Gynaecology and Sexual Health

Question 1

What are the main HSV viruses which causes genital herpes?

Answer 1

HSV 1 and HSV2

Question 2

What is the 1st line investigation for genital herpes?

Answer 2

Diagnostic investigation- NAAT Swab (women- vulvo-vaginal swab and first void urine in males)

Question 3

Name Secondary and Tertiary features of Syphillis?

Answer 3

Secondary Features:
* Fever
* Lymphadenopathy
* Rask on hands, trunk and feet
* Buccal ‘snail track’ ulcers

Tertiary Features:
* Gummas
* Anyeurism
* Argyll Robertson Pupil

Question 4

What is the management of vaginal candida/thrush?
b) what is the management in pregnancy?

Answer 4

1st line- oral fluclonazole
Pregnant- pessary or topical creams. Oral form is contra-indicated

Question 6

What is the most common cause of septic arthritis in sexually active young adults?

Answer 6

gonorhoea

Question 7

What is the management of Chlamydia in pregnancy?

Answer 7

1st line- doxycycline or azithromycin (fine to take if penicllin allergy)

Question 8

What is the 1st and 2nd line management of hyperemesis gravidarum?

Answer 8

1st line- buccal promethazine or cyclizine
2nd line- ondansteron (avoid 1st trimester)

Question 9

What is the diagnostic criteria of hyperemesis gravidarum?

Answer 9

• Dehydration
• Lost >5% body weight
• Electrolyte imbalance
  *otherwise patient just has nausea and vomiting of pregnancy

Question 10

What is the diagnostic criteria used in PCOS?

Answer 10

Rotterdam Criteria:
-biochemical marker- high LH:FSH ratio, androgens, raised prolactin
-oligomennhorea
-US- cysts present

Question 11

What is the management of PCOS?
a) women looking to concieve
b) women not looking to recieve at the moment

Answer 11

a) 1st line- clomifine citrate
2nd line- metformin

b) 1st line-COCP
2nd line- metformin

Question 12

What is the management of Termination of Pregnancy?
a) >14 weeks
b) <14 weeks

Answer 12

<14 weeks
oral- mifepristone and 48hrs later misoprostol

surgery- mannual vacuum or electric

> 14 weeks
1st line- evacuation and dilation

Question 13

What is management for a TOP >20 weeks

Answer 13

1st line- potassium chloride injection (Induces foetal cardiac arrest)

Question 14

What are mechanisms of the following drugs?
a) mifepristone
b) misoprostol

Answer 14

a) mifepristone- anti-progesterone
b) misoprostol-prostaglandin

Question 15

What is the management of miscarriages?
a) missed
b) incomplete

Answer 15

Missed:
1st line- oral mifEpristone + 48hrs later- misoprostol

Incomplete
1st line- single dose of misoprostol