EBCOG Part 1-Postnatal Care & Sexual Reproductive Health-Day 8 (EMQ)

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.

1. 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?

2.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?

3.A 22-year-old woman attends the sexual health clinic with offensive vaginal discharge. 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?

4.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?

5. A 38-year-old woman presents with vulval irritation and lumps in her vulva. On examination multiple keratinised warts are seen on the vulva. What is the appropriate management option?