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Bo5 Flashcards

1
Q 
35 yr old gay man complains of a flickering light in the left eye. VA right 6/6, left 6/36 (amblyopia). Retinal examination shows red lesions extending from the periphery in a 'brush fire' pattern.
What is the likely cause?
a. CMV retinitis
b. Retinal detachment
c. Diabetic retinopathy
A

CMV retinitis

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2
Q 
35 yr old gay man complains of a flickering light in the left eye. VA right 6/6, left 6/36 (amblyopia). Retinal examination shows red lesions extending from the periphery in a 'brush fire' pattern.
What is the first line treatment?
a oral valganciclovir
b IV ganciclovir
c iv cidofovir
d iv foscarnet
A

Oral valganciclovir first line

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3
Q

35 yr old gay man complains of a flickering light in the left eye. VA right 6/6, left 6/36 (amblyopia). Retinal examination shows red lesions extending from the periphery in a ‘brush fire’ pattern. He has new diagnosis of HIV and is not on HAART.
What is the management plan?
a induction followed by maintenance oral valganciclovir and immediate start HAART
b induction followed by maintenance oral valganciclovir and start HAART after 30 days
c induction followed by maintenance oral valganciclovir, oral steroids and start HAART

A

???
valganciclovir + start HAART
Steroids only if immune reconstitute uveitis

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4
Q 
Which ARVs will affect/interact with POP?
a lopinavir
b lamivudine
c tenofovir
d abacavir
A

???

lopinavir

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5
Q

What is the level of evidence for moxifloxacin for PID Rx?
a grade 1A
b grade 1B
c grade 2A

A

grade 1A

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6
Q

Review sensitivity/specificity/PPV/NPV

A

Discuss

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7
Q 
HIV diagnoses in MSM in the UK are reducing. Which part of the country has seen the greatest decline?
a London
b Midlands and East England
c North England
d Scotland
e Northern Ireland
A

London
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/835084/hpr3119_hiv18-v2.pdf

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8
Q 
HIV diagnosis in heterosexual people in the UK are declining. Which ethnic group is experiencing the greatest decline?
a White
b Black African
c Black Caribean
d Asian
A

Black African
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/835084/hpr3119_hiv18-v2.pdf

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9
Q 
Which exposure group is seeing the greatest decline in new HIV diagnoses since 2014?
a gay/bisexual men
b heterosexual women
c heterosexual men
d PWID
A

gay/bisexual

https://www.hiv-lens.org/visualisation/overview/country/england/

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10
Q

What is the difference between empirical and epidemiological treatment?

A

???

Discuss

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11
Q 
A 26 yo woman presents with multiple painful friable vesicular lesions on her vulva. You suspect herpes simplex virus. Which test will confirm this for you?
a swab for HSV DNA PCR
b swab for HSV culture
c serology for HSV-2 IgG
d serology for HSV-1 & 2 IgG
A

swab for HSV DNA PCR

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12
Q 
A 21 yo MSM is diagnosed with HIV and hepatitis B. His HBV DNA PCR is >2000. What is the recommended treatment of hepatitis B?
a tenofovir + emtricitabine
b entecavir + ART
c lamivudine + dolutegravir
d lamivudine + emtricitabine
A 
Crap options...
TDF/FTC or TDF/3TC as part of ART
Never FTC or 3TC alone
TDF can be alone
entecavir only is fully suppressed HIV
https://www.bhiva.org/file/TcrCoXjAGRaHb/HepatitisGuidelines2013.pdf
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13
Q 
12 yr old girl with vaginal discharge tests positive for gonorrhoea. On examination she has intact hymen. She denies sexual contact. What is the likely explanation?
a vertical transmission
b fomite transmission
c consensual sex
d sexual abuse
e false positive
A

???
False positive
or
Sexual abuse (BASHH guideline suggest this but no comment about relevance of hymen)
https://www.bashhguidelines.org/media/1081/2674.pdf

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14
Q 
25 yo woman with TB. treatment includes rifampicin and isoniazid. She asks you for contraception. What is the best option for her?
a COCP
b CHC patch
c Implant
d DMPA
e POP
A

DMPA

oral pills, patches, rings and SDI can all be reduced by enzyme inducers
IUS/IUD alternative contraception but not in Bo5

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15
Q 
If you need a second test to confirm a positive test for chlamydia trachomatis - what do you need the second test to have?
a high sensitivity
b high specificity
c high PPV
d high NPV
A

???

