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Repro and Sexual Health > Week 2 > Flashcards

Week 2 Flashcards

1
Q

When are the average ages of menopause; Premature ovarian insufficiency and early menopause?

A

Respectively: 51, 40, 40-44

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2
Q

Define perimenopause

A

the period of time between development of menopausal symptoms and the menopause (one year after the last period) (usually years)

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3
Q

Is there management of perimenopause?

A

For perimenopause, we treat symptoms not hormone levels. Even if blood results are tested and normal we still try HRT

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4
Q

When do we test hormone levels in perimenopause?

A

In women between 40-45
In women >45 with atypical symptoms
Women aged >50 on hormonal contraception who want to stop it before 55

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5
Q

What are contraindications of HRT?

A

History of breast or endometrial cancer, unexplained vaginal bleeding, active liver disease, CHD, TIA or stroke

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6
Q

What types of HRT are given in women with hysterectomies or mirena coil

A

Estrogen only HRT

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7
Q

What types of HRT are given in women without hysterectomies or a mirena coil

A

Estrogen and progesterone

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8
Q

When can you stop contraceptives in a woman of 50-54?

A

One year after the last natural menstrual period

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9
Q

What is the mechanism of action of the copper coil for emergency contraception

A

prevention of implantation

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10
Q

What is the MoA of levonorgesterel and Ulipiristal Acetate

A

Delay Ovulation

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11
Q

How effective are Levonorgesterel and Ulipristal Acetate

A

60%-80%

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12
Q

In what situations would Levonorgesterel given over Ulipristal Acetate

A

When hormonal contraception has been used in the proceeding week or is planned on being used in the following week

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13
Q

How long should additional contraception be used for when CHC or POP is started, out with, the first 5 days of your period

A

7 days after CHC or traditional POP and 2 days after POP with desonestregel

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14
Q

What is the management for gonorrhoea?

A

Ceftriaxone 1G IM given as 2 injections, 1 in each butt cheek simultaneously, if antibiotic sensitivities ciprofloxacin 500mg orally

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15
Q

Describe the 4 classifications of FGM

A

Type 1: Clitirodectomy +/- prepuce
Type 2: partial/total removal of the clitoris and the labia minora +/- labia majora
Type 3: narrowing the vaginal orifice by creating a covering seal
Type 4: all other harmful procedures to the female genitalia for non-medical purposes

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16
Q

What bacteria causes syphilis?

A

spirochete bacterium Treponema pallidum

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17
Q

What is the MoA of Sayana Press/Depo Provera?

A

It lowers oestradiol and suppresses FSH

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18
Q

Which STI is caused by a protozoa and can cause strawberry cervix?

A

Trichomoniasis caused by trichomonas vaginalis

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19
Q

What is the management of candidiasis aka thrush?

A

clotrimazole 500mg pessary or fluconazole 150mg stat + clotrimazole 1% cream for external symptoms

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20
Q

How do you drain excess fluid in the pouch of Douglas?

A

via a needle placed through the posterior fornix of the vagina

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21
Q

Where does the ovarian artery originate?

A

The abdominal aorta

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22
Q

Where does the uterine artery originate from?

A

Internal iliac

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23
Q

Where does the vaginal artery originate from?

A

It is a branch of the uterine artery

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24
Q

What types of herpes most commonly causes genital herpes?

A

Type 1: probably because of condomless oral sex

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25
Q

What is the management of Syphilis?

A

Single dose of Benzathene penicillin IM Injection

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26
Q

Which STI is most likely to cause a rash on the palms of the hands and soles of the feet

A

Syphilis

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27
Q

What is the window for Post-exposure Prophylaxis (PEP) against HIV?

A

72 hours

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28
Q

What is the management of PCP?

A

High dose Co-trimoxazole +/- steroid

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29
Q

When is prophylaxis for PCP given and what is given?

A

Co-trimoxazole given when a person with HIV’s CD4 count goes <200

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30
Q

What is the CD4 threshold for cerebral toxoplasmosis?

A

CD4: <150

31
Q

What is the CD4 threshold for CMV?

A

CD4: <50

32
Q

What is the CD4 threshold for PCP?

A

CD4: <200

33
Q

What are the 3 components of the single tablet anti-retroviral therapy (ART)

A

Tenofovir + emtricitabine + efavirenz

34
Q

Name 3 AIDS defining cancers

A

Kaposi’s Sarcoma, non-hodgkins lymphoma, cervical cancer

35
Q

What is the target site for HIV?

A

CD4+ receptors
(CD4 cells are helper t cells)

36
Q

Can mothers with HIV breastfeed?

A

NO

37
Q

What is the management of a woman with HIV having a baby?

A
  1. HAART during pregnancy
  2. Vaginal delivery only if UNDETECTABLE
    VIRAL LOAD (c-section if detectable)
  3. 2-4/52 PEP for neonate
  4. Exclusive formula feeding
38
Q

What is the pharmacological management of Pelvic inflammatory disease?

