EBCOG Part 1-Postnatal Care & Sexual Reproductive Health-Day 7 (SBA)

1.What percentage of women with gonorrhoea are coinfected with chlamydia?

A. 10%
B. 20%
C. 30%
D. 40%
E. 50%

2.Chlamydia trachomatis is associated with all of the following except?

A Is an obligate intracellular virus
B Can cause conjunctivitis in the newborn
C Can cause pneumonia in the newbornC. Gonorrhoea, chlamydia, HIV and syphilis.
D Is the causative organism for lymphogranuloma venereumD. Gonorrhoea, chlamydia, HIV and human papilloma virus (HPV).
E It can be transmitted to the neonate during its passage through the birth canal and may cause conjunctivitis and pneumonia.

3.Chlamydia trachomatis infection is known to have a high frequency of transmission. If one partner is infected, what is the likelihood that the other partner will also be infected?

A. 10%
B. 25%
C. 50%
D. 75%
E. 100%

4.A 21-year-old woman attends the emergency department. She has recently changed partners. She complains of pelvic pain and vaginal discharge. Speculum and pelvic examination reveal discharge at the cervix and vagina, with pelvic tenderness and cervical excitation. As the on-call registrar who examined her, you suspect Chlamydia infection. What is the best test to confirm your suspicion?

A Endocervical swab for a nucleic acid amplification test (NAAT)
B Low vaginal swab for a NAAT
C Low vaginal swab for enzyme immunoassay
D Urine test for enzyme immunoassay
E Urine test for a NAAT

5.Which one of the following is correct in relation to neisseria gonorrhoea?

A.Culture requires anaerobic medium.
B.Is not a recognised cause for neonatal ophthalmia neonatorum (neonatal ‘sticky eye’)
C.Infects superficial mucosal surfaces lined with squamous epithelium.
D.Untreated, may cause a syndrome of fever, skin lesions, arthritis and endocarditis.
E.Vaccine preventing transmission exists.

6.Which one of the following is correct in relation to chlamydia?

A. Chlamydial infection is the second most common bacterial sexually transmitted infection in the UK.
B. If diagnosed during pregnancy, antibiotic treatment should be deferred till after delivery.
C. May cause triad of arthritis, conjunctivitis and urethritis in young men.
D. More likely to be symptomatic than asymptomatic in women.
E. Previous chlamydia does not increase the risk of ectopic pregnancy.

7.A 20-year-old pregnant woman presented to the genitourinary medicine clinic two weeks previously and was found to have a chlamydia infection. She received azithro- mycin 1 g as a single dose. You arranged for contact tracing.What is the next step?

A. Follow-up after six months.
B. Full STI screen.
C. Nothing to be done.
D. Test of cure during this visit.
E. Test of cure after five weeks.

8.During diagnostic laparoscopy on a 28-year-old female for chronic pelvic pain, you noticed inflammation of the liver capsule and adjacent peritoneum. What is the most likely causative organism?

A. Calymmatobacterium granulomatis.
B. Chlamydia trachomatis.
C. Haemophilus ducreyi.
D. HSV-type 2.
E. Treponema pallidum.

9.A young woman presents to the genitourinary medicine clinic. After a swab was taken from the endocervix, microscopic examination reveals a Gram-negative diplococcus. What organism looks like this under a microscope?

A. Actinomyces israeli.
B. Chlamydia trachomatis.
C. Haemophilus ducreyi.
D. Neisseria gonorrhoea.
E. Trichomonas vaginalis.

10.Which of the following is not true about Neisseria gonorrhoea infection?

A. Almost half of the cases with gonorrhoea may be asymptomatic.
B. Heavy menstrual bleeding is a known symptom.
C. Neisseria gonorrhoea are Gram-negative bacilli.
D. Pharyngitis, meningitis and endocarditis are known presentations.
E. Postcoital or intermenstrual bleeding can be seen in cases with cervicitis.

11.A 21-year-old woman comes to the genitourinary medicine clinic complaining of vaginal discharge. Vaginal high-swab results show that she has bacterial vaginosis. She asks you about treatment of her sexual partner.Which infection needs treatment of an asymptomatic sexual partner?

A. Bacterial vaginosis.
B. Candidiasis.
C. Human papilloma virus.
D. Herpes simplex virus.
E. Trichomonas vaginalis.

12. A 25-year-old woman has come to your registrar-led clinic with vaginal discharge. This started 3 years ago after a surgical termination of pregnancy. The GP has repeatedly arranged investigations, including swabs and pelvic ultrasound, but no cause has been identified for the discharge. The woman does not believe the investigation results are normal. She feels that the discharge has been caused by an instrument left behind during the termination of pregnancy.How should she be managed?

A Check for Candida
B Arrange a psychosocial intervention
C Re-examine the pelvis to rule any other cause
D Repeat the check for sexually transmitted infections
E Repeat ultrasound

13.A28-year-old female during diagnostic laparoscopy for chronic pelvic pain she suffered it more than 6 months, you noticed inflammation of the liver capsule and adjacent peritoneum. What is the most likely causative organism?

A.Calymmato-bacterium granulomatis.
B.Haemophilus ducreyi.
C.HSV-type 2.
D.Treponema pallidum.
E.Chlamydia trachomatis.

14.A 20-year-old woman comes to the outpatient clinic requesting testing for gonorrhoea as she read a poster about gonorrhoea infection. She has had one sexual partners in the last year ( her husband ) but uses condoms for contraception.What tests should you offer her?

A.Gonorrhoea only.
B.Gonorrhoea and chlamydia.
C.Gonorrhoea, chlamydia, HIV and syphilis.
D.Gonorrhoea, chlamydia, HIV and human papilloma virus (HPV).
E.Gonorrhoea, chlamydia, HIV and hepatitis C virus (HCV).