Discuss

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16
Q 
HIV positive patient with eGFR 40, what ARV can be given at normal dose?
a abacavir
b lamivudine
c zidovudine
d tenofovir disoproxil
e emtricitabine
A 
???
abacavir
or 
zidovudine
both ok until severe CKD or ESRF (emc and bnf)
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17
Q

A 23 yo woman has vaginal discharge and vulvitis, a high vaginal swab shows yeasts. What is the recommended treatment?
a clotrimazole pessary 500mg
b fluconazole 150mg oral
c clotrimazole 5% cream

A

fluconazole oral (if no contraindication)

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18
Q

A 23 yo woman presents with recurrent vaginal discharge and vulvitis. A high vaginal swab confirms candida. What is the most likely non-albicans candida?
a C. guilliermondii
b C. glabrata
c C. parapsilosis

A

C. glabrata
and
C. krusei most common non-albicans

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19
Q

A 23 yo woman presents with recurrent vaginal discharge and vulvitis. A high vaginal swab confirms Candida krusei. What is the recommended treatment?
a fluconazole 150mg orally once weekly for 6 months
b topical imidazole 14 days
c Nystatin pessaries 100,000units for 14 nights

A

Nystatin pessary first line for non-albicans or azale resistance

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20
Q 
25 yo man presents with a swollen right scrotum. He thinks it has grown over the past month. There is no pain and he cannot recall any injury. On examination there is obvious right scrotal swelling which feels fluctuant. The testis is difficult to palpate. What is the likely diagnosis?
a epididymitis
b hydrocele
c varicocele
d epididymal cyst
e inguinal hernia
A

Hydrocele

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21
Q

25 yo man presents with a swollen, painful right scrotum over the past week. He has no other symptoms. He last had sex 2/52 ago with his girlfriend. He has been with her for the past 2 months. On examination he has tender epididymus and right testicle. What is the best treatment?
a oral doxycycline 100mg BD 2 week
b IM ceftriaxone 1g and doxycycline 100mg BD 2 weeks
c IM ceftriaxone 1g and ofloxacin 200mg BD 10 days

A

cef + DOXY

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22
Q

29 yo man presents with a swollen, painful right scrotum over the past week. He has no other symptoms. He last had UIAI sex 2/52 ago with casual male partner. He has had 4 partners in the past 3 months, all UIAI. On examination he has tender epididymus and right testicle. What is the best treatment?
a oral doxycycline 100mg BD 2 week
b IM ceftriaxone 1g and doxycycline 100mg BD 2 weeks
c IM ceftriaxone 1g and ofloxacin 200mg BD 10 days

A

cef + OFLOXACIN
For acute epididymitis most likely caused by sexually-transmitted chlamydia and gonorrhoea and/or
enteric organisms (men who practice insertive anal sex)

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23
Q 
25 yo man presents with a swollen right scrotum. He thinks it has grown over the past month. There is no pain and he cannot recall any injury. On examination there is obvious right scrotal swelling which feels fluctuant. The testis is difficult to palpate. What is the next most appropriate investigation?
a NAAT for GC/CT
b US testes
c Urethral culture
d No further investigation
e AFP
A

US testes

- hydrocele in 20-40 yr old or unable to palpate teste needs exclusion malignancy

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24
Q

21 yo male presents with dysuria for 1 week and swelling and pain of right knee for past 4 days. He has had sex with female partners in past 3 months and has never used condoms. Microscopy shows PMNLs >5/5xhigh power field. You suspect SARA. What is the best treatment?
a doxycyline 100mg BD 1 week
b IM ceftriaxone 1g +doxycycline 100mg BD
c doxycycline 100mg BD 2 week
d azithromycin 2gram oral
e prednisolone 30mg daily

A

doxycycline 100mg BD 7 days
As per uncomplicated GU infection guideline
would also add NSAID and supportive care

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25
Q 
25 yo woman who has sex with women attends the GUM clinic for a routine sexual health screen. She asks you about her risk of STIs. What is the most common STI in WSW?
a chlamydia
b gonorrhoea
c HSV
d syphilis
e HIV
A

??? no idea - data lacking
HSV
or
chlamydia

Found another Q that suggests HPV…

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26
Q 
25 yo woman who has only female sexual partners attends the GUM clinic with vaginal discharge. She has no vulval discomfort. What is the most common cause for the vaginal discharge?
a gonorrhoea
b mycoplasma
c chlamydia
d bacterial vaginosis
e candida
A

Bacterial vaginosis

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27
Q 
Which topical treatment may damage condoms?
a topical steroid
b clotrimazole cream
c permethrin
d imiquimod
e catephen
A

Imiquimod

28
Q

Management of Hepatitis B contacts?

A

Discuss

29
Q 
A 29 yo heterosexual woman attends for her smear result. It shows hrHPV with cytology negative. Candida is also identified. What advice should she be given?
a treat candida and recall
b repeat in 6/12 
c back to routine recall
d colposcopy
e repeat 12/12
A

??

1 yr recall
high grade HPV, cytology neg
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/773338/Appendix_1_cervical_screening_protocol.pdf

30
Q 
A 29 yo heterosexual woman attends for her smear result. It shows hrHPV with cytology abnormal. What advice should she be given?
a test her partner
b repeat in 6/12 
c back to routine recall
d colposcopy
e repeat 12/12
A

colposcopy

31
Q 
A 29 yo heterosexual woman attends for colposcopy following a smear which shows hrHPV with cytology abnormal. Colposcopy shows no CIN. What advice should she be given?
a repeat colposcopy 1 yr
b repeat smear in 1 yr 
c back to routine recall
d recall in 3 yrs
e proceed to LLETZ
A

Recall in 3 yrs (36 months)

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/789636/Appendix_2_colposcopy_management.pdf

32
Q 
A 30 yo African man presents with multiple raised skin coloured lesions on his genitals and pubic region. They are non-tender or itchy. They have a central dimple. He would like treatment but is worried about scarring. What treatment should be offered?
a imiquimod
b cryotherapy
c podophylotoxin
d no treatment
A

No treatment

33
Q

A 24 yo MSM attends GUM clinic for routine screen. He asks for advice on how to reduce his risk of HIV. What is the most effective way to reduce HIV?
a insertive anal sex only
b Pre exposure prophylaxis
c Withdrawal before ejaculation

A

???old Q
Original answer was condoms, what is the efficacy comparison between condoms and PrEP

This answer would be PrEP I expect

34
Q 
A 33 yo woman presents with 2 months frequent and irregular bleeding and requests her contraceptive implant be removed. It was inserted 1 yr ago. She has no other symptoms and they are not associated with sex. She has a regular male partner since 3/12, they do not use condoms.  Her smear is up to date (last year) and has never been abnormal. What investigation should be offered?
a repeat smear
b pregnancy test
c VVS NAAT
d High vaginal swab
e full blood count
A

VVS NAAT

35
Q 
A 26 yr old MSM attends the gay mans clinic and request a rapid HIV test. He has had 10 casual male partners in the past 3 months and does not use condoms. The POCT shows a faint blue circle for HIV. What should you do next?
a Refer to new HIV diagnosis service
b Perform 4th generation HIV serology
c reassure no HIV
d advise return 3 months
e send HIV viral load
A

4th gen serology

36
Q 
A 26 yr old MSM attends the GUM clinic with sore throat, lymphadenopathy and fever. He has had 10 casual male partners in the past 3 months and does not use condoms. A POCT is non-reactive for HIV. What should you do next?
a give supportive care advice
b Perform 4th generation HIV serology
c reassure no HIV
d advise return 3 months
A

4th gen serology

37
Q

A 23 yo woman presents with lower abdominal pain and deep dyspareunia. She has a new sexual partner. You suspect PID and discuss treatment with her. What is the evidence for PID Rx?
a Im ceftriaxone + doxycycline and metronidazole grade 1A
b supportive therapy grade 1A
c antibiotic therapy for mycoplasma grade 1A
d review at 72 hours grade 1D

A

A - cef+doxy+met grade 1A

supportive therapy grade 1D
antibiotic therapy for mycoplasma grade 1D
d review at 72 hours grade 2D

38
Q

Treatment for uncomplicated gonorrhoea infection with IM ceftriaxone is grade 1C. What does this mean?
a weak recommendation with moderate evidence
b strong recommendation with moderate evidence
c strong recommendation with low quality evidence

A

C
1 = strong recommendation 2 = weak recommendation
A = high qual evidence
B = moderate qual
C = low
D = very low
https://www.bashhguidelines.org/media/1229/2015-guidelines-framework-amended-dec-2019.pdf

39
Q

Treatment for mycoplasma genitalium with Moxifloxacin 400 mg orally once daily for ten days if organism is known to be macrolide- resistant is what level of recommendation?
a strong recommendation, high quality evidence
b weak recommendation, high quality evidence
c weak recommendation, moderate quality evidence
d strong recommendation, moderate quality evidence

A

strong recommendation, moderate quality evidence (grade 1B)

40
Q 
16 yo Scottish woman presents with 2 separate 4 mm square ulcers at the vestibule. She is currently sexually active and has one regular male partner, also 16. They always use condoms. What is the most likely diagnosis?
a Herpes simplex
b syphilis
c behcets
d aphthous ulcer
e trauma
A

Discuss

Aphthous ulcers

41
Q 
A 28 yo HIV positive woman on tenofovir, emtricitibine and efavirenz tells you that she plans to try for pregnancy. What ARV regimen should be prescribed?
a TDF/FTC/EFV
b TDF/FTC + lopinavir
c PI mono therapy
d TDF/FTC + Darunavir/cobicistat
e ABC/3TC + dolutegravir
A

Discuss
TDF/FTC + EFV
this original Q asked if EFV safe in pregnancy
BHIVA guideline states EFV recommended 3rd agent
https://www.bhiva.org/file/5f1aab1ab9aba/BHIVA-Pregnancy-guidelines-2020-3rd-interim-update.pdf
BUT increase neural tube defect reported so EMC and BNF suggest caution 1st trimester
All the rest in answer - no good

42
Q

A 23yo heterosexual man present with recurrent urethral discharge despite completing a course of doxycycline for NGU. Micro confirms NGU and he tests positive for mycoplasma genitalium with macrolide resistance. What is the first line treatment?
a doxycyline 100mg BD 14 days
b moxifloxacin 400mg OD 10 days
c doxycyline 100mg BD 10 days + azithromycin 1gram
d moxifloxacin 400mg OD 14 days

A

moxifloxacin 400mg OD 10 days

14 days for complicated infection PID or EO

43
Q 
A pregnant woman presents with recurrent trichomonas vaginalis. She states her partner has taken treatment and that they have abstained from sex. She had no problem taking her initial treatment. What is the next treatment?
a metronidazole 400mg BD 7 days
b metronidazole 2 gram OD 7 days
c metronidazole 800mg TDS 7 days
d tinidazole 1gram BD 14 days
e tinidazole 2gram BD 14 days
A

(repeat) metronidazole 400mg BD 7 days
all other regimens are used for subsequent failure
tinidazole NOT for pregnancy

44
Q 
25 yo woman attends for assessment following sexual assault last night. The assailant was male and a friend of a friend. He is Black African born in the UK. There was vaginal penetration but no anal or oral. She has the contraceptive implant. What prophylaxis should be offered?
a PEPSE
b oral cefixime and oral doxycycline
c IM ceftriaxone and oral doxycycline
d IUD for emergency contraception
A

???
IM cef + doxy (offer)

not sure about PEPSE - discuss

45
Q 
25 yo woman attends for assessment following sexual assault last night. The assailant was male and a friend of a friend. There was vaginal penetration but no anal or oral. She has the contraceptive implant. She requests referral for forensic tests. How long does DNA persist following vaginal penetration?
a 48 hours
b 3 days
c 5 days
d 7 days
A

7 days

46
Q 
25 yo woman attends for assessment following sexual assault last night. The assailant was male and a friend of a friend. There was oral penetration only. She requests referral for forensic tests. How long does DNA persist following vaginal penetration?
a 48 hours
b 3 days
c 5 days
d 7 days
A

48 hours

47
Q 
30 yo man attends for assessment following sexual assault by a man 2 days ago. He does not know the assailant. He requests referral for forensic tests. How long does DNA persist following anal penetration?
a 48 hours
b 3 days
c 5 days
d 7 days
A

3 days

48
Q 
A 17 yo woman presents for contraceptive advice. She is sexually active with a regular male partner who she met at school. She is normally fit and well. She has no PMH. Her BMI is 32 and her BP is 120/75. Which contraceptive option may cause weight gain?
a COCP
b POP
c CHC patch
d Implant
e DMPA
A

DMPA

esp <18 BMI >30

49
Q 
A 20 yo woman has been referred for contraceptive advice. She is sexually active with a regular male partner of 2 years. She has recently been diagnosed with ulcerative colitis and started on sulfazalazine and prednisolone. She has been advised of a potential need or colectomy in the future. Her BMI is 21 and her BP is 120/75. Which is the best contraceptive option?
a COCP
b POP
c CHC patch
d Implant
e CuIUD
A

CuIUD (LARC best idea)

All progestogen only ukmec 2 if major surgery

50
Q 
A 20 yo woman has been referred for contraceptive advice. She is sexually active with a regular male partner of 2 years. She has recently been diagnosed with Crohn's disease and started on methotrexate and prednisolone. Her BMI is 21 and her BP is 120/75. Which is the best contraceptive option?
a COCP
b POP
c CHC patch
d Implant
e condoms
A

LARC best option

Potential reduced efficacy of oral meds in Crohn’s (unlikely UC)

51
Q

A 26 yo man has been referred with his female partner for pre-conception counselling. He has recently been diagnosed with Crohn’s disease and started on methotrexate and prednisolone. They have been using condoms consistently but are keen to start a family. What advice should you give them?
a partner should start folic acid
b patient should take extra folic acid
c no conception whilst on MTX and for 3 months after
d to get pregnant stop using condoms
e refer patient for colectomy

A

no conception whilst on MTX and for 3 months after

- teratogenic

52
Q

A 26 yo man has been referred with his female partner for pre-conception counselling. He has recently been diagnosed with Crohn’s disease and started on methotrexate and prednisolone. They have been using condoms consistently. What advice contraceptive advice would you give them?
a partner should start folic acid
b patient should take extra folic acid
c consider LARC
d condoms are the most effective contraception
e refer patient for colectomy

A

consider LARC

partner needs effective contraception during patients MTX Rx and for 3 months after

53
Q

A 21 yo woman complains of watery, offensive smelling vaginal discharge. It seems to come and go. She washes more when it is present. She stopped using condoms with her boyfriend a few months ago. She is otherwise well. Examination shows normal vaginal mucosa and cervix with thin discharge. A HVS is performed. On microscopy you see:
a gram neg rods and no lactobacilli
b mixed flora of lactobacilli and gram neg rods
c no bacteria present
d lactobacilli and epithelial cells

A

gram neg rods (gardnerella) and no lactobacilli (Hay/Ison 3)

54
Q 
A 21 yo woman complains of watery, offensive smelling vaginal discharge. It seems to come and go. She washes more when it is present. She stopped using condoms with her boyfriend a few months ago. She is otherwise well. Examination shows normal vaginal mucosa and cervix with thin discharge. A HVS is performed. On microscopy you see:
a Hay/ison grade 1
b Hay/ison grade 2
c Hay/ison grade 3
d Hay/ison grade 4
A

grade 3

55
Q 
A 32 yo pregnant woman presents with 3 weeks of itchy spots on her thighs and extending to her abdomen. She has noticed similar lesions on her hands and along the lateral aspect of her feet. She has a new sexual partner. for the past 2 months. She is otherwise well. What treatment do you suggest?
a permethrin 5% cream
b malathion 0.5% aqueous liquid
c ivermectin 3mg tabs
d promethazine antihistamine
e Ursodeoxycholic acid
A

Treat as scabies
permethrin

can use malathion is permethrin contraindicated

56
Q

A 7 day old baby presents to conjunctivitis. His mother is well post partum. She has no regular partners and is 23 yr old. She last had sex with a casual male partner a few weeks ago. what treatment is indicated for baby?
a erythromycin 12.5mg/kg QDS 14 days
b erythromycin 50mg/kg/day divided QDS 14 days
c erythromycin 250mg QDS 7 days
d azithromycin 1gram stat
e azithromycin 50mg/kg/day for 3 days

A

neonate - erythromycin 12.5mg/kg QDS 14 days (risk of hypertrophic pyloric stenosis as <2week old), can use azithromycin BUT 20mg/kg/day 3 days

https://www.bashhguidelines.org/media/1081/2674.pdf

57
Q

A 27 yo man with new diagnosis HIV presents for discussion about hepatitis B vaccination. His hep B serology is HBsAg -ve, HBcAb -ve and HBsAb -ve. What advice should you give?
a Engerix B 20mcg 0, 1, 2 and 6 months + sAB 8 weeks
b Fendrix 40mcg 0, 1, 2 and 6 months + sAB 8 weeks
c Engerix B 40mcg 0, 1, 2 and 6 months + sAB 8 weeks
d Engerix B 40mcg 0, 1, 2 and 6 months + sAB 1 year

A

C - Engerix 40mcg 0, 1, 2 and 6 months + sAB 8 weeks

Double dose engerix ONLY, not Fendrix
if ultra rapid do not double dose (no safety data)
sAB at 4-8 weeks after last vaccine

https://www.bhiva.org/file/NriBJHDVKGwzZ/2015-Vaccination-Guidelines.pdf

58
Q

23 yo MSM attends with 4 days UM discharge. Micro performed PMNLs and intracellular GNDC. What advice should be given for PN?
a await test results before contacting
b contact all partners 2 weeks before symptoms
c contact all partners 4 weeks before symptoms
d contact all partners 3 months before symptoms
e no need for PN

A

2 weeks or last partner if >2 weeks since sex

59
Q

23 yo MSM attends with 1 week rectal discomfort. He returns in 1 week and is advised rectal swab GC positive. What advice should be given for PN?
a await culture results before contacting
b contact all partners 2 weeks before symptoms
c contact all partners 4 weeks before symptoms
d contact all partners 3 months before symptoms
e no need for PN

A

contact all partners 3 months before symptoms

for infection at other sites than urethra or asymptomatic

60
Q

20 yo female presents with 5 days dysuria following UPSI with casual male partner 2 weeks ago. Her NAAT is CT positive. What advice should be given for PN?
a no need for PN
b contact all partners 2 weeks before symptoms
c contact all partners 4 weeks before symptoms
d contact all partners 3 months before symptoms
e contact all partners 6 months before symptoms

A

6 months (all index cases other than men with NGU)

61
Q

20 yo male presents with 5 days dysuria and urethral discharge following UPSI with casual female partner 2 weeks ago. His NAAT is CT positive. What advice should be given for PN?
a no need for PN
b contact all partners 2 weeks before symptoms
c contact all partners 4 weeks before symptoms
d contact all partners 3 months before symptoms
e contact all partners 6 months before symptoms

A

4 weeks (prior to symptoms and include contacts since symptoms started)

62
Q

A 19 yo woman asks for emergency contraception. She had UPSI 4 nights ago. Her LMP was 13 days ago, her cycle is 7/28. She asks you about starting contraception too. What advice do you give?
a offer ullipristal 30mg and start POP now
b offer levonorgestrel 1.5mg and start POP now
c offer ullipristal 30mg and start POP in 5 days
d offer levonorgestrel 3mg and start COC now
e offer ullipristal 30mg and insert implant now

A

C offer ullipristal 30mg and start POP in 5 days

Ullipristal only oral EC option
No HC until 5 days after UPA includes hormonal LARC

63
Q

A 19 yo woman asks for emergency contraception. She had UPSI 4 nights ago. Her LMP was 13 days ago, her cycle is 7/28. She asks you about starting contraception too. What advice do you give?
a offer ullipristal 30mg and start POP now
b offer levonorgestrel 1.5mg and start POP now
c offer ullipristal 30mg and start POP in 5 days
d offer levonorgestrel 3mg and start COC now
e offer ullipristal 30mg and insert implant in 5 days

A

E - offer ullipristal 30mg and insert implant in 5 days
B is alternative but not best option
preferred contraception is LARC

64
Q

A 29 yo woman presents with vulval itch and irritation with increasingly painful sex. She is normally fit and well, no medication or allergy. Her mother has hypothyroidism no other family history. On examination there is labia atrophy with evidence of fissures. What treatment is recommend?
a skin care advice and emollients
b hydrocortisone 0.1% daily 3 months then reducing
c clobetasone butyrate (eumovate) daily then reducing
d clobetasol propionate (dermovate) daily then reducing course

A

Lichen sclerosus

Ultra potent steroid - dermovate

65
Q 
You are asked to explain the cervical smear programme to a 24 yr old woman. When will she stop having smears?
a 55 yrs old
b 65 yrs old
c 70 yrs old
d 50 yrs old
e until end of life
A

65yrs old

DipGUM (39 decks)

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