Sexual health

Question 1

What would you see on MC and S high vaginal swab if candida thrush?

Answer 1

Oval spores and budding hyphae

Question 2

What class of drug do you treat thrush with?

Answer 2

Imidazoles

Question 3

Which drugs do you use to treat thrush with?

Answer 3

Intravaginal Clotrimazole or micanazole
If vulval symptoms then topical clotrimazole or micanazole pessary
Oral fluconazole

Question 4

What organisms involved in BV and what is pH?

Answer 4

ph>4.5

Gardanella vaginalis and atopium vaginae

Question 5

How do you diagnose BV, what criteria? What will microscopy show?

Answer 5

1. pH >4.5
2. Positive whiff test
3. Microscopy- will show clue cells

Amsels criteria (3/4 including thin white grey discharge)

Question 6

How do you treat BV?

Answer 6

Oral 400mg Metranadizole
Intravaginal Metranadizole
Intravaginal clindamycin

Question 7

How do do you treat BV during pregnancy and what is it associated with?

Answer 7

Oral clindamycin

preterm labour (give before 20 weeks to prevent) and chorioamnionitis

Question 8

What should be avoided when taking metranadizole?

Answer 8

Alcohol

Question 9

What type of organism is trichomonas vaginallis?

Answer 9

Flagellated protozoan

Question 10

What are the features of trichomonas? in female and male

Answer 10

Female- green/grey discharge which is offensive
Vulvovaginitis- itchy, superficial dyspaeurenia, dysuria
Strawberry cervix

Male- purulent urethral discharge, dysuria, urtheral irritation, frequency

Question 11

How do you diagnose trichomonas and what would you seen on microscopy?

Answer 11

1. HVS- microscopy- motile trichomonads
2. Gold standard- NAATs
3. In males do culture of first void urine

Question 12

How do you treat trichomonas and how long should they abstain from sex?

Answer 12

Metranadizole

1 week until contract tracing and until partner has completed follow up

Question 13

How do you investigate gonorrhoea? What will micscopy show

Answer 13

Microscopy culture and sensitivity- endocervical swab or urethral swab- gram negative diplococcus
NAATS

Question 14

Management of gonorrhoea?

Contact tracing?

Answer 14

Anogenital disease- IM ceftriaxone single dose with Azithromycin

if male symptomatic urehtritis- tracing from 2 weeks previous
All other- 3 months previous

Question 15

How is chlamydia trochomanis treated?

In pregnancy?

Answer 15

Doxycline- 7 days and Azithromycin single dose

Oral Azithromycin

Question 16

What are genital herpes caused by and how do you investigate?

Answer 16

HSV1- oral HSV2- recurrent (primary and latent infection in dorsal root ganglia)

Viral swab from base ulcer for NAATs and PCR
Or HSV serology- HSV1 IgG antibidoes and HSV2 IgG antibodies

Question 17

Conservative and pharmacological management of genital herpes?

Answer 17

C: saline bath, analgesiae, topical anaesthetic, analgesia

Pharamcological: Aciclovir

Question 18

What are genital warts caused by and how are they treated?

Answer 18

HPV 6 & 11

If not regressed or recurrent then Imiqioud cream and cryotherapy

Question 19

What is the organism causing syphilis?

Answer 19

Spirochoaete: Treponema pallidum

Question 20

What is IX and TX of syphillis?

Answer 20

EIA and serological tests

IM benzylpenicillin

Question 21

What clade of HIV virus is repsonsible for HIV infection in Europe?

Answer 21

HIV 1 virus- clade B

Question 22

What are three phases of HIV?

Answer 22

Primary infeciton- seroconversion at 6 weeks- most infectious

Latency periods- lasts 6-7 years

ARDC or AIDS- <200 CD4 and oppurtunistic infection, constituinal symptoms, persistent generalized lymphoadenopathy

Question 23

What are the IX for HIV?

Answer 23

1. Serum/salivary HIV antibody using ELISA and confirm with Western blot
   if negative…
2. PCR for HIV RNA

Monitor progression with HIV RNA, and CD4 cell count

Question 24

How often should you conduct smear tests in HIV positive women?

Answer 24

Every year because progression to disease is faster

Question 25

What drugs are included in HAART therapy (Clue reverse transcriptase inhibitors all together 5)

Answer 25

2 nucleoside reverse transcriptase inhibitors
1 non-nucleoside reverse trasncriptase inhibitor
2 protease inhibitors

Question 26

lesion colour in lichen planus and lichen sclerosus

Answer 26

Lichen planus- purple flat papular lesions

Lichen sclerosus- pink white papules with fissures and thin skin, and vaginal inflammatory adhesions (have severe pruiritis)