
Q

What diagnosis premature ejaculation

A
  1. Within 1 min of penetration

2. BEFORE they wish to

168
Q

Three features of female orgasmic disorder

A
  1. Delay
  2. Infrequency
  3. Absence of orgasm
169
Q

When is sildenafil taken before sex

A

30 mins to 1 hour BEFORE

170
Q

How is alprostadil delivered

A

Intracacvernous injection

171
Q

How is vaginismus treated

A

Botox injection A

  1. Vulvar vestibulectomy
  2. Lidocaine
172
Q

Gender identity vs expression

A
  1. Own sense of gender vs how they present themselves to the world
173
Q

Define transgender

A

GI is discordant from sex assigned at birth

174
Q

What Hep B serology is seen if positive

A
  1. HepBsAg
    HepBcAb

AntiHBs - vaccination

175
Q

What Microbe causes warts

A

HPV 6 and 11

176
Q

Symptoms of anogenital warts

A
  1. Single or multiple lumps
  2. irritation or discomfort
  3. Bleeding
  4. Rarely, secondary infection or maceration
177
Q

Appearance of genital warts

A

Soft cauliflower-like growths of varying size but can be flat, plaque-like or pigmented.

Lesions can be BOTH moist and non-keratinised and also firm and keratinised

178
Q

Anogenital warts diagnosis

A

Just the appearance

179
Q

Management of genital warts

A
  1. Podophyllotoxin twice daily

Or cryotherapy

180
Q

Management of a pregnant mown with Hep B

A

Only give immunoglobulins and vaccinations

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year 3 (25 decks)

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