Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sheff 3a > Sexual Medicne > Flashcards

Sexual Medicne Flashcards

1
Q

What is female sexual dysfunction

A

Disorder of 1 or more of
Sexual desire, arousal, orgasm, sexual pain (dyspareunia / vaginismus)
-> significant personal distress and reduced quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of female sexual dysfunction

A

Psych - previous trauma / abuse, body image, depression / anxiety

Social - relationship concerns, stress (work, wishes and fears, pressure to perform)

Biological - diabetes, vascular, hormone imbalance (eg menopause), alcoholism
Neurologcal - Eg cauda equina / paralysis

Drugs - SSRIs, b-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Superficial and deep egs of dyspareunia ?

A

Superficial - thrush, herpes, vaginismus (pelvic floor spasm)

Deep - PID, endometriosis

Both - lack of lubrication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ix in dyspareunia ?

A 
Sexual hx 
Physical exam - esp if in pain 
Bloods -glucose and lipids (DM/CVD) 
- sex hormones: testosterone, SHBG (sex hormone binding globulin), oestrogen 
Prolactin, TSH, FBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Psychological treatments in sexual probs

A

Cognitive (addresses unhelpful thinking styles)

Behavioural (sensate focus = increasing touch exercises with partner, self growth programme)
Educations, sex toys, lubricant, kegel exercises

CBT (cognitive + behavioural combo)

Psychodynamic (unconscious though processes) - Eg unresolved conflicts and past dysfunctional relationships

Systemic (interactions and roles in relationship/ family dynamics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Other than behavioural /psych treatments what can be done for female sexual issues?

A

Kegel exercises
Treat any medical causes
Oestrogen replacement
?androgen therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Erectile dysfunction
Causes?
Ix?
Mx?

A

Physiological - Neuro disease, CVD, androgen deficiency, prolactin, venoocclusive

Psychological - depression, substance abuse, performance anxiety, relationship problems, sexual script problems

Ix
Glucose, lipids, BP, testosterone

Mx 
Viagra
Injectable / intraurethral aloprostadil 
Vacuum device 
Penile / scrotal ring 
Kegal exercises 
Enhanced lube / vibrators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of androgen deficiency?

A

Lack of testosterone, older men, obesity
Chemo / radiotherapy / mumps (affect testicular function)
Pituitary issue - adenoma / prolactinoma (stops production of gonadotropins)
Hypothalamic
Absent gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mx of androgen deficiency in men ? CI/SE?

A

1st line - viagra (PDE 5 inhibitor)
Eg sildenafil, vardenafil
S/E - side effect, headache, facial flushing, dyspepsia
CI- hypotension

Injectable / intraurethral alprostadil
CI- partner is pregnant / tiring
S/E - penile fibrosis, priapism

Vaccum device - don’t use >30mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define rapid ejaculation?
Cause? Comorbid common?
Ix?
Mx?

A

Inability to control ejaculation sufficiently for both partners to enjoy sex

Physiological - penile hypersensitivity, hyperthyroid,
Psychological - Anxiety, early learned experience, lack of sexual experience, relationship issues

Co-morbid - erectile dysfunction

Ix
LFTs, lipids, sugar, testosterone, prolactin, TSH

Mx
Stud 100 spray - local anaesthetic
Couples therapy
Behavioural - kegal exercises , stop-start technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypoactive sexual desire causes? Treatment?

A

Physiological - chronic disease, CVD, anaemia, DM, obesity, androgen deficiency, hypothyroid, hyperprolactinaemia

Psychological - previous abuse, sexual script, relationship problems, body image

Tx - psychosexual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is couples therapy? 4 types?

A

Work together to overcome conflicts

CBT - focus on the dysfunction belief and behaviours in the here and now

Psychodynamic - relationship between current and past issues - explore

Systemic - process and context

Integrative - uses understanding + interventions from more than 1 approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is paraphilia ?

A

Sexually arousing fantasies / urges / behaviour that involves non human objects, suffering or children

Eg fetish, cross dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BV signs?
Cause?
Mx?

A

Grey/white discharge, raised pH, fishy odour, clue cells

Gardnerella vaginallis and mycoplasma hominis

Metronidazole / clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of candida Albicans? What if it is recurrent?

A

Clotrimazole pessary and cream (or tablets)

Fluconazole tablets if recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment choices for chlamydia ? What is related syndrome?

A

Azithromycin – 2 or 4 tabs at once
Doxycycline – two caps a day for a week

Reiter’s syndrome – conjunctivitis, uveitis and urethritis -> reactive arthritis

17
Q

Type of organism is gonorrhoea ? Treatment? Issues in pregnant? Birth?

A

Gram negative diplococcus

Ceftriaxone IM and oral azithromycin

Preterm, LBW, chrioamnionitis

Birth - purulent conjunctival discharge -> corneal damage

18
Q

Type of organism is trichomonas vaginalis ? Famous feature? Signs? Treatment?

A

Flagella Protozoa
Strawberry cervix
Green/grey smelly frothy discharge
Wet film -> polymorphonuclear leucocytes

Metronidazole

19
Q

Sexual health ix in aSx men ? What extra if sx?

