Tiêu đề SCA Imtiyaz Medical - Women Health-III.pdf ✅

Dr.Amr Ibrahim MB ChB, MD, Alexandria University, Egypt MSc, University of Tsukuba, Japan
▪ Cases: ➢14 F, has PV discharge, on COCP for irregular periods. Swabs => positive for chlamydia. Mum not aware, phone call with the pt or F2F. ➢ 17 F with painful spots down below, no PMH, nil regular meds. ➢ 31 F , itchiness down below, sore, has multiple sexual partners.
▪ Open questions , tell me more. ▪ STI symptoms. (PV bleeding, discharge, pain or bleeding after sex, pelvis or abd pain, fever ) ▪ UTI symptoms ▪ Detailed sexual hx. Including partner and +/- safeguard ▪ Detailed menstrual hx. ▪ Any contraception? ▪ Is mum aware of your attendance ? ▪ ? UTD with smears, or no? ▪ SH and impact on life ▪ ICE Please Remember: ❑ 13 years old and above ❑ Below 13 Assure Confidentiality Whatever you telling me is very confidential unless there is danger to yourself or others, only on these occasions we need to break confidentiality.
MX GUM clinic , Why ? , if afraid from near GUM => Offer her different one Full screen of STI FU with repeat tests Contact tracing Meds for Chlamydia 1 st line Rx: Doxy 100 mg BD for 7 days (CI in preg and breast feeding) Azithro 1 g STAT then 500 mg OD for 2 days Erythro 500 mg BD for 10-14 days Oflox 200 mg BD for 7 days or 400 mg OD for 7 days (CI in preg, growing adolescents and kids) Counsel her about safe sex Condoms Offer refer to sexual health education services FU To make sure symptoms resolved Assess compliance If < 25 years old => repeat chlamydia swab after 3-6 m to r/o re-infection TOC and chlamydia: in pregnancy What is the Rx for Gonorrhoea?!