EBCOG P1 3 Months May- Contraception and STIS -Day 5 EMQ

Name

A. Candida albicans
B. Chlamydia trachomatis
C. Gardnerella vaginalis
D. Haemophilus ducreyi
E. Herpes simplex virus
F. Herpes zoster virus
G. Human papillomavirus
H. Molluscum contagiosum virus
I. Mycoplasma genitalium
J. Neisseria gonorrhoeae
K. Phthirus pubis
L. Sarcoptes scabiei
M. Treponema pallidum
N. Trichomonas vaginalis

In each of the following scenarios, what is the most likely organism that is being described? Each option may be used once, more than once or not at all.

1. A large DNA pox virus that causes a benign epidermal eruption of the skin. The lesions are usually characteristic, presenting as smooth-surfaced, firm, dome- shaped papules with central umbilication.

2.A sexually transmitted infection commonly presenting with vulval discharge and itching, dysuria and offensive odour. Overall, 10–50% of women are asymptomatic. Of women that are infected, the urethra is colonised in 90%, and 2% of women will have a ‘strawberry cervix’.

3.Permethrin is the first-line treatment for infection with this organism. Classic sites of infection include the interdigital folds, the wrists and elbows, and around the nipples in women.

A. <50 human immunodeficiency virus (HIV) RNA copies/ml
B. 50–399 HIV RNA copies/ml
C. ≥400 HIV RNA copies/ml
D. >1000 HIV RNA copies/ml
E. >100,000 HIV RNA copies/ml
F. CD4 cell count <350 cells/μl
G. CD4 cell count ≥350 cells/μl
H. CD4 cell count between 350 and 500 cells/μl
I. CD4 cell count <500 cells/μl
J. CD4 cell count >500 cells/μl
K. Hepatitis B virus (HBV) DNA >2000 IU/ml

For each of the following clinical scenarios, choose the single most applicable test result from the list of options above. Each option may be used once, more than once or not at all.

4. An HIV-positive woman who presented late for antenatal care at 34 weeks of gestation is now in labour. What would be the threshold parameter for offering intrapartum intravenous zidovudine therapy?

5.A 27-year-old woman is reviewed in the antenatal clinic at 36 weeks in her first pregnancy. She has HIV and is on highly active antiretroviral treatment (HAART). What is the threshold parameter for which delivery by elective caesarean section would be recommended?

6.An HIV-positive woman presents with spontaneous rupture of membranes at term. What is the threshold parameter to recommend induction of labour?

A . azithromycin 2 g stat
B. pelvic ultrasound
C. laparoscopic drainage and parenteral antibiotics
D. contact tracing
E. test of cure
F. azithromycin 1 g stat
G. metronidazole 400 mg twice daily for 1 week
H. pregnancy test
I. intravenous ceftriaxone and intravenous doxycycline followed by oral antibiotics
J. Ceftriaxone 1g intramuscularly as a single dose and referral to the genitourinary medicine clinic
K. laparoscopic adhesiolysis
L. removal of intrauterine contraceptive device (IUCD) and ofloxacin and metronidazole for 14 days
M. podophyllin ointment
N. steroid cream
O. electrocautery
P. removal of the IUCD
For each description below, choose the single most appropriate answer from the above list of options. Each option may be used once, more than once, or not at all.
7. A 27-year-old woman undergoes pre-IUCD insertion screening with triple swabs. She is asymptomatic and has been in a new relationship for the past 3 months. Her endocervical swabs show intracellular Gram-negative diplococci. What is the appropriate management option?

8.A 33-year-old woman is admitted to the gynaecology ward with abdominal pain and a swinging temperature. She was treated for vaginal discharge in a walk-in clinic, but details of the swab results are not available. On examination her temperature is 38.7°C with diffuse rigidity in the lower abdomen. A pregnancy test is negative. Ultrasound pelvis shows normal adnexa. What is the appropriate management option?

9.A 22-year-old woman attends the sexual health clinic with offensive vaginal dis- charge. She has been in a stable relationship for the past 4 years. Triple swabs are taken. Wet-mount examination shows motile flagellated protozoa. What is the appropriate management option?

10. A 28-year-old woman attends the emergency gynaecology clinic with vaginal discharge and abdominal pain. Her last menstrual period was 2 months ago, and an IUCD was fitted 3 months ago. She has been in a new relationship for the past 4 months. What is the appropriate management option