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UKMLA > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

What is 1st line treatment of BV ?

A

Metronidazole

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2
Q

What is treatment for chlamydia?

A

Doxycycline

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3
Q

What is treatment for gonorrhea ?

A

Ceftriaxone

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4
Q

What cell are characteristic in BV?

A

Clue cells (stippled vaginal epithelial)

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5
Q

What’s a complication in HIV patients that can cause breathlessness?

A

Pneumocystitis jivroveci pneumonia

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6
Q

How in labs i.e. what stain can identify fungus that causes pneumocystis jivroveci?

A

Silver stain

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7
Q

What organism does India ink stain identify?

A

Cryptococcus

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8
Q

What type of meningitis is an AIDs defining illness?

A

Cryptococcal meningitis

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9
Q

What is classic presentation for cryptococcal meningitis?

A

Blurred vision
Bilateral papilledema
Confusion
CT head will be normal

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10
Q

What’s the name of the single painless ulcer in syphilis?

A

Chancre

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11
Q

What type of bacteria is gonorrhoea?

A

Gram negative diplococci

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12
Q

What is first line treatment for trichomoniasis (strawberry cervix)?

A

Metronidazole

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13
Q

When can sex be resumed with hsv genital lesions?

A

Once lesions are gone

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14
Q

How many cigarettes smoked is a contraindication for COCP?

A

Over 35 a day

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15
Q

How long is the pill not effective for when first taken?

A

7 days

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16
Q

How is fitz-hugh-curtis characterised?

A

Hepatitis and liver adhesions, can cause RUQ pain and shoulder tip pain : can be due to gonorrhea or chlamydia

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17
Q

What is prescribed prophylactically to prevent further episodes of PCP in HIV patients with CD4 below 200?

A

Co-trimoxaloe - continued until immune function improves - i.e. CD4 above 200 for a while

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18
Q

What’s a good CD4 count?

A

Anything above 500

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19
Q

What’s treatment for secondary syphilis?

A

IM benzathine benzylpenicillin

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20
Q

Which infection is caused by a flagellated protozoan parasite?

A

Trichomoniasis

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21
Q

What are the features of PID?

A

Fever
Lower abdo pain
Deep dyspareunia
Cervical excitation
Pain on movement of cervix

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22
Q

What is treatment of PID?

A

IM ceftriaxone, oral doxycycline + metronidazole

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23
Q

What is oral treatment for thrush?

A

Fluconazole

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24
Q

How is outbreak of HSV managed?

A

Oral aciclovir

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25
Q

Which type of pessary do you use in thrush?

A

Clotrimazole

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26
Q

Why is COCP a risk factor for thrush?

A

The oestrogen in the pill can alter the vaginal environment making it more conductive for fungal growth

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27
Q

If patient is pen allergic and has gonorrhea what should be given? Because remember the cross similarity of cefotaxime and penicillin’s

A

IM gentamicin and oral azithromycin

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28
Q

Missing more than one pill means?

A

Barrier method or abstinence is needed for a week

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29
Q

When would a pill free week be skipped?

A

If the missed pills are from the last week of the pack

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30
Q

Which pill week prevents ovulation and therefore if missed would need emergency contraception?

A

The first week

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31
Q

Which bacteria most commonly causes BV?

A

Gardnerella vaginalis

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32
Q

If patients vomit within 3 hours of taking COCP or within 2 hours of taking progesterone only pill then what?

A

Take another pill straight away

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33
Q

If COCP pills are missed in week 3 then what?

A

Finish current pack and start next pack immediately

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34
Q

Which condition can cause painless genital ulcer and painful inguinal nodes?

A

Lymphogranuloma venereum - caused by a strain of chlamydia

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35
Q

What is first line treatment for pneumocystitis pneumonia? with and without an oxygen of 8 or less?

A

Without oxygen less than 8 is co-triomxazole
When oxygen is 8 or less than C–Trimoxazole and steroids.

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36
Q

What’s treatment of chlamydia in breastfeeding women?

