STI & Breast

Question 1

Chlamydia Ix

Answer 1

NAAT

Question 2

Chlamydia Mx

Answer 2

Doxycycline 100mg BD 7 Days
Azithromycin if pen allergic.

Question 3

Chlamydia Symptoms

Answer 3

Women - odourless discharge, IMB/PCB, dysuria
Men - Dysuria, Clear/white discharge.

Question 4

Gonhorroea Ix

Answer 4

NAAT, culture, gram staining (-ve coffee bean pairs)

Question 5

Gonhorroea Mx

Answer 5

1g IM Ceftriaxone
Gent if pen allergic

Question 6

Gonhorroea Symptoms

Answer 6

Urethral discharge, tenderness, swelling. Purulent exudate of endocervix

Question 7

Syphillis Ix

Answer 7

VDRL cafbon antigen test
Smear from primary lesion

Question 8

Syphillis Mx

Answer 8

Benpen G 2.4 Million units IM Stat

Question 9

Syphillis presentation

Answer 9

Primary - painless chancre

Secondary - Hepatitis, splenomegaly, CN palsy, uveitis

Tertiary - Neurosyphilis, tabes dorsalis, dementia, aortic aneurysms

Question 10

HSV Ix

Answer 10

Viral PCR of vesicle fluid

Question 11

HSV Mx

Answer 11

Saline bath, lignocaine
Abstinence
Aciclovir 200-400mg

Question 12

HSV presentation

Answer 12

Primary - flu like illness, headache etc
Inguinal lymphadenopathy
Painful vesicles

Recurrence - reactivation in sacral ganglia
Triggered by stress, sex, menstruation.

Question 13

HSV types

Answer 13

Type 1 - Oral
Type 2 - genital

Question 14

HPV Ix

Answer 14

Clinical

Question 15

HPV Mx

Answer 15

Podophyllotoxin topical BD 3 days
Imiquimod Three times weekly at night, wash off in morning
Cryotherapy

Question 16

HPV presentation

Answer 16

Condyloma, may itch and bleed

HPV 6 and 11

Question 17

HIV Ix

Answer 17

NAAT 10-33d post exposure
Antigen/Ab blood test
Rapid antigen ab test

Question 18

HIV Mx

Answer 18

HAART 3 drugs from 2 classes

Usually 2 NRTI and 1 Protease/non NRTI

Question 19

HIV prevention

Answer 19

PEP exposure <72 hrs
PrEP
Condom

Question 20

HIV opportunistic infection

Answer 20

Pneumocystiis jyroveicci

Question 21

Epididymo-orchitis presentation

Answer 21

Unilateral pain and swelling
Epididymal swelling
Erythema, oedema, secondary hydrocele

Question 22

Balanitis presentation

Answer 22

Inflammation of foreskin and glans

Question 23

Prostatitis presentation

Answer 23

Bacterial infection of prostate, commonly E.Coli and Chlamydia.

LUTS, Pain

PR, swollen boggy prostate, urine culture, STI Screen

Question 24

Prostatitis Mx

Answer 24

Ciprofloxacin 500mg BD

Question 25

Proctitis

Answer 25

Inflammation of last 12cm GIT Common in MSM + receptive anal

Question 26

Proctitis Mx

Question 27

If CD4 <200 in HIV

Answer 27

Add oral co-trimoxazole (prophylactic)

Question 28

Most common breast cancer

Answer 28

Invasive ductal carcinoma

Question 29

Breast cancer Ix

Answer 29

2ww if >30 and lump 2ww if >50 and discharge, retraction or other sign

Question 30

Risks for breast cancer

Answer 30

Uninterrupted oestrogen, OCP, FHx, Ionising radiation, age

Question 31

Breast cancer triple assessment

Answer 31

Mammogram Clinical assessment FNAC

Question 32

If HER2 +ve BCa

Answer 32

Trastuzumab (herceptin)

Question 33

If ER/PR +ve BCa

Answer 33

Tamoxifen (pre-peri menopausal)/anastrazole (in menopause)

Question 34

Breast abscess Presentation

Answer 34

Pus collection, commonly due to mastitis in breast feeding Commonly staph aureus +/- acillary lymph

Question 35

Breast abscess Mx

Answer 35

USS I&D MC&S pus Usually flucloxacillin

Question 36

Fibroadenoma

Answer 36

Mobile, fibrous lump Triple assessment Watch and wait, excision if pain