Vaginal Examination

Vaginal walls a mucous discharge is normally present. This has a cleansing and protective function. The amount, colour and consistency of mucous discharge changes during the menstrual cycle and also with use of hormonal contraception. Typically there is a small-moderate amount of whitish discharge normally present. Observe for abnormal discharge, which may be caused by a non-sexually or a sexually acquired infection. NON-SEXUALLY ACQUIRED CONDITIONS Candida albicans Candida albicans can have a...

Seroconversion

Seroconversion usually occurs between 1 and 10 weeks after the onset of the acute primary exposure to HIV. If a patient is potentially seroconverting, i.e. has had a recent high-risk exposure (Table 4) and has indicative symptoms (Table 5) then a full physical examination and appropriate serological testing should be undertaken the patient should be handed over to the most senior doctor on duty, depending on the local clinic protocol. This acute primary seroconversion illness is self-limiting,...

References

Abraham C, Sheeran P (1993) In search of a psychology of safer sex promotion beyond beliefs and texts. Health Education Research 8(2) 245-54 Aggleton P, Tryrer P (1994) Sexual Health in Aggleton P, Rivers K, Warwick I, Whitty G (eds), Learning About Aids Scientific and Social Issues, 2nd end. Churchill Livingstone HEA, London Alder M (2003) Sexual health report finds services to be in a shambles. British Medical Journal 327 (12) 62-3 Cooper Y (2001) Foreword Better Prevention, Better Services,...

Vulvovaginal Candidiasis

The most common cause of vulvo-vaginal candidiasis is Candida albicans. Other non-albicans species, such as C. glabrata, account for less then 10 per cent of cases but it is this group that may be more resistant to treatment (Kinghorn and Priestly, 1998). Around 75 per cent of women will experience candidiasis at some time. It is usually related to pregnancy or follows antibiotic therapy. However, while sexual acquisition plays a small role in the aetiology of vulvo-vaginal candidi-asis, the...

Std Sex Colleges Girling

Aikens J et al. (2003) cited in Lotery H, McClure N, Galash R (2004) Vulvodynia. The Lancet 363 9414 1058-61 Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK (1983) Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. American Journal of Medicine 74 14-22 Bailey J, Farquhar G, Owen C, Mangtani P (2004) Sexually transmitted infections in women who have sex with women. Sexually Transmitted Infections 80 244-6 BASHH (British Association for...

Irregular Bleeding Patterns

Menorrhagia is defined as a complaint of heavy cyclical menstrual bleeding over several consecutive cycles. It is also worth being aware that an average menstrual cycle occurs every 21 to 35 days and last from 2 to 7 days. Normal blood flow is 30 to 80ml (RCOG, 2004). Menorrhagia can be defined objectively or subjectively. Objective menorrhagia is taken to be a total menstrual blood loss of 80 ml or more. Subjective menorrhagia is defined as a complaint of excessive menstrual blood loss over...

Pathological Infective Skin Rashes That May Be Seen In Gum Clinics

Lesions associated with secondary or disseminated syphilis occur more than three weeks, and usually four to ten weeks, following initial inoculation with Treponema pallidum. The rash of secondary syphilis is reported to start as an evanescent macular rash that usually goes unnoticed by both patient and clinician. A few days later a symmetrical papular eruption appears that involves the whole trunk and the extremities, including the palms of the hands and the soles of the feet. Papules are...

Pelvic Inflammatory Disease

As has been indicated earlier, Pelvic Inflammatory Disease may be either acute or chronic. PID is a common cause of morbidity, and accounts for 1 in 60 consultations by women under the age of 45 (Simms et al., 2000). It has been reported that a delay of a few days in receiving appropriate treatment can increase the risk of sequelae, which include infertility, ectopic pregnancy and chronic pelvic pain (Hillis et al., 1993). The RCOG Guidance (2003) recommends that, owing to a lack of definitive...

Rectal pain

The most commonly complained of rectal pain is intermittent severe rectal pain that is not associated with defecation but may wake the sleeping patient. It is difficult to explain and does not usually result from organic disease. In men prostatitis is a common cause of rectal pain symptoms include perianal pain. Rectal pain will be worse on defecation (Hopcroft & Forte, 2003). Pelvic pain is a common presentation in women. Pelvic Inflammatory Disease, ectopic pregnancy, endometriosis,...

Findings on anal inspection

Pruritus ani, perianal warts, perianal abscess, perianal haematoma, prolapsing haemorrhoids, thrombosed haemorrhoids, skin tags, anal discharge, anal fistulas, anal fissures, anal cancer, rectocele, rectal prolapse, threadworms, faecal soiling of the perineum are all possible findings (Rhodes & Hsin, 1995 Barkauskas, 2002). The anal tone can be observed at rest and on voluntary contraction. The patient should be asked to strain down as if opening bowels to show perianal descent, prolapsing...

Groin And Pubic Area

Literature supports the examination of the male patient in both the supine (Epstein et al., 2000 Swartz, 2002) and the standing position (Walsh et al., 1999 Fuller & Schaller-Ayers, 2000). The exceptional case for not laying the patient down is when checking for scrotal hernias and varicoceles. In a standing position the groin or inguinal area should be examined for lymphadenopathy (enlargement of lymph nodes and also noting any tenderness). Even in the absence of any sexually transmitted...

Skin Anomalies Nonpathological

Fordyce spots are ectopic sebaceous glands, and are seen primarily on the labia minora and the shaft of the penis. They are large sebaceous glands seen through mucosal skin. Their appearance is that of small yellow spots. Angiokeratomas are more common in older people, and are tiny clusters of dilated blood vessels associated with keratinised tissue. They may be bright red, and will often darken to black with time. They are mainly seen on the scrotal skin in men and the labia majora in women....

Consultant Nurse in Sexual Health and HIV St Marys NHS Trust

Matthew qualified as a nurse in 1992 at the age of 20, being one of the youngest students to qualify from the Brent and Harrow School of Nursing and Midwifery. Initially, he worked as a staff nurse in Trauma Orthopaedics, before moving into Sexual Health in 1994. Since starting as an outpatient Staff Nurse in GUM and HIV in 1994 he has worked in various roles Health Adviser, Nurse Practitioner, Senior Nurse for Sexual Health and HIV and Advanced Nurse Practitioner. He has broad experience in...