A

Oral azithromycin and doxycycline is contraindicated

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37
Q

Which herpes causes kaposi’s sarcoma?

A

HHV-8

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38
Q

Which HPV causes genital warts?

A

HPV 6

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39
Q

When does latent syphilis occur?

A

Absence of any symptoms and occurs after primary and secondary stages

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40
Q

What are the potential side effects of co-trimoxazole?

A

Stevens-johnson syndrome
Drug induced Lupus
Agranulocytosis
Toxic epidermal necrolysis

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41
Q

How long after UPSI can ella one be taken?

A

Up to 120 hours so five days

42
Q

How long within can levonelle be used after UPSI as emergency contraception?

A

Within 3 days

43
Q

What is a complication of untreated or recurrent urethritis?

A

Urethral stricture - can lead to scarring and narrowing of the urethra

44
Q

Which tests are used for diagnostic of gonorrhoea and chlamydia?

A

NAAT

45
Q

How would molluscum vs. HSV genital bumps present differently?

A

Molluscum: dome shaped flesh coloured or pink papule with a central indentation
HSV: painful fluid filled blisters- no central indentation

46
Q

How long can IUD last for?

A

5-10 years

47
Q

What is a chancroid?

A

Bacterial STI - erythematous papule forms at site of inoculation: deep ulcer with soft , irregular border and friable base

48
Q

How can BV affect a pregnancy?

A

Can cause preterm rupture of membranes and premature labour

49
Q

Which pessary is treatment in women with recurrent candida infections?

A

Nystatin pessary

50
Q

What’s the difference between chancroid and lymphogranuloma venereum?

A

Lymphogranuloma venereum: Painless ulcer and tender inguinal lymph nodes
Chancroid: PAINFUL ulcer + tender inguinal lymph nodes

51
Q

What is chancroid caused by?

A

Bacterium haemophilus ducreyi

52
Q

Which patients is oral fluconazole contraindicated in?

A

Pregnant or breastfeeding

53
Q

What does HBsAg mean?

A

Detected following initial infection

54
Q

What does Anti-HBs mean?

A

Either cleared infection OR vaccination against hep b

55
Q

What does anti-HBc mean?

A

Hep b infection is either chronic or resolved

56
Q

If there is negative anti-HBc and positive Anti-HBs what does this mean?

A

Patient is vaccinated against hep B

57
Q

Is oesophageal candidiasis a AIDS defining illness?

A

Yes

58
Q

What are pearly penile papules?

A

Harmless rounded / finger like growths found near head of penis - may also look yellow or pinkish - patient can be reassured and discharged

59
Q

What treatment is used for genital warts that are non keratinsed?

A

Podophyllotoxin

60
Q

What is an alternative treatment for non-keratinized genital warts other than podophyllotoxin?

A

Imiquimod

61
Q

What is disseminated gonococcal infection?

A

Rare complication of gonorrhoeae.
Involving arthritis-dermatitis syndrome and tenosynovitis
There will pain with passive flexion and tenderness along flexor sheath
Commonly affects fingers, wrists, and toes.

62
Q

What is jarisch herxheimer reaction?

A

Self resolving high fever, heart rate and unwell can be due to IM benzylpeniccilin for a primary syphilis

63
Q

What HIV viral load is appropriate for a vagina delivery ?

A

Under 50 if greater than 50 then it should be C-section

64
Q

What is infant post-exposure prophylaxis for HIV ?

A

Zidovudine monotherapy or cART

65
Q

Is breastfeeding safe in HIV?

A

Only okay if women has low viral load on cART - even so more recommended to formula milk

66
Q

What the gold standard for diagnosis for HIV?

A

HIV antibody and HIV antigen

67
Q

When can the HIV antibody test detect HIV infection?

A

21-25 days post infection -it’s used as the point of care test

68
Q

What is bronchoalveolar lavage?

A

diagnostic procedure that involves collecting a fluid sample from the lungs to help diagnose lung conditions

69
Q

What is the gold standard investigation for PCP?

A

Bronchoalveolar lavage

70
Q

How do anti-epileptics and COCP react?

A

Anti-epileptics will increase metabolism of COCP due to being enzyme inducers , therefore the COCP becomes less effective

71
Q

What is an appropriate contraception of choice in epileptics?

A

Contraceptive injection as it does not interact with liver enzymes

72
Q

What is treatment for primary CNS lymphoma (HIV related0

A

Commence CRT and whole brain irradiation

73
Q

How is Primary CNS lymphoma seen on brain CT?

A

Single lobulated lesion with single homogenous enhancement

74
Q

Who can receive HIV post-exposure prophylaxis?

A

Anyone - don’t need to have risk factors but they must have a determined HIV status first so that it isn’t given to someone who already has HIV

75
Q

What would a smear show for chlamydia?

A

5 or more polymorphs per high power field with no evidence of gram negative diplococci

76
Q

If doxycycline is contraindicated what is offered?

A

Azithromycin, ofloxacin, erythromycin

77
Q

What are the most specific signs for primary HIV infection?

A

Maculopapular rash on upper areas and mucosal ulcers

78
Q

What is treatment for toxoplasmosis?

A

Sulfadiazine and pyramethamine

79
Q

Which medication needs to be co-prescribed with sulfadiazine and why?

A

Folate as sulfadiazine can lead to folate deficiency

80
Q

How often does the progesterone injection need to be administered?

A

Every 3 months

81
Q

What organism is responsible for molluscum?

A

Poxvirus

82
Q

Except from ovarian cancer why else can ca-125 be raised?

A

PID

83
Q

How can PID present?

A

Bilateral abdominal pain
Inter-menstrual bleeding

84
Q

Are HIV patients on long term cART at risk of stroke?

A

Yes

85
Q

What’s the most common cause of fitz-hugh curtis syndrome?

A

Chlamydia

86
Q

What is mitterlschmerz?

A

Mic-cycle abdo pain in lower abdomen - subsides within 24-48 hours after onset

87
Q

What is treatment for recurrent thrush?

A

3 doses of oral fluconazole 150mg to be taken every 3 days. Then 150mg oral fluconazole once a week for 6 months as maintenance

88
Q

Can molluscum cause eye things?

A

Yes small umbilicated lesions on lid margins but also other stuff around eye

89
Q

What is a trachoma?

A

Leading cause of blindness worldwide. Particularly endemic in Africa. Damage to cornea occur when eyelid turns inward - entropion
aused by chlamydia

90
Q

What’s the normal dose of oral aciclovir for hsv vs in pregnancy?

A

200mg three times a day normally but in pregnancy due to higher circulating blood volume it’s 400mg three times a day

91
Q

Which antiepileptics interact with cocp to induce liver enzymes and which one is safe?

A

Phenytoin, barbituates, carbamezapine - induce liver enzymes
Levetiracetam - is fine

92
Q

How many years breast cancer free in order to take cocp?

A

Not within 5 years

93
Q

Is cholestatic jaundice in pregnancy a contraindication for cocp?

A

Yes

94
Q

What BP measures are contraindications for cocp?

A

systolic higher than 160 or diastolic higher than 100

95
Q

What is treatment regime with doxycycline for chlamydia?

A

100mg twice a day for 7 days

96
Q

What does multiple ring enhancing lesions on CT scan suggest in a HIV patient?

A

Toxoplasmosis

97
Q

What is treatment for CMV retinitis?

A

IV ganciclovir

98
Q

How does CMV retinitis present?

A

Rapid painless vision loss
Flashes of light
Retina has pizza slice appearance
Affected section appear to have marked haemorrhages

99
Q

What’s the mechanism of action of doxycycline?

A

Tetracycline antibiotic that blocks translation by binding the bacterial 30s ribosomal subunit

100
Q

What is most definitive option for diagnosing fitz-hugh-curtis syndrome?

A

Laparoscopy - may reveal adhesions between diaphragm and liver or between liver and anterior abdominal wall

101
Q
A

UKMLA (12 decks)

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