Sexual Health

Question 1

When should you do Hep C serology on MSM ?

Answer 1

Once a year

Question 2

When should you do Hep C serology on high risk patients?

Answer 2

Every 3 months

Question 3

At what stage of syphillis will the vDRL blood test level be the highest?

Answer 3

In secondary syphillis

Question 4

What are the 3 STIs that there is worry about anti microbial and viral resistance in?

Answer 4

Gonorrhoea

HIV

Mycoplasma Genitalum

Question 5

How many anti retrovirals are use in post exposure prophylaxis?

Answer 5

3 anti-retrovirals

Question 6

How many anti-virals are used in pre exposure prophylaxis?

Answer 6

You use 2 anti-retrovirals

Question 7

Who can discuss and assess the benefits of PREP, PEP for a patient ?

Answer 7

ANYONE

Question 8

What are some disease complications associated with HIV?

Answer 8

1. Hodgkin’s Lymphoma
2. PJP
3. Shingles
4. Kaposi Sarcoma
5. Cervical Cancer

Question 9

What is classed as a late diagnosis of HIV?

Answer 9

CD4 count of less than 350

Question 10

Why do untreated HIV patients have a higher than average level of protein in their blood?

Answer 10

Due to excess levels of immunoglobulin

Question 11

What organism causes thrush?

Answer 11

Candida Albicans

Question 12

What are 3 RF for candida?

Answer 12

Diabetes

Antibiotics

Pregnancy

Question 13

What are some symptoms of candida?

Answer 13

Thick cottage cheese white vaginal discharge

Superficial dyspareunia

Itchy genital pain, erythema and Balanitis

Question 14

What swab would you do on someone with suspected Candida?

Answer 14

Amies Swab

Question 15

What is the management of candida ?

Answer 15

Fluconazole

Question 16

What ulcers does the following HSV viruses cause?

HSV 1
HSV 2

Answer 16

HSV 1: mouth ulcers

HSV 2: genital ulcers

Question 17

What are 3 triggers of HSV?

Answer 17

1. Sexual intercourse
2. Stress
3. Menstruation.

Question 18

What are some of the symptoms of HSV infection?

Answer 18

Inguinal Lymphadenopathy
Flu like symptoms

Vulvitis and pain
Ulcer formation

Question 19

What is the treatment of HSV ulcers?

Answer 19

Acyclovir

Question 20

When is a C section indicated in a patient who has HSV infection?

Answer 20

Still active lesions 6 weeks pre labour. Need a C Section

Question 21

What antibiotic are most gonorrhoea strains resistant to?

Answer 21

Ciprofloxacin

Question 22

What are some of the symptoms of gonorrhoea?

Answer 22

Green watery discharge
Pharyngitis
Proctitis
PID
Epididymal-orchitis

Question 23

What are 3 diagnostic tests for gonorrhoea?

Answer 23

Endocervical swab (Amies Swab)
Urethral swabs
Rectal + Pharyngeal Swabs

Question 24

What are the antibiotics you use to treat gonorrhoea?

Answer 24

1. IM ceftriaxone + Azithromycin

Question 25

What are 3 complications of Gonnorhoea?

Answer 25

PID Tubal infertility Septic arthritis

Question 26

What investigations would you do in a patient with suspected trichomonas vaginalis?

Answer 26

Amies Swab Wet smear and microscopy

Question 27

What is the management of patients with trachoma vaginalis?

Answer 27

Metronidazole STAT PO

Question 28

What is seen on examination of a patient with Trichoma? What is the clinical presentation of someone with trichomonas ?

Answer 28

Strawberry Cervix Clinical Presentation: frothy discharge, vulval itching and dysuria

Question 29

If you see Clue Cells on microscopy.. what do you diagnose?

Answer 29

Bacterial vaginosis

Question 30

What criteria do you sue when diagnosing bacterial vaginosis?

Answer 30

Amsel’s Criteria

Question 31

Is bacterial vaginosis a sexually transmitted disease?

Answer 31

NO

Question 32

What is the pathophysiology of bacterial vaginosis? How is it treated?

Answer 32

You get a proliferative of anaerobic bacteria and decreased lactobacilli Management is via metronidazole

Question 33

What type of microorganism is chlamydia?

Answer 33

Intracellular Parasite Gram Negative

Question 34

What is the treatment for chlamydia infections?

Answer 34

Doxycycline

Question 35

What structures are affected in pelvic inflammatory disease?

Answer 35

1. Uterus 2. Fallopian Tubes 3. Ovaries

Question 36

How does PID present?

Answer 36

You get bilateral lower abdo pain Fever Abnormal cervical discharge and vaginal bleeding Normally see mucopurulent cervical discharge and have cervical motion tenderness

Question 37

What are 4 complications of PID?

Answer 37

Ectopic Infertility Chronic Pelvic Pain Reactive Arthritis

Question 38

How do you manage PID? Mild Moderate to Severe ?

Answer 38

Mild: you give the patient IM ceftriaxone and PO doxycycline Moderate to Severe: give above and keep the patient in hospital

Question 39

What are the 4 stages of Syphillis?

Answer 39

Primary: 1-90 days post infection. Single painless chancre on the genitals, cervix or mouth. Alongside inguinal lymphadenopathy. Secondary: occurs within 2 years of infection. You get a generalised pink rash on the palms or the soles. You get generalised lymphadenopathy, fever and malaise. Can also get uveitis with wart like lesions on the mucous membranes. Latent: no new changes Tertiary: dementia, stroke. Aortitis and visual loss . Normally > 2 years post infection.

Question 40

What is the diagnostic test for syphillis?

Answer 40

VDRL carbon antigen test

Question 41

How do you treat syphillis?

Answer 41

IM Benzyl Penicillin

Question 42

What are 3 complications of syphillis in pregnancy?

Answer 42

Still Birth Congenital Syphillis Preterm Delivery

Question 43

What are 5 STDs that you can transmit from male partner to pregnant female?

Answer 43

Ebola Zika Syphillis HIV HSV , gonorrhoea and chlamydia

Question 44

How does Zika virus present in an infected mother?

Answer 44

Conjunctivitis Joint pain Rash Fever

Question 45

What are two signs of Zika Virus in a child?

Answer 45

Microencephaly Heart Defects Miscarriage Still Birth

Question 46

What are two tropical STDs?

Answer 46

Donovanosis Chancroid: Symptoms same for the above: lymphadenopathy, ulcerative lesions that bleed easily in perianal region

Question 47

In a patient who has MSM and is recently positive for chlamydia . What condition should you take a sample to check for?

Answer 47

LGV (lymphogranuloma venereum) More expansive lesions and lymphadenopathy

Question 48

What is the pathogen behind syphillis?

Answer 48

Treponema Pallidum