A

14 days metronidazole and doxycycline b.d. or IV if in hospital

39
Q

What are some risk factors for PID?

A

<25 years old
PMHx of PID
more than 1 and/or a new sexual partner
not using barrier contraception
having and IUD

40
Q

What are some risk factors for PID?

A

<25 years old
PMHx of PID
more than 1 and/or a new sexual partner
not using barrier contraception
having and IUD

41
Q

What is the pharmacological management of chlamydia?

A

doxycycline bd 7 days
or if there is any chance theyre pregnant azithromycin for 3 days

42
Q

What is the pharmacological management of bacterial vaginosis?

A

Metronidazole for 5 days

43
Q

What is the presentation of bacterial vaginosis?

A

may be asymptomatic (in 50%)
- fishy smelling discharge
- no irritation/discomfirt/itch

44
Q

If a women has a PMHx of breast cancer, what is the best form of contraception for her?

A

Copper coil (IUD)

45
Q

List some of the benefits of taking HRT

A

SYMPTOM RELIEF: reduction of vasomotor symptoms, improvement of low mood associated with the (peri-) menopause, increased cognitive function, increased sexual function
Decreased osteoporosis
Decreased CVD

46
Q

What is the first line pharmacological management of GMS?

A

Local/topical oestrogens +/- moisturisers and lubricants

47
Q

Which red flag symptoms require urgent cessation of the Oral Contraceptive Pill?

A
  • high blood pressure
  • new onset headache or neurological
    symptoms
  • acute chest-pain / SOB
48
Q

How long can HIV tests be negative after HIV infection?

A

3 months

49
Q

What is the management of premenstrual syndrome?

A
  1. Lifestyle: exercise, relaxation, yoga, breathing, vitamin B6
  2. Pharmacology: CHC
    Progesterone mirena IUS or POP + estradiol patches
50
Q

What are some triggers of vaginismus?

A
  • fearing that your vagina is too small
  • a bad first sexual experience
  • an unpleasant medical examination
  • believing sex is shameful or wrong
  • a painful medical condition, like thrush
51
Q

Can you take lithium during pregnancy?

A

Yes
(It is important to take it to lower the risk of puerperium psychosis)

52
Q

Does sodium valproate affect the efficacy of any contraceptive measures?

A

No

53
Q

Which anti-convulsants are liver enzyme inducers?

A
  • phenytoin
  • carbamazepine
    NOT lamotrigine
54
Q

What forms of contraception are contraindicated if on lamotrigine?

A

Oral contraceptives (due to potential interactions)

55
Q

If a patient is on a liver enzyme inducer for epilepsy, what is the best form of contraception for her?

A

Cu-IUD

56
Q

Under what age would we generally offer STI screening even if they have had the same partner for >1 year

A

25

57
Q

What form of contraception does high BMI have risks that outweigh the benefits, and at what BMI?

A

CHC
BMI>35
this is because of VTE risk

58
Q

A patient used to suffer from migraines with aura, but they stopped 6 years ago, can CHC be prescribed?

A

In migraines with aura 5+ years ago, the risks of CHC outweigh the benefits

59
Q

Is past pelvic inflammatory disease a contraindication for coils?

A

No- not at all

60
Q

Which contraceptives does smoking affect?

A

Only CHC
this is because of VTE risk

61
Q

What is the social limit for a TOP?

A

23 weeks + 6 days

62
Q

How do you perform an HIV test?

A

A blood test where antibodies are tested is the typical screening test for HIV. The p24 antigen is a specific HIV antigen in the blood that can be tested for. This can give a positive result earlier in the infection compared with the antibody test.

63
Q

What colour is discharge due to candidiasis?

A

Creamy white discharge with redness

64
Q

What is the appearance of discharge due to bacterial vaginosis

A

fishy malodorous discharge. It is grey and whitish in colour

65
Q

How does trichomoniasis usually present

A

Asymptomatic in about 70%
If symptomatic, yellowish/green frothy along with itching

66
Q

How do you test men for chlamydia?

A

Urine sample

67
Q

What is the biggest contributor to HIV ART resistance?

A

Poor adherence to medication

68
Q

How long is the incubation period of gonorrhoea?

A

2-5 days

69
Q

What is the management of trichomoniasis?

A

Metronidazole

70
Q

If Gonorrhoea is diagnosed, what must you do?

A
  • Treat the gonorrhoea
  • Test for, chlamydia, syphilis and HIV (Hep B if risk factors)
  • Partner notification
71
Q

When in a woman’s cycle does PMS affect sufferers?

A

Luteal phase (after ovulation, relief with period)

72
Q

When can you stop contraceptives in a woman of under 50 if she’s lost her period?

A

2 years

73
Q

What is the copper coil’s MoA when not used for emergency contraception

A

Prevention of fertilisation (through toxicity to sperm and ova)

74
Q

Which cancers risk increases with use of CHC?

A

Breast and cervical (breast far more)

Repro and Sexual Health (7 decks)

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