A

First void urine CT/GC
NAAT
Syphilis / HIV serology

Dipstick
Urethral swab with GC culture

20
Q

Additional Ix in aSx MSM? If sx?

A

Pharyngeal / rectal swab for NAAT
Hep b serology

Gram stain and culture for CT/GC

21
Q

What is NAAT?

A

Nucleic acid amplification test

For virus / bacteria Eg chlamydia

22
Q

Sexual Ix in aSx women? Additional if Sx?

A

Endocervical / self taken Volvo-vaginal swab CT/GC NAAT
Syphilis /HIV serology

Wet and dry high vaginal swabs for candida, BV and trichomonas
Gram stain and culture for CT/GC

23
Q

Mx of candida?

A

Clotrimazole pessary
Oral fluconazole
Topical antifungal to remove itching

24
Q

How many are asymptomatic in gonorrhoea? Mx?

A

50% women (most men have sx)

Ceftriaxone 500mg IM + azithromycin 1g stat dose

CONTACT TRACING

25
``` Syphilis organism ? Stages? Ix? Mx? What often worsens prognosis? ```
Treponema pallidum 1- chancre (ulcer) 2- non-Prurtic maculopapular rash - ESP on soles and palms Condylomata Lata - moist wart like lesions Snail tract lesions Viral type illness Latent - positive serology with no symptoms 3- neurosyphilis, aortitis, gummatous Ix - blood test IM benzylpenicillin & contact tracing Co-infection with HIV
26
Herpes sx? Ix? Mx?
HSV 1 (oral) or 2 Painful blisters external genitalia and surrounding skin -can have viral illness / discharge Recurrent after a latent period - usually less severe Viral culture Oral acyclovir & abstain from sex until lesions cleared
27
A 23 year old woman comes to see you because her boyfriend has recently noticed some discharge from his penis. He says it’s ‘fine’ but she is worried it might be something sinister. She has no symptoms herself. You take endocervical swabs and culture shows a gram negative bacteria that is sensitive to doxycycline. What organism is causing her infection?
Chlamydia trichomatis
28
A 24 year old man sees you in GUM clinic. He has recently had unprotected sex with his male housemate. He admits to having tried IV drugs in the past. What investigations are appropriate? He has syphilis - what 2 approximate mx steps?
First void urine, pharyngeal/rectal swabs, Syphilis/HIV/Hepatitis B serology IM benzylpenicilin & contact tracing
29
Natural hx of syphilis?
Primary – chancre lesion Secondary – palmar/sole rash (maculopapular), flu like symptoms Latent phase Tertiary – neuro, CV, Gummatous
30
Man has mouth ulcers - which virus is most likely? | Could he give his GF genital ulcers through oral sex?
HSV1 | Yes can cause genital as well as HSV2
31
A 19 year old female visits you in GP. She is worried because she has noticed some ‘unusual’ discharge from her vagina. It doesn’t smell particularly and though she admits to being sexually active, she says she always uses condoms. What investigations would you want to do? Swabs come back clear - what advice?
Wet and dry high vaginal swabs, endocervical swabs, offer HIV/syphilis serology Discharge is likely physiological - might be cycle related Return to GP if any change or odour occurs
32
Causes of delayed ejaculation in men? 4 from each category
``` Psych Pressure to perform Previous sex problems Trust issues Guilt Poor arousal Lack of stimulation Relationship conflict ``` ``` Medication Radiotherapy SSRI Antipsychotics Pelvic surgery ``` ``` Physical Prostitis Neuropathy - Diabetes Congenital Trauma Neurological disorders -MS Decreased testosterone, increased prolactin Infectious disease ```
33
main parts of IX for delayed ejaculation and what happens?
Physical exam Penis, scrotum, epididymus, prostate, vas deferents Bloods PSA, prolactin, lipids, sex hormone binding globulin, TSH,FBC, Swabs, Blood pressure Urine sample -> sperm / fructose -> rules out retrograde ejaculation
34
Management of delayed ejaculation
``` Couples therapy Senate focus Individual CBT Personal sexual growth Kegals ``` Vacuum device - CI in warfarin Viagra - CI if hypotension
35
Investigations for reduced desire in women ?
Oestrogen, LH,FSH, GnRH, testosterone TSH, prolactin, HbA1C, lipids, glucose, FBC
36
Physical causes of female reduced desire ?>
``` Menopause Depression Diabetes Hypothyroid Anaemia ``` Pelvic pain disorders MS Drugs SSRIs, COCP, tamoxifen, HRT
37
Impact of reduced desire on partner?
``` Low self esteem Unwanted / rejected Inadequate Pressure on relationship Choose to leave Partner blames self -> Develops own sexual problems ```
38
How does homosexuality affect treatment of reduced desrire ?
Doesn’t if they’re comfortable If uncomfortable -> explore in therapy - how do they feel about self
39
Management of female reduced desire ?
``` Eros devise Senate focus, sexual growth Lube / oestrogen (vaginal dryness) Masturbation and exploration Individual and couple therapy Kegals ```

Sheff 3a (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions