Reproductive system

Question 1

Where is the most common site for ectopic pregnancies?

Answer 1

Fallopian tubes - and specifically, most commonly, the ampulla

Question 2

What is the most accurate method to detect a tubal pregnancy?

Answer 2

Transvaginal ultrasound

Question 3

What criteria must be filled for a woman to be offered medical management (methotrexate) of an ectopic pregnancy?

Answer 3

Able to return to hospital easily.
No significant pain.
Unruptured ectopic pregnancy with an adnexal mass <35 mm and no visible heartbeat.
No intrauterine pregnancy seen on ultrasound scan.
Serum hCG <1500 IU/L.

Question 4

Which strains of HPV are over 95% of anogenital warts caused by?

Answer 4

HPV 6 and HPV 11

Question 5

What are the treatment options for anogenital warts?

Answer 5

Podophyllotoxin cream (for soft, non-kerarinised external warts)
Imiquimod cream (for keratinised & non-keratinised external warts)
Ablation: Cryotherapy, excision, electrocautery or laser

Question 6

Which strain of the herpes simplex virus is more commonly associated with genital herpes?

Answer 6

HSV-2

Question 7

What is the management of genital herpes?

Answer 7

Oral aciclovir (only really effective if 1st occurrence of genital herpes, less effective if a recurrence)

Question 8

How is genital herpes during pregnancy managed?

Answer 8

If first appearing after 28 weeks, oral aciclovir tds
If a known recurrent problem, oral aciclovir from the beginning.
N.B. if genital herpes and pre-term rupture of membranes, iv aciclovir during the delivery

Question 9

What is the classical description of the discharge resulting from infection with neisseria gonorrhoea?

Answer 9

Odourless, green, purulent discharge

Question 10

What type of test is used to detect chlamydia and gonorrhoea infections?

Answer 10

Nucleic acid amplification testing (NATT)

urine sample in males and self low-swab in females (if asymptomatic

Question 11

What is the treatment for gonorrhoea?

Answer 11

single dose of IM ceftriaxone 1g

Question 12

What is the pathogen that causes syphilis?

Answer 12

Treponema pallidum

Question 13

What is the first line treatment for syphilis?

Answer 13

IM ben pen

Question 14

What might you expect to feel on PR of a patient with acute bacterial prostatitis?

Answer 14

Tender, boggy prostate gland

Question 15

What is the recommended treatment for acute bacterial prostatitis?

Answer 15

14 day course of a quinolone e.g. ciprofloxacin

Question 16

What is the recommended treatment for non-gonococcal urethritis?

Answer 16

Either oral doxycycline for 7 days or single dose of oral azithromycin

Question 17

What is the first line investigation to diagnose testicular cancer?

Answer 17

Ultrasound scan

Question 18

What ages qualify for breast cancer screening?

Answer 18

47-73

Question 19

What is the hormonal therapy of choice for women with tumours positive for hormone receptors in the pre- and post-menopausal group respectively?

Answer 19

Pre- and peri-menopausal: Tamoxifen for up to 5 years

Post-menopausal: Anastrazole (an aromatase inhibitor)

Question 20

What are the important side effects of Tamoxifen to be aware of?

Answer 20

Increased risk of endometrial cancer, venous thromboembolism and menopausal symptoms.

Question 21

If a breast tumour is HER2 positive, what biological treatment may be offered?

Answer 21

Herceptin (aka trastuzumab