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Medicine > GUM > Flashcards

GUM Flashcards

1
Q

Name 2 organisms that can cause dysuria.

A

Chlamydia

Gonorrhoea

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2
Q

If a patient presents with subacute dysuria with no urethral discharge, are they more likely to have Chlamydia or Gonorrhoea?

A

Chlamydia

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3
Q

If a patient presents with acute dysuria with urethral discharge, are they more likely to have Chlamydia or Gonorrhoea?

A

Gonorrhoea

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4
Q

Which antibiotic is used to treat Chlamydia infections?

A

Doxycycline 100mg BD for 7 days

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5
Q

Which antibiotic is used to treat Gonorrhoea infections?

A

Ceftriaxone

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6
Q

What treatment is used for Candida infection?

A

Clotrimazole (anti-fungal)

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7
Q

What treatment is used for Bacterial Vaginosis and Trichomonas Vaginalis?

A

Metronidazole

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8
Q

Name the 3 most common causes of vaginal discharge?

A
  1. Candida albicans
  2. Bacterial vaginosis
  3. Trichomonas vaginalis
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9
Q

Name the 2 most common causes of genital ulcers?

A
  1. Syphilis

2. Herpes

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10
Q

What treatment is used for Syphilis?

A

Penicillin IM

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11
Q

What treatment is used for Herpes?

A

Aciclovir (400mg TDS 5 days)

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12
Q

If a patient presents with acute painful genital ulcers, with vesicles like dew drops, are they more likely to have Syphilis or Herpes?

A

Herpes

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13
Q

If a patient presents with a large painless genital ulcer that has developed over several weeks, are they more likely to have Syphilis or Herpes?

A

Syphilis

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14
Q

Give 3 or more signs/symptoms of pelvic inflammatory disease.

A
  1. Asymptomatic in many
  2. Dysuria
  3. Lower abdominal pain
  4. Bleeding after sex
  5. Irregular menstruation
  6. Vaginal discharge
  7. Adnexal mass/ tenderness
  8. Fever
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15
Q

Give examples of 5 or more features of early HIV/ seroconversion.

A
  1. Fever
  2. Fatigue
  3. Myalgia/ arthralgia
  4. Headache
  5. Night sweats
  6. Nausea and vomitting
  7. Oral/ genital ulcers
  8. Rash
  9. Leukopenia, thrombocytopenia
  10. Elevated LFTs
  11. Lymphadenopathy
  12. Pharyngitis
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16
Q

Early HIV disease features typically affect which 3 regions of the body?

A
  1. Mouth
  2. Skin
  3. Lymph nodes
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17
Q

Give 1 or more example of common skin conditions which may present in a persistent or refractory way in patients with early HIV disease.

A
  1. Acne
  2. Psoriasis
  3. Seborrhoeic dermatitis
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18
Q

Give 1 or more example of skin conditions which may present in an odd way in patients with early HIV disease.

A
  1. Herpes zoster in multiple dermatomes/ recurrent chicken pox
  2. Herpes simplex genitalia reoccurence
  3. Unusual fungal infections eg. of proximal nail bed
  4. Molluscum contagiosum of the face
  5. TB
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19
Q

Give 1 or more example of mouth conditions which may occur in patients with early HIV disease.

A
  1. Oral Candida
  2. Oral hairy leukoplakia
  3. Recurrent oral ulcers
  4. Kaposi’s sarcoma
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20
Q

Give 3 or more examples of AIDS defining conditions.

A
  1. Respiratory- TB, Pneumocystis pneumonia
  2. CNS- Toxoplasmosis, Lymphoma, Cryptococcal meningitis, Progressive multifocal leukoencephalopathy
  3. Derm- Kaposi’s sarcoma
  4. Ophthalmology- CMV Retinitis
  5. GI- Recurrent Cryptosporidiosis
  6. Oncology- NHL, Cervical cancer
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21
Q

Name 2 or more lung conditions that may occur in patients with late HIV.

A
  1. Pneumocystis pneumonia
  2. Lymphoma (NHL)
  3. TB
  4. Mycobacterium avium
22
Q

Name 2 or more CNS conditions that may occur in patients with late HIV.

A
  1. Cerebral toxoplasmosis
  2. Cerebral lymphoma
  3. Progressive multifocal leukoencephalopathy
  4. Cryptococcal meningitis
  5. CJD disease
23
Q

What is the most common cause of genital ulcers?

A

Herpes

24
Q

How is potential Herpes investigated?

A
  1. PCR

2. Viral culture from lesions

25
Q

How is potential Syphillis investigated/ diagnosed?

A
  1. Dark field microscopy- from swab of active lesion

2. Syphilis serology (blood test)- for antibodies. Repeat after 6 weeks if negative/ suspicion

26
Q

How does Herpes present?

A
  1. Multiple vesicles like “dew drops”
  2. These burst to form large PAINFUL ulcers
  3. Lymphadenopathy
  4. Dysuria
  5. Fever/ flu like symptoms
  6. Urine retention
27
Q

Name 1 feature of primary syphilis.

A
  1. Chancre- painless ulcer
28
Q

Condylomata lata (wart like genital lesions), a rash, oral mucosal lesions (“snail tracks”) and patchy alopecia are all features of which stage of syphilis?

A

Secondary syphilis

29
Q

Tabes dorsalis is a feature of tertiary syphilis and effects which senses?

A

Proprioception
Vibration
Fine touch

30
Q

Gummas are soft granulomas found on the skin, bone and internal organs in which stage of syphilis?

A

Tertiary syphilis

31
Q

If a pregnant HIV positive woman who is not on treatment has a child, what is the % chance that the child will be infected with HIV?

A

25-35%

32
Q

Name 3 or more of the 6 steps that are taken to prevent Mother to Child Transmission (MTCT) of HIV.

A

1, Universal HIV testing during pregnancy

  1. Mother on ARV treatment throughout pregnancy
  2. Appropriate mode of delivery (birth)
  3. ARV treatment for baby
  4. Avoidance of breastfeeding
  5. HIV testing in the baby
33
Q

Name 3 or more classes of HIV ARV drugs.

A
  1. Nucleoside reverse transcriptase inhibitors (NRTIs)
  2. Non-Nucleoside reverse transcriptase inhibitors (NRTIs)
  3. Integrase Inhibitors
  4. Protease Inhibitors
  5. Fusion Inhibitors
  6. CCR5 Inhibitors
34
Q

Name 2 or more clinical settings where the British HIV Association recommend universal HIV testing.

A
  1. Antenatal screening
  2. Pregnancy termination services
  3. Healthcare provision for patients with TB, Lymphoma, Hep B and Hep C
  4. GUM clinics
  5. Drug dependency programs
35
Q

What are the aims of partner notification?

A
  1. Break the chain of infection
  2. Identify previously undiagnosed infection in the population
  3. Reduces the risk of patient becoming re-infected
  4. Reduces the risk of infection related complications
36
Q

What is the look back period for Chlamydia and Gonorrhoea in terms of partner notification?

A

6 months

37
Q

What is the look back period for male urethral Gonorrhoea in terms of partner notification?

A

6 weeks

38
Q

What is the look back period for primary syphilis in terms of partner notification?

A

90 days prior to chancre onset

39
Q

Name 5 or more risk factors for obtaining STIs.

A
  1. Young age (18-24yrs)
  2. Marriage status
  3. Occupation (increased risk with travel and armed forces work)
  4. Method of contraception used
  5. Occupational sex work
  6. MSM
  7. Increased sexual partners
  8. Female gender
  9. Overseas travel
  10. Drug use (alcohol and illicit drugs associated with risk taking behaviour)
  11. Young age at first coitus
  12. Socio economic status
40
Q

The diagnosis of Herpes is more common in which gender?

A

Women

41
Q

What is the UK prevalence of HIV?

1.6/1000
11.6/1000
111/1000

A

1.6/1000

42
Q

What is the UK prevalence of HIV in MSM?

1/100
5.9/100
10/100

A

5.9/100

43
Q

In which patient group should Azithromycin be used to treat Chlamydia?

A

Pregnancy

44
Q

Podophyllotoxin cream is used to treat which STI?

A

Genital warts (HPV)

45
Q

Which 2 antibiotics can be used to treat non-specific urethritis?

A

Doxycycline 100mg BD 7 days

Azithromycin 1g stat, then 500mg OD for 2 days

46
Q

What is the most common cause of epididymo-orchitis in men aged <35 years?

A

Chlamydia

47
Q

What is the most common cause of epididymo-orchitis in men aged >35 years?

A

UTI

48
Q

Which antibiotic is usually used 1st line for management of UTIs in non-pregnant women?

A

Nitrofurantoin 100mg BD 3 days

49
Q

Nitrofurantoin should only be prescribed if the patient’s eGFR is > ___ml/min.

A

45

50
Q

Which antibiotic is usually used 1st line for management of UTIs in pregnant women?

A

Nitrofurantoin 100mg BD 7 days

51
Q

How long after completing PEPSI should a repeat HIV blood test be done to check for HIV antibody?

2 weeks
1 month
2 months

A

2 months

52
Q

Give 2 differential diagnoses for the symptoms that present in HIV seroconversion.

A
  1. Syphilis (secondary syphilis)

2. EBV/ Glandular fever

Medicine (11 decks)

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