Nose, Ears, Mouth And uTI

Question 1

What’s the shape of normal uterus

Answer 1

Mid line, firm and smooth, not tender to touch

Question 2

Abnormal uterus

Answer 2

Enlarged, asymmetrical and discomfort with palpitation

Question 3

Trachomonasis is caused by what?

Answer 3

T. Vaginalis.
Women>men, increase with sex increase in sex patterers

Question 4

What’s the clinical manifestations of T vaginalis infection

Answer 4

Off white or yellow frothy vigainal discharge often malodorous and profuse
Erythema of Vulva and cervix
STRAWBERRY CERVIX
Itch
Dysuria
10-50% asymptomatic in women

Question 5