15.Which one of the following is correct in relation to Neisseria gonorrhea?

a)Culture requires anaerobic medium.
b) not a recognized cause for neonatal ophthalmia neonatorum (neonatal sticky eye)
c)Infects superficial mucosal surfaces lined with squamous epithelium.
d)Untreated, may cause a syndrome of fever, skin lesions, arthritis and endocarditis.
e)Vaccine preventing transmission exists.

16.Which one of the following is correct in relation to chlamydia?

a)Chlamydial infection is the second most common bacterial sexually transmitted infection in the UK.
b)If diagnosed during pregnancy, antibiotic treatment should be deferred till after delivery.
c)May cause triad of arthritis, conjunctivitis and urethritis in young men.
d)More likely to be symptomatic than asymptomatic in women.
e)Previous chlamydia does not increase the risk of ectopic pregnancy.

17.Which of the following is not true about Neisseria gonorrhea infection?

a)Almost half of the cases with gonorrhea may be asymptomatic
b)Heavy menstrual bleeding is a known symptom.
c)Neisseria gonorrhea are Gram-negative bacilli
d)Pharyngitis, meningitis and endocarditis are known presentations
e)Postcoital or intermenstrual bleeding can be seen in cases with cervicitis

18.The following are modalities used in the treatment of woman with anogenital warts: All of the following are false except?

A Podophyllotoxin – oral route
B Trichloroacetic acid – oral route
C Podophyllin – local application
D 5-fluorouracil – local application
E Gentian violet – local application

19.Trichomonas vaginalis infection in pregnancy is associated with preterm birth and low birth weight. What percentage of infected women are asymptomatic?

A. 10–50%
B. 50–60%
C. 60–70%
D. 70–80%
E. 80–90%

20.Bacterial vaginosis is associated with the all of the following except?

A An excess growth of anaerobic organisms in the vagina
B An excess growth of Gardnerella vaginalis in the vagina
C A >4.5 pH in the vagina
D A positive amine test
E An overgrowth of lactobacilli in the vagina

21.What is the most sensitive test for detection of Trichomonas vaginalis infection?

A. Immunochromatographic capillary flow (dipstick) assay
B. Laboratory culture
C. Light-field microscopy
D. Nucleic acid amplification test (NAAT)
E. Trichomonas serum antibody test

22.A 20-year-old pregnant woman presented to the genitourinary medicine clinic with anogenital warts. She is diagnosed with human papillomavirus (HPV) infection-type 11. What are her treatment options?

A. 5-fluorouracil.
B. Cryotherapy.
C. Imiquimod.
D. Podophylline.
E. Trichloracetic acid.

23.Which one of the following is correct in relation to vaginal discharge?

A. Empirical treatment, based on history taking alone, is appropriate if BV or can- dida is clinically suspected and the risk of PID is considered very low.
B. Is more characteristic with chlamydia than trichomonas vaginalis infection.
C. The presence of Gardnerella vaginalis alone is sufficient to diagnose BV.
D. Vaginal pH measurement can help distinguish between bacterial vaginosis and trichomonas vaginalis.
E. Wet microscopy of the discharge is unreliable and unlikely to yield causative organism.

24.Candida infection: All of the following are false except?

A It is considered a sexually transmitted disease.
B Is a sexually transmitted disease
C Is more common in pregnant women
D Is not common in women with diabetes
E Is more common in women with a copper intrauterine contraceptive device (IUCD)

25.Regarding bacterial vaginosis: All of the following are true except?

A It is a sexually transmitted disease
B Most women are asymptomatic
C On wet microscopy, bacteria surround the epithelial cells
D It is not important to treat the partner to avoid recurrence of infection
E Clindamycin cream 2% can be used for treatment during pregnancy

26.In evaluation and management of women with vaginal discharge, which of the following statements is incorrect?

A. Allergic reactions can cause excessive vaginal discharge.
B. Douching the vagina as part of daily hygiene helps reduce vaginal discharge.
C. Exclusion of infective and other causes can help confirm that a vaginal dis- charge is physiological.
D. There is some association between methods of contraception and vaginal discharge.
E. Women with cervical ectopy may complain of increased physiological discharge.

27.Which one of the following is correct in relation to vaginal discharge?

a)Empirical treatment, based on history taking alone, is appropriate if BV or candida is clinically suspected, and the risk of PID is considered very low
b)Is more characteristic with chlamydia than trichomonas viginalis infection.
c)The presence of Gardnerella viginalis alone is sufficient to diagnose BV.
d)Vaginal pH measurement can help distinguish between bacterial vaginosis and trichomonas viginalis
e)Wet microscopy of the discharge is unreliable and unlikely to yield causative organism

28.In evaluation and management of women with vaginal discharge, which of the following statements are incorrect?

a)Allergic reactions can cause excessive vaginal discharge
b)Douching the vagina as part of daily hygiene helps reduce vaginal discharge
c)Exclusion of infective and other causes can help confirm that a vaginal discharge is physiological
d)There is some association between methods of contraception and vaginal discharge
e)Women with cervical ectopy may complain of increased physiological discharge

29.High vaginal swabs (HVS) may be used to aid the diagnosis of BV, VVC, TV or other genital tract infections (e.g. streptococcal organisms) which may be the cause of vaginal discharge, but their use should generally be reserved for some specific situations. In the following list, HVS is of very limited value in which of the following situation:In the following list, HVS is of very limited value in which of the following situation:

a)Failed treatment
b)Pregnancy, postpartum, post abortion or post-instrumentation
c)Presence of thick, curdy white discharge with itching in vulva with vaginal pH < 4.5
d)Recurrent symptoms
e)When symptoms, signs and/or pH are inconsistent with a specific diagnosis

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