Wk 32 - Female biological sex Flashcards
What are the risk factors of UTI?
- Female (15-34)
- Pregnancy
- Intercourse
- Hx UTI
- Catheterization
- Immunosuppression
What are the symptoms of UTI?
- Dysuria
- Freq.
- Urgency
- Foul smelling
- Suprapubic tenderness
What is first line treatment for UTI?
- Usually resolves w/in 3 days
- Drink fluids
- Paracetamol
- Hygiene - front to back
- Avoid caffeine, alcohol + acidic drink
- Don’t resist urge to urinate
What are the red flags for UTI?
- No improvement after 3 days
- Systemic infection
- Pregnant
- <16
- Confused elderly
- Uncontrolled diabetes
- Male
What are the risk factors of thrush?
- Broad spec antibiotics: cephalexin, claryth, co-amox
- Cushing
- Uncontrolled diabetes + SGLT2
- Corticosteroids
- Immunosuppression
- Pregnancy, COC, HRT
What are the symptoms of thrush?
- Vulval or vagincal itching
- Redness, burning + irritation
- Discharge white + cheese like
- No smell
- Dysuria
What is first line for thrush?
Oral fluconazole
- 150mg caps stat
- CI: pregnant + breastfeeding
What is second line for thrush?
Clotrimazole 2%:
- 16-60
- BD/TDS for wk
- > 7 days refer
- W/ 500mg pessary 1 stat at night
What are the counselling points for thrush?
- Avoid tight fitting clothes
- Wear loose fitting underwear
- Avoid perfumed prods around genital area
- Clotrimazole can damage condoms
- Should clear w/in 7-14 days
What are the red flags for thrush?
- 1st presentation
- <16 + >60
- Diabetic
- 2 in 6 months
- Hx STI
- Ab bleed
- No improvement after 7 days
- Systemic infection
What are the risk factors of BV?
- pH greater than 4.5
- Sexually active
- Deodorant + vag washes
- Menstruation
- CuIUD
- Smoking
What are the symptoms of BV?
- Fishing smelling discharge
- Grey/white watery discharge
- Not associated w/ soreness, itching or irritation
What is the treatment for BV?
REFER!
- GP: oral metronidazole
What are the counselling points for BV?
- Avoid douches, deodorant + vag washes, use water
- Don’t put antiseptic liquid in bath
What is dysmenorrhoea?
- Painful cramping
- Caused by prod of uterine prostaglandins causing uterine contraction
- Last 24-72hrs
- Starts 6-12 months after menarche
When would you refer dysmeenorrhoea?
Associated w/ fibroids, endometriosis, PID + IUD
What are the risk factors of dysmenorrhea?
- Early age menarche
- Heavy flow
- Nulliparity
- Fx dysmenorrhea
- Stress
What are the symptoms of dysmenorrhoea?
- Cramps
- Before menstruation for upto 72hrs
- Cyclical mastalgia (breast pain)
- N+V
What are the treatment options for dysmenorrhoea?
- Paracetamol + ibuprofen
- Feminax: 15-50, 1st day 2 tabs when pain starts and 1 after 6-8 hrs, 2nd + 3rd 1 every 6-8hrs, max 3 days
What are the counselling points for dysmenorrhoea?
- Hot water bottle/heat packs
- Warm bath
- Tea: regular, camomile, mint
- TENS
What are the red flags for dysmenorrhoea?
- Severe ab pain
- Pregnant
- Persistent post coital bleed
- Naproxen: Hx peptic ulceration/active bleed, asthma
What is menorrhagia + what is the treatment?
- Heavy bleed
- Tranexamic acid 500mg tabs
- 18-45yrs w/ regular 21–35-day cycles
- Once bleeding starts 2 500mg tablets tds
- If heavy inc to max 8 tabs/day
– Max 4 consecutive days
When would you refer when taking tranexamic acid for menorrhagia?
- No red in bleed after 3 cycles
- Hx thrombotic disease
- Anticoag
- Oral contraceptives
- Tamoxifen
- Pregnancy + breastfeeding
- Obese
- Diabetic
- Endometrial cancer in 1st degree relative
What are the red flags for menorrhagia?
- Unusual vag discharge
- Fever
- > 45
- Irregular periods
- Pregnant
- Hx endometrial cancer 1st degree relative
What is amenorrhoea?
- Absence of menstruation
- Refer!
- Primary: failure to start by 15
- Secondary: absence for 6 months
What are the symptoms of chlamydia?
- Postcoital bleed
- Inc discharge
- Dysuria
- Pelvic pain
- Men: dysuria, urethral discharge + discomfort
What is the treatment for chlamydia?
Doxycycline 100mg BD
What are the risk factors of pelvic inflammatory disease?
- Multiple sex partners
- Unprotected sex
- IUD
- Giving birth
- Vag Surgery
What are the symptoms of pelvic inflammatory disease?
REFER!!
- Lower ab pain
- Vag discharge
- Ab bleeding
- Nausea + V
- Pain during sex
Levonorgestrel
- > 16
- upto 72hrs
- Vom occurs w/in 2 hrs take another
- Not for: severe liver dysfunction, ectopic pregnancy
- Avoid nursing for 8 hrs
- Take pregnancy test if >5 days late
Ulipristal
- No minimum age
- upto 120hrs
- Vom occurs w/in 3 hrs take another
- Not for: severe liver impairment + asthma on oral glucocorticoid
- Avoid nursing for 1 wk
- Take pregnancy test if >7 days late
What are the red flags for EHC?
- Severe chest pain
- Breathlessness
- Swelling of 1 calf
- Prolonged headache
- Vision loss
What are counselling points for pregnancy?
- Healthy eating
- Avoid caffeine + alcohol
- Folic acid 400mcg + vit D 10mcg daily
- Avoid Vit A
- N+V: ginger, sea bands
- Indigestion: gaviscon
- Constipation: avoid stimulant, use ispaghula husk
OTC product for UTI
Potassium citrate/sodium citrate:
- CI: males, children, HPT, pregnancy, CKD + CVD
What is the cause of BV?
- Overgrowth of anaerobic organism + loss of lactobacilli
- pH inc >4.5
