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Perfect. However, everyone, we'll just give it maybe two minutes and then we can start uh just for some people to trickle in in the meantime. All right, everyone, I think we'll, we'll give it a start and then whoever else wants to join us, they can just trickle in um at the end. So, yeah, welcome everyone. This is our last uh final series session of the year. Um It's been a road. Um I'm nearly, I've probably met some of you before some other sessions and I've got Sophia as well with me. Um and we'll both be doing the session today. We'll cover sexual health topics really kind of leaning into what we were done last week. So I do. Oh, sorry, that's just a bit of feedback from my side. Um So yeah, um will cover a lot of the STD S that you might see will cover a bit of HIV um Hepatitis, which obviously STD is fine on the same side, a bit of contraception. Um And yeah, that's really it. So I think let's get started. We'll have the same format. We'll have some questions that you guys can answer. We'll put them in a poll. Um, and then we'll go over the answer options and, um, explain a bit on the topic as well. So our first question is this one. I'm just gonna let you guys read it. Um, and then we'll pop the po in a second up and then we'll see. I got a 5050 split between A and B which is good to, yeah, just wait to see if anyone else wants to shift it right away to see uh that option. Ok, fine. Yeah. So this is really just to test the new guidelines on it. Um Something worth knowing, to be honest. OK. All right, perfect. It's got a lot, a lot of options um with a split between A B and C. Um The majority of you guys are saying A um which is absolutely right. Um The main point in depth question why the people who didn't pick be are not correct is this woman is pregnant? Um So we can't give any Doxycycline um in a pregnant woman. Um So that's why Azithromycin is first line in. So in someone who's pregnant, whereas Doxycycline is pregnant is first line for everyone else. So, um let's talk a bit about the chlamydia. Sorry. Um So chlamydia is a STD. Um It's the most common STD that we can find in the UK. Um It is largely asymptomatic and which is one of the problems. Um It's easily treated as well. Um The symptoms usually from men range into old men. We should say someone um who's got um, a urethra um has um they have dysteria and urethra discharge that's usually white. Um They can also have e epididymitis. So think of kind of your uti symptoms that maybe a bit of discharge on top of that um for vaginal again. So it could be dysuria, same as uti um you might have some PV discharge similar to, to the um urethral discharge, um PV, bleeding um or pelvic inflammatory disease. So, pain um can be another late complication as well. Um Rectal gonorrhea, so important to know that rectal chlamydia, sorry is also a thing. Um Vast, vast, vast majority is going to be asymptomatic or you're going to think of sort of proctitis. So, um pain or bleeding and discharge from the rectum as well. Oral chlamydia again. Um is usually asymptomatic. Generally, oral ST is you're not going to have any symptoms of it. Um So if someone's got a sore throat, that's not really an indication to do an S TI test. Um But yeah, that's how I would present in terms of testing. Um In women, we tend to do a whole vaginal swab first. So it's um I have a self testing or we can do that as well. Um If you're thinking P ID, you can do it and no cervical swab as well. Um You for men, we'll just do a first, void urine um remember that the window period is two weeks time. So in the first two weeks, if you do a chlamydia nuts test, um and fa negative might be forced just because it's in the initial period after two weeks. Um If it's a false, if it's a negative that that's reliable. Um What you can also do in a sexual health practice is you can do a gram, a gram slide um of the discharge itself. And generally, that's more for the men um that we do um and dishwasher you nongonococcal ris. So you can you see loads of past cells which you can see here, they look like paw prints. Um But you're not gonna be able to see any bacteria and equally, that's very suggestive of chlamydia. It's not a, it's not an obviously not a diagnostic class, but it's very suggestive. Um which means that usually we would treat it in a sexual clinic as well. Um Treatment just quickly. So doxy 100 M GS BD for seven days is generally the first line. Um and second line would be uh something you rightly said something like I prefer um on amoxicillin as well. Um If someone is pregnant, we obviously can't give doxy or hands, the Azithromycin will be first line um counseling. So the pardon notification for men is four weeks prior to onset of symptoms um for women and asymptomatic men is actually six months or so, it's a very long time, um, they need to abstain from sex for seven days or until they complete the doxy essentially. Um And because chlamydia is usually very sensitive to um the doxy, the, the, the doxy Doxycycline, um, you don't need a test of cure if you use the first line treatment in pregnant women or, and if you use second line treatment, you might want to consider a test of cure. Um Just remember that chlamydia test. So, nat testing also picks up the DNA from bugs. So your test is going to remain positive for up to six weeks. So, if someone does want a test for reinsurance, well, make sure you tell them only to do it after six weeks time. Otherwise it's going to distress and bla uh, yeah. And I think that's it. Let's move on to question two. All right. Getting some people for b gonorrhea. Let's just see if we can get a few more responses maybe in 10 seconds. Um, but yeah, um, those of you wrote it, um, you're absolutely right. It has gonorrhea and I'll explain in a second while why gonorrhea over chlamydia. Um, and nobody ever wants to be honest. Um, so, yeah, so gonorrhea, um, the other really common.