gynae plus genitourinary

Question 1

premature ovarian failure is associated with

Answer 1

autoimmune causes

Question 2

what is the contraceptioon of choice in a patient with a history of epilepsy

Answer 2

injection or IUS

Question 3

non-keratined (soft ) genital warts can be treated by

Answer 3

podophyllotoxin…. keratinised lesions can be removed using cryotherapy whilst non keratinised lesions can be removed using podophyllotoxin, imiquimod or sinecatechins. T

Question 4

what are the 4 features present in tertiary syphylis

Answer 4

cns signs like rombergs, aortic regur, cutaneous lesions and dementia,….. the investigation will be enzyme immunosorbent assay

Question 5

what is the management of fibroids more than 3 cm

Answer 5

myomectomy…If abnormal bleeding and under 3cm in size with no uterine distortion can be targeted with medical options:

NSAIDs

Anti-fibrinolytics

Combined hormonal contraception

Levonorgestrel-releasing intrauterine system (Mirena)

The Mirena is often used first-line, however the other treatments may be selected depending on the patient’s wishes to remain fertile, any contraindications, or patient preference.

Question 6

exertitional dyspnoae in a HIV positive patient could be most likely due to

Answer 6

PCP infection

Question 7

what is the gold standard test used in a patient with high suspicion of HIV

Answer 7

HIV antigen and HIV ANTIBODY

Question 8

menorrhagia with no underlying pathology is called

Answer 8

dysfunctional uterine bleeding

Question 9

what is the management of chancroid

Answer 9

cipro plus ceftriaxone and its caused by haemophilous ducreyi

Question 10

what is the management of the endometriosis in a apatient who wants to conceive

Answer 10

laproscopic ablation of the endometrial tissue.

Question 11

what is the managament of CIN TYPE 3

Answer 11

LLEOTZ of the transission zone and in cin type 1 there is regular monitoring but in type 2 and 3 there is resection because the chances of it turning metastatic is high.

Question 12

in a patient with HIV what is the most common cause of meningitis?

Answer 12

cryptococcus meningitis which stains in the india ink

Question 13

what are the two additional symptoms seen in woman with large uterine fibroids

Answer 13

urinary incontinence and constipation.

Question 14

in a patient who received anal sex and presented to the gum clinic worried about HIV , what is the managamanet

Answer 14

give PEP if presents within 72 hrs irregardless or the partner hiv status. he two drugs used are Raltegravir and Truvada. These are prescribed for 28 days

Question 15

what is the triad associated wth vasa previa?

Answer 15

painless vaginal bleeding, rupture of membrane and fetal bradykardia

Question 16

what is the advice that can be given to a patient who present swith itching and tingling in the genital region and has a history of being treated for hsv

Answer 16

abstain from all form of sexual activity as this could be a prodromal symptom for herpes reinfection.

Question 17

In a patietn who was treated with benzathine pennicaline for secondary syphylis was brought to the emergency department with high fever and chills and rigor. what is the management

Answer 17

reasure that the symptoms would resolve in 24 hrs. as he is suffering from Jarisch-Herxheimer Reaction due to treatment of syphylis

Question 18

what is the management of molluscom contagiosum in a HIV positive patient

Answer 18

reassure of not then can treat with cryotherapy.

Question 19

what is teh one cancer whose risk is decreased by smokng

Answer 19

endometrial

Question 20

Painless ulcer and painless lymphadenopathy= Syphilis Painless ulcer and painful lymphadenopathy= LGV Painful ulcer and painful lymphadenopathy= Herpes/ Chancroid

Answer 20

read

Question 21

what happens to lh and fsh levels in pcos

Answer 21

the ratio of lh to fsh ratio is mostly increased to 2:1 or 3:1 with sometimes fsh in the normal range.

Question 22

Brain lesion with solid homogenous enhacement in a HIV patient what is the management

Answer 22

commence cART and whole brain irradiation. because it is cns lymphoma ……in toxoplasmosis the lesion with have ring enhancement.

Question 23

what is the management of PCP in a patient who has paO2 of less than 8

Answer 23

co-trimoxazole with steroids

Question 24

what is the treatment of Kaposi’s sarcoma

Answer 24

cART commencement and if the patient is aready on it then check compliance….purple nodules at the back

Question 25

what is the first second and third line management of uterine fibroids

Answer 25

ius(1st) then tanexamic acid and cocp are teh second line and third like is oral progesterone only pills

Question 26

what is a complication of bacterial vaginosis if the infection occurs during pregnancy

Answer 26

preterm rupture of membrane

Question 27

what are the two signs to look for in primary HIV

Answer 27

oral ulcer and trunk maculopapular rash

Question 28

Which cancer has the presence of psomomabodies?

Answer 28

serous cystadenocarcinoma….krukenberg tumour will have signet ring cells

Question 29

In a patient with previous uterine procedures who complains of secondary amenorrhea what is the most likely cause

Answer 29

ashermann syndrome

Question 30

what is the halmark of tertiary syphylis and what is the investigation a patient should have?

Answer 30

cardioshyphyllis and csf examination is important to see the evidence of neurosyphylis

Question 31

urethritis guy with a result of “ 6 polymorphs per high power field “ without the presence of gram negetive diplo should be treated as

Answer 31

clamydia and the treatment should be doxy

Question 32

what is the second line treatment for a PCOS patient who has failed to get pregnant after the metformin and clomiphene therapy

Answer 32

2nd line is leproscopic ovarian drilling and the third line is assisted

Question 33

An 18 year old man presents to the GP. He describes multiple lesions on his penis.

On examination, there are multiple uniform smooth lesions present around the coronal margin of the glans.

Given the likely diagnosis, what is the most appropriate management?

Answer 33

no treatment for pearly penile papules