Download - WOMENS HEALTH Sexually Transmitted Infections & Cervical Screening Zoe Wragg, Bradford VTS
WOMEN’S HEALTH
Sexually Transmitted Infections & Cervical Screening
Zoe Wragg, Bradford VTS
AIMS
How to take a sexual history
How to recognise STI’s and potential complications
Know of sexual health services available to us in Bradford area
Know cervical screening guidelines
Plan for station:
Picture Quiz – ‘Spot the Spots’
Taking a sexual history
Case studies
What help is out there?
Common things – recognising and treating
“Spot the Spots”
Taking a Sexual History
Key points: Lack of experience Embarrassment for the patient and doctor Practice…..
Privacy Ask permission and explain Don’t make assumptions Use the right terminology Only ask what you need to know
History of presenting complaint:
Symptoms…. Partners………….. Contraception Previous STI diagnoses Menstrual history PMH Smear history Drug and social history
Case Studies:
A 21 year old woman complains of a vaginal discharge. She was treated for similar symptoms 6 weeks ago with a clotrimazole pessary.
What is the differential diagnosis and how should she be investigated?
A 25 year old woman attends the surgery for her first cervical smear. When she sees the practice nurse, the woman tells her that she has noticed some lumps developing on her vulva.
A 20 year old woman has been on your list for 3 years and started the COCP 18 months ago. She is complaining of 3 months of break-through bleeding.
What’s out there for us?
GUM clinic
The Information Shop for Young People
Chlamydia Screening Project
Bradford District Public Health Network: Pantman –
http://www.bbc.co.uk/radio1/onelife/fun/health/pants/pantman.html
No internet based resources / helpline
GUM CLINIC
Prefer us to refer rather than treat!
At SLH Opening hours on web out of date – till 7pm Tues and Wed
Symptoms: seen within 24 hours Just advice: seen within 48 hours
GP refer, or self refer No audit, but no reason to believe people not happy with
going through it all again
Cervical Screening
Very topical, as just starting to vaccinate teenage girls against HPV 16 & 18
Not boys
What about smears?
No NICE guidelines – PACE guidelines
Common Things – Recognising and Treating
Vaginal Discharge
Herpes
Warts
Cervical conditions
Non-infective causes of vulval irritation
Vaginal Discharge:
Also vulval irritation and odour:
Candida / Thrush
Bacterial vaginosis
Trichamoniasis Vaginalis
Thrush
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long term effects?
BV
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long-term effects?;
TV
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long-term effects?:
Herpes
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long-term effects?:
Genital Warts
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long-term effects?:
Chlamydia:
Discharge: Course: Findings on examination: Treatment: Sexually transmitted?: Long-term effects?:
Non-infective Causes of Vaginal Irritation
Psoriasis Seborrhoeic dermatitis Tinea cruris Lichen simplex chronicus Chronic dermatitis (contact or irritant) Lichen planus Lichen sclerosus
Any questions?