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Flashcards in Sexual Health: Discharge Deck (30)
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1
Q

Most common cause of abnormal vaginal discharge in child-bearing age

A

BV

2
Q

BV:
Vaginal pH
Dominated by what bacteria
RFs

A

pH >4.5
Lactobacilli

RFs: anything increasing pH (menstruation, semen, products). black ethnicity, smoking, change in partner, STI

3
Q

BV: complications in pregnancy

A

Late miscarriage, preterm birth, PROM, post-partum endometriosis

4
Q

BV: who to treat (3)

A

Symptomatic women
Undergoing some surgical procedures
Patient choice

5
Q

Mx of BV

How would you treat if breast feeding?

A

Metronidazole 400mg BD for a week

Breast feeding: give vaginally

6
Q

Cautions when taking metronidazole

A

Don’t drink alcohol

Warfarin monitoring

7
Q

Give 3 RFs for candida infection

A

Immunosuppression (w.g. DM, pregnancy)
Antibiotic use
Elevated oestrogen

8
Q

Diagnosis of candida

A

Often symptomatic
? microscopy
? culture of low vaginal swab

9
Q

Mx of candida

A

Clomitrazole pessary

OR oral fluconazole

10
Q

Mx of candida in pregnancy

A

Pessary (NOT ORAL!!)

11
Q

Presentation of trichomanas in women

A

Offensive frothy yellow discharge
Vulvitis & vaginitis
Dysuria

12
Q

Diagnosis of TV

A

High vaginal swab for wet mount microscopy

OR NAAT (make sure to include TV)

13
Q

Mx of tricomonas vaginalis

A

2g metronidazole STAT

or 400mg BD for 7 days

14
Q

Chlamydia:
Infection of
Usually symptomatic or not?
Type of bacteria

A

Infection of endocervix

Usually asymptomatic

Intracellular bacteria

15
Q

Presentation of chlamydia in women

A
Vaginal discharge
Dysuria
Deep dyspareunia
Lower abdo pain
PCB & IMB
16
Q

Complications of chlamydia

A

PID, endo, tubal infertility, ectopic, SARA, FHC syndrome

17
Q

Chlamydia in pregnancy: what does it increase the risk of?

A

PPROM, preterm delivery, low birth weight

18
Q

Management of chlamydia

A

Doxycycline for 7 days

19
Q

Mx of chlamydia in pregnancy

A

Azithromycin

20
Q

Where does gonorrhoea affect?

A

Urethra, endocervix, pharynx, conjunctiva

21
Q

Mx of gonorrhoea

A

Ciprofloxacin or ceftriacone IM PLUS azithromycin PO

22
Q

Invs in gonorrhoea

A

NAAT

Always culture!! for sensitivity testing

23
Q

In men, what type of urine sample is needed?

How long are they recommended to hold urine?

A

First catch urine sample

Hold for an hour

24
Q

Presentation of gonorrhoea in men

A

Urethritis, yellow discharge

25
Q

MSM: where do you need to screen?

A

Urethra, rectum + throat

26
Q

Presentation of chlamydia in men

A

Clear/ white urethral discharge

27
Q

What is lymphogranuloma venerum?

Who is it most common in?

A

Form of chlamydia that can invade the lymphatic system

Most common in MSM

28
Q

Mx of non-specific urethritis (NSU)

A

Investigate as per gonorrhoea + chlamydia
If tests neg: refer to GUM
Mx like chlamydia (doxycycline)

29
Q

Microplasma genitalium:
Presentation
Testing
Mx

A

Usually asymptomatic/ F: PID/ M: urethritis

Abx: but can be difficult due to resistance

30
Q

STI causes of rectal discharge

A

Chlamydia
Gonorrhoea
Herpes
STI enteric infections (e.g. shigella)