Infections

Question 1

Grey/white fishy discharge with no vulval soreness?

Answer 1

Bacterial vaginosis

Question 2

pH of vaginal secretions in BV is usually…?

Answer 2

> 4.5

Question 3

Management of bacterial vaginosis?

Answer 3

Oral metronidazole first-line

Intravaginal metronidazole/clindamycin are alternatives

Question 4

Management of chlamydia? (4)

Answer 4

Advise to attend GUM clinic
Antibiotics- doxycycline 100mg bd for 1/52 is first line
Treat partner also
Abstain from sex until treatment complete

Question 5

Classical findings in trichomonas vaginalis?

Answer 5

Frothy yellow discharge

“Strawberry cervix”

Question 6

First-line treatment of trichomonas vaginalis?

Answer 6

Metronidazole for 1/52

Question 7

Investigation of gonorrhoea in men? (2)

Answer 7

Symptomatic- swab

Asymptomatic- first void urine

Question 8

Investigation of gonorrhoea in women? (2)

Answer 8

Symptomatic- endocervical swab

Asymptomatic- vulvovaginal swab

Question 9

Management of gonorrhoea?

Answer 9

Ceftriaxone 500mg IM stat + azithromycin 1g PO stat

Question 10

How long after exposure is post-exposure prophylaxis effective for?

Answer 10

72 hours

Question 11

How long can it take to generate HIV antibodies?

Answer 11

up to 3 months

Question 12

At which level of CD4 count is the patient considered to have AIDS?

Answer 12

<200

Question 13

Cause of lymhogranuloma venereum?

Answer 13

Chlamydia infection, almost exclusively in HIV+ MSM

Question 14

Contraceptive considerations in HIV?

Answer 14

Antiretrovirals reduce efficacy of hormonal contraception; if using levonorgestrel, provide double (3mg) dose

Question 15

Immunization guidance for HIV?

Answer 15

Annual influenza vaccination, pneumococcal, hepatitis A/B vaccine
Live vaccines generally contra-indicated; however give varicella and MMR (for women of childbearing age) if seronegative

Question 16

Cervical screening frequency in HIV?

Answer 16

Annual

Question 17

Management of genital herpes?

Answer 17

Aciclovir if presents <5 days while new lesions are still forming

Question 18

In women, most CIN is associated with which HPV serotypes?

Answer 18

16 and 18

Question 19

Which HPV serotypes are associated with 90% of genital warts?

Answer 19

6 and 11

Question 20

Management options for genital warts?

Answer 20

Podophyllotoxin and imiquimod can be used at home

Excision/cryotherapy

Question 21

Latency of HPV?

Answer 21

3 weeks to 8 months

Question 22

Fusiform protozoa on cervical cytology are pathognomonic of…?

Answer 22

Trichomonas vaginalis