Sexually History Taking Flashcards
What are the core components of a sexual history?
Presenting Complaint History of Presenting Complaint Past Medical History Past Surgical History Drug History Menstrual/Reproduction History Cervical Smear History Social History- Sexual History and BBV risk assessment
What should you ask about in the history of presenting complaint section of the history?
Description Onset Associated features Pain Bowel or bladder symptoms
What should you ask about in the past medical history section? (inc surgical history here too)
Medical conditions that you see you’re doctor for
Ever been diagnosed with and treated for an STI?
Complete the treatment? Was partner treated?
How was it treated?
Any surgeries
What should you ask about in the drug history section?
Drug allergies- anti-biotic therapy is indicated for most Recent drug treatments (esp antibiotics)
STIs
Alcohol and Smoking
Elicit drug use
(Not alcohol and drug use is associated with an increased risk of STI)
What should you ask about in the menstrual/reproductive section of the history?
Last menstrual period Are periods regular Any spotting in between periods Any bleeding after sex Painful periods Any pregnancies and were these all to term? (any miscarriages)
What should you ask about in the cervical smear section of the history?
Have you ever had a cervical smear?
Have you every had an abnormal result from a smear test? What was the outcome of this?
When was the last time you had a cervical smear test?
All women aged 25 to 64 are invited for cervical screening. 25-49 invited every 3 years. 50-64 every 5 years. 65 and older if 1 of last three tests was abnormal.
What two components are asked about in the social history?
Sexual History
BBV risk assessment
What would you want to ask about in the sexual history part of the social history?
Introduce this part carefully- in order to know what tests or investigations I should request I need to ask you a few personal questions about the last time you had sex and any other times before this. If there are any questions you don’t want to answer you don’t have to. Is that okay?
When was the last time you had sex?
Was this with a man or a woman?
Was this with a regular sexual partner?
What type of sex did you have?- Vaginal, oral, anal (receptive or active)
Did you use any protection or a condom?
Have you had sex with anyone else in the last 12 months?
Same questions as above
Does you sexual partner have any symptoms?
What questions would you want to ask when assessing the risk of blood borne viruses in the social history?
Introduce this part- It is routine to ask everyone some questions to assess their risk of having contracted a blood borne virus such as HIV or Hepatitis B or C. Do you mind if I ask you some questions to assess if there is any chance you could’ve contracted one of these viruses?
Have you ever had a HIV test? Where, when, result.
Have you every had sex with someone who is/was known to be HIV positive?
Have you every had sex with a man who may have sex with other men?
Ever had sex with a man (if a man)?
Have you ever had sex with someone who injects drugs?
Have you ever injected drugs?
Have you been vaccinated for hepatitis B?
Have you ever had a blood transfusion? When, where?
Have you ever had a partner who is from abroad? Where from?
What is four conditions are tested for in a standard STD screen?
Chlamydia
Gonorrhoea
Syphilis
HIV
(Can go suck him)
