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Phase 3A > Sexual Medicine Peer Teaching > Flashcards

Sexual Medicine Peer Teaching Flashcards

1
Q

What is female sexual interest/ arousal disorder

A

Reduced or absent sexual interest, physical responses to sexual stimuli, erotic thoughts, sexual pleasure

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2
Q

What is female orgasmic disorder

A

Absent, infrequent, reduced or delayed orgasm

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3
Q

What is genitopelvic pain/ penetration disorder

A

Fear/anxiety, tightening, vulvovaginal pain with attempted vaginal penetration during or after seex

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4
Q

What is the normal female physical response to sexual stimuli

A

Pelvic vasocongestion, swelling of external genitalia, vaginal lubrication and expansion

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5
Q

Biological causes of female sexual dysfunction

A 
Age
Menopause
Thyroid, DM, pituitary adenoma
Atherosclerosis
Neuro
Meds
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6
Q

Why can menopause cause sexual dysfunction

A

Low oestrogen causes urogenital atrophy, thin, dry skin, pain

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7
Q

Which class of drugs in particular cause female sexual dysfunction?

A

SSRI

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8
Q

Psychological causes of female sexual dysfunction

A

Previous abuse
Body image
Depression/ anxiety

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9
Q

Social causes of female sexual dysfunction

A

Relationship troubles
Life stresses
Pressure to perform

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10
Q

Causes of superficial dyspareunia

A

Vaginismus, insufficient lube, thrush, herpes, vestibulo/vulvodynia

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11
Q

Causes of deep dyspareunia

A

Insufficient lube, pelvic inflammatory disease, endometriosis, cervical pathology

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12
Q

Investigation of female sexual dysfunction

A

History
Exam
Blood pressure
Bloods

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13
Q

Which bloods would you do for female sexual dysfunction

A

TFT, Prolactin, testosterone, oestrogen, SHBG (sex hormone binding globulin), glucose, lipids, FBC

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14
Q

Treatment for female sexual dysfunction

A

Pyschotherapy
Treat underlying physical cause
Kegel exercises
Topical oestrogen

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15
Q

Causes of erectile dysunction

A 
Atherosclerosis
Neuro
DM
High prolactin
Pscyhological
Agnrodgen deficiency
Venoclusive disease
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16
Q

Causes of androgen deficiency

A 
Lack of testosterone
Age, obesity
Chemo, radio, mumps affect testicular function
Pituitary adenoma or prolactinoma
Hypothalamus
Absent gonads
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17
Q

Bloods for ED

A

TFT, Prolactin, testosterone, SHBG (sex hormone binding globulin), glucose, lipids, FBC

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18
Q

Why are atherosclerosis and ED an important connection

A

Will present clinically earlier as smaller artery so smaller plaque has bigger effect on flow

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19
Q

ED treatments

A 
Sildenafil
Intracorporeal injection of alprostadil
Vacuum device
Kegels
Penile ring
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20
Q

What type of drug is sildenafil

A

PDE5 inhibitor (phosphodiesterase)

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21
Q

What type of drug is alprostadil

A

Prostaglandin E1 (PGE1)

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22
Q

Definition of premature ejaculation

A

Inability to control ejaculation, usually under 60s. Requires minimal stimulation, inadequate for both partners to enjoy sex

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23
Q

Causes of premature ejaculation

A

Penile hypersensitivity
Hyperthyroid
Psycho- anxiety, lack of experience, relationship troubles

24
Q

Premature ejaculation treatment

A

Desensitising gel
Couples therapy
Kegels
Stop start continue

25
Q

Name 4 psychosexual couples therapy approaches

A

CBT
Psychodynamic
Stystemic
Inegrative

26
Q

Describe CBT approach to couples therapy

A 
Cognitive= reduces unhelpful thinking
Behavioural= touch exercises with partner, personal sexual growth programme
27
Q

Describe psychodynamic approach to couples therapy

A

Explore unresolved issues, previous dysfunctional relationships

28
Q

Describe systemic approach to couples therapy

A

Interactions/ roles in a relationship

29
Q

Describe the integrative approach to couples therapy

A

Mixed approach

30
Q

What must a sexual disorder be to be classed as a disorder

A

Persistent

Cause marked distress

31
Q

Hypoactive sexual disease disorder

A

Lack or loss of sexual desire causing distress (doesnt preclude sexual enjoyment or arousal but makes the initiation of sex less likely)

32
Q

How is testosterone replacement given

A

Repeat tests, injections, transdermal patches, buccal, subcut implants

33
Q

Premenopausal and hypoactive sexual desire disorder treatment in women

A

Flibanserin

34
Q

Side effects of sildenafil

A

Head aches and flushing

35
Q

Contraindications of sildenafil

A

Hypertension

36
Q

Female orgasmic disorder treatment

A

Topical oestrogens

Behavioural interventions: guided masturbation and vibrators

37
Q

Define vaginismus

A

Spasm of the pelvic floor muscles that surround the vaginal opening, make penile entry painful or impossible

38
Q

Causes of vaginismus

A

Thrush, FGM, Congenital abnormality. Previous trauma/abuse, fear/dislike of partner or pregnancy, misinformed

39
Q

Treatment of vaginismus

A

Self exploration, vaginal dilators, graded penetration therapy

40
Q

Describe candida albicans

A

Cottage cheese.
Immunosuppresion causes it. Diagnosis: MC+S shows mycelia spores
Antifungals: Clotrimazole, fluconazole

41
Q

Describe bacterial vaginosis

A

White fishy smelly
Sexually active, IUCD, new partner
Ix: pH>4.5, CLUE CELLS.
Tx: Metronidazole

42
Q

Describe gonnorhea

A

Neisseria gonorrhoea
Previous STI, multiple partners.
NAAT
IM Ceftriaxzone (+Aziothromycin for chlamydia), contract tracing

43
Q

Descirbe Neisseria Gonorrhoea

A

Gram negative diplococcus

44
Q

What is NAAT

A

Nucleic acid amplification test

45
Q

What symptoms can you get for gonorrhoea

A

Normally none but can get discharge and dysuria

46
Q

What symptoms can you get for chlamydia

A

Usually none but can get discharge, dysuria and IMB

47
Q

Describe chlamydia

A 
Chlamydia Trachomatis
Previous STI, multiple partners. 
NAAT, swabs
PID/ Reiters
Aziothromycin
Contact tracing
48
Q

Describe chlamydia trachomatis

A

Gram negative cocci

49
Q

What is Reiters syndrome

A

Cant see, cant wee, cant climb a tree

Conjuctivitis, urethritis, reactive arthritis

50
Q

What is PID most commonly caused by

A

Chlamydia

51
Q

Describe trichmonas vaginalis

A 
T. Vaginalis
Frothy offensive yellow/green discharge, strawberry cervic, dysuria, itchy and sore
NAAT, swabs
Metronidazole
Treat partner too
52
Q

Describe trichomonas vaginalis histologically

A

Flagellated protozoan

53
Q

Cause of genital warts and consequence

A

HPV 6 and 11, both external so dont have cervical cancer risk

54
Q

Describe genital warts

A

Growths/lesions, multiple or solitary, painless, itch, dyspareunia

55
Q

Diagnosis of genital warts

A

Examination and STI screen

56
Q

Treatment of genital warts

A

Cryotherapy and podophyllotoxin cream

Phase 3A (25 decks)

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