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PHAM02 - term 2 > Wk 34: GUM > Flashcards

Wk 34: GUM Flashcards

1
Q

What are the long term complications of STIs?

A
  • Ectopic pregnancy
  • Infertility
  • Cervical + rectal cancer
  • Arthritis
  • Pregnancy: abortion, intrauterine death
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2
Q

Which STI has the highest risk of antimicrobial resistance?

A

Gonorrhoea

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3
Q

Where would you refer the different levels of STIs to?

A
  • 1 + 2: GP, pharmacy
  • 3: GUM
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4
Q

What are the main pathogens causing STIs?

A
  • Neisseria gonorrhoea: gonorrhoea
  • Chlamydia trachomatis: chlamydia
  • Treponema pallidum: syphilis
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5
Q

What are the complications of chlamydia?

A
  • Pelvic inflammatory disease
  • Epididymo-orchitis
  • Conjunctivitis
  • LGV men
  • Sexually acquired reactive arthritis
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6
Q

What are the risk factors of chlamydia?

A
  • Under 25
  • New sexual partner
  • More than 1 in last year
  • Lack consistent condom use
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7
Q

What are the symptoms of chlamydia in females?

A
  • Vag discharge
  • Dysuria
  • Pelvic pain
  • Intermenstrual/postcoital bleed
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8
Q

What are the symptoms of chlamydia in males?

A
  • Fever
  • Classical urethritis with dysuria and urethral discharge
  • Unilateral testicular pain
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9
Q

What is used to screen chlamydia?

A

Nucleic acid amplification tests (NAATs):

  • Women: vag swab or first void urine sample
  • Men: first void urine sample
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10
Q

What is first line treatment for chlamydia?

A

Doxycycline 100mg BD 7 days

  • CI pregnant + BF
  • GI effects + photosensitivity
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11
Q

What are alt for the treatment of chlamydia?

A
  • Azith 1g stat, 500mg OD for 2 days
  • Eryth
  • Ofloxacin
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12
Q

What is the treatment for pregnant ppts w/ chlamydia?

A
  • Azith 1g stat, 500mg OD for 2 days
  • Eryth
  • Amox
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13
Q

What is the follow up for chlamydia?

A
  • Avoid intercourse til treatment complete
  • Screen other STI
  • Refer GUM for partner notif: symptomatic male (2 wks), asymptomatic (3 months)
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14
Q

What are complications of gonorrhoea?

A
  • Men: Epididymitis, prostatitis, infertility
  • Women: PID, pregnancy dangers
  • Babies: blindness
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15
Q

What are symptoms of disseminated gonorrhoea?

A
  • Skin lesion
  • Arthralgia
  • Tenosynovitis
  • Arthritis
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16
Q

What are the symptoms of gonorrhoea for females?

A
  • Inc discharge
  • Low ab pain
  • Dysuria
  • Intermenstrual bleed
17
Q

What are the symptoms of gonorrhoea for males?

A
  • Urethral discharge
  • Dysuria
18
Q

What is the screening for gonorrhoea?

A
  • Women: vuvlovaginal swab
  • Men: first pass urine

Culture required if +ve NAAT

19
Q

What is the treatment for gonorrhoea if antimicrobial susceptibility is not known?

A

Ceftriaxone 1 g intramuscular (IM) injection

20
Q

What is the treatment for gonorrhoea if antimicrobial susceptibility is known?

A
  • Ciprofloxacin 500mg orally single dose
  • BF/pregnant: Azithromycin 2g orally single dose
21
Q

What is the treatment for disseminated gonorrhoea?

A
  • Ceftriaxone 1g IM/IV every 24 hrs
  • Cefotaxime 1g IV every 8 hrs

24-48hrs after symptoms improve switch:

  • Cefixime 400 mg BD OR
  • Ciprofloxacin 500 mg BD
22
Q

What is the follow up for gonorrhoea?

A
  • 1 wk after treatment: confirm adherence, s/e + partner notif
  • Asymptomatic: NAAT 2 wks after treatment
  • Signs persist: culture 3 days after treatment
23
Q

What is HPV?

A
  • Double stranded DNA virus
  • Infects squamous epithelia: skin + mucosa of upper respiratory + anogenital tracts
24
Q

What is the immunisation schedule for HPV?

A
  • Under 15: 0.5ml 6 months apart
  • > 15: 0, 1 + 4-6 months
25
Q

What are the treatment options for genital warts?

A
  • Self applied: podophyllotoxin 0.5% solution
  • Abrasive: cryotherapy, excision + electrocautery
  • Specialist: TCA 80-90% solution
26
Q

What is the follow up for genital warts?

A

Change treatment if intolerant or less than 50% response by 4-5 wks

27
Q

What causes herpes reactivation?

A
  • Local trauma
  • UV light
  • Smoking + drinking
  • Tight clothes
  • Stress
28
Q

What is the treatment for 1st episode herpes?

A
  • Aciclovir 400 mg TDS OR
  • Valaciclovir 500 mg BD
29
Q

What is the treatment for episodic herpes?

A
  • Aciclovir 800mg TDS 2 days
  • Famciclovir 1g BD 1 day
  • Valaciclovir 500mg BD 3 days
30
Q

What is the suppressive treatment for herpes?

A

> 6 attacks per year:

  • Aciclovir 400mg BD
  • Famciclovir 250 mg BD
  • Valaciclovir 500 mg OD

Takes 5 days therapy, discontinue after 12 months

31
Q

What are the supportive management options for herpes?

A
  • Saline bathing
  • Oral painkillers
  • Topical anaesthetic
  • Inc fluid intake

PHAM02 - term 2 (21 decks)

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