Gynae Conditions

Question 1

Young women presents with discharge and itchy vagina. She has type 1 diabetes and on examination there is a cottage cheese look on the labia. What is the likely diagnosis?

Answer 1

Candida albicans

Question 2

How do you treat candida albicans of the vagina

Answer 2

Confirm with a high vaginal swab for culture

Then clotrimazole pessary or cream
If doesnt settle then oral fluconazole

Question 3

Man presents with lots of pus of the urethra described as a greenish yellow, and also of the rectum. He has pain when peeing. Has occurred for the last 3 days. Mentions he had unprotected sex around a week ago now. What is the likely diagnosis? What investigation should be offered?

Answer 3

Neisseria gonorrhoea

PCR of first pass urine sample or swab of discharge but can only do after 14days since contact

Question 4

What is the type of bacteria of neisseria gonorrhoea

Answer 4

Gram negative intracellular diplococci

Question 5

What is the treatment for neisseria gonorrhoea?

Answer 5

Ceftriaxone 1g IM first line

Cefixime 400mg and azithromycin 2g IM 2nd line

Then NAAT test of cure

Question 6

Do you need partner notification for neisseria gonorrhoea

Answer 6

YES

Anyone had sexual contact with in the last 2 weeks of symptoms

Question 7

Women 22yrs presents with irregular bleeding, and lower abdominal pain and has noticed discharge in her underwear recently. She has been sleeping around. But her last partner was over 2 weeks ago and she’s been having these symptoms a few days now. What is the likely diagnosis?

Answer 7

Chlamydia

Question 8

What is the treatment for chlamydia?

Answer 8

Doxycycline twice a day for 7 days

If allergic then erythromycin or ofloxacin

Question 9

Do patients with chlamydia need partner notification?

Answer 9

Yes in last 2 weeks

Question 10

What are some of the complications associated with chlaymydia infection?

Answer 10

Pelvic inflammatory disease
Tubal infertility
Reactive arthritis

Question 11

Which serovars of chlamydia causes genital infection?

Answer 11

Serovars D-K

Question 12

Which serovars of chlamydia causes lymphogranuloma venerum?

Answer 12

L1-L3

Question 13

What is amsels criteria used to diagnose?

Answer 13

Bacterial vaginosis

Question 14

What are the points of amsels criteria? What does 3/4 suggest?

Answer 14

Thin white homogenous discharge
Clue cells (outlined cells)
Vaginal PH >4.5
Positive whiff test (adding potassium hydroxide

Bacterial vaginosis

Question 15

Who is most likely to get bacterial vaginosis?

Answer 15

Women who have sex with women

Question 16

What is the treatment for bacterial vaginosis?

Answer 16

Not sexually transmitted but an overgrowth of anaerobic organisms like garnella vaginallis HENCE

Oral metronidazole 400mg for 5-7days cant drink alcohol during this time

Question 17

Women presents with vaginal discharge, of a yellow/greenish colour appearing with bubbles. On examination there is vulvovaginitis, and a strawberry cervix. What is the likely diagnosis?

Answer 17

Trichomonas vaginalis

Question 18

Does bacterial vaginosis require partner notificiation?

Answer 18

NO dont treat partners as no benefit

Question 19

Does trichomonas vaginalis require partner notification?

Answer 19

No dont treat partners as procides no benefit

Question 20

What is the treatment for trichomonas vaginosis?

Answer 20

Oral metronidazole for 5-7days

Caused by sexual contact a flagellated protozoan parasite

Question 21

What is the incubation period for syphilis?

Answer 21

9-90 days with an average of 21days

Question 22

what is the investigation for syphilis infection? Can only do after chancre healed

Answer 22

PCR with viral medium

VDRL and RPR are non specific antibodies that react to syphilis infection both become negative after treatment

TPHA is treponema specific antibody that remains positive even after treatment

Question 23

Left lower abdo pain for 7 months, pain during sex, regular cycle, on ultrasound ovary has a fluid filled cyst of ground glass echogenicity. Diagnosis?

Answer 23

Endometriosis of ovary

Question 24

What is the transformational zone in the cervix cell type change?

Answer 24

Squamous to columnar

Question 25

Genital warts is typically caused by what type of HPV/

Answer 25

6 or 11

Question 26

What type of HPV causes cervical cancer?

Answer 26

16 and 18

Question 27

Long term use of oral contraceptives puts you at risk of what type of cancer>

Answer 27

Cervical

Question 28

What cancer type utilises CA125 as an indicator?

Answer 28

Ovarian cancer

Question 29

What conditions predispose you to endometrial carcinoma?

Answer 29

Lynch syndrome (hereditary non-polyposis colorectal cancer)

Polycystic ovarian syndrome

Question 30

What drugs can cause gynacomastia

Answer 30

Spironolactone
Exogenous oestrogens
Cimetidine
Steroids
Cannabis

Question 31

Women with painful cyclical breasts. Has smooth muscle discrete lumps, known turner syndrome. Likely diagnosis

Answer 31

Fibrocystic change

Question 32

Differential for breast pain

Answer 32

Fibrocystic change (cyclical pain
Sclerosing adenosis (lumpy breasts)
Duct ectasia
Mastitis

Question 33

What are some of the risk factors for endometrial adenocarcinoma?

Answer 33

Hypertension
Obesity
Diabetes
Polycystic ovarian syndrome

Question 34

What hpv type causes genital warts

Answer 34

Type 1 and2

Question 35

Which type of herpes is associated with cold sores?

Answer 35

Type 1

Question 36

What organism causes pneumonia in HIV patients

Answer 36

Pneumocystis jirovecci

Question 37

Viral shedding is higher with which genital herpes simplex

Answer 37

Type 2

Question 38

What may also cause a high CA125 level?

Answer 38

Produced on mesothelium found in lungs, ovary and peritoneum so any disease affecting it will raise

Question 39

what is the normal thickness of the endometrium?

Answer 39

<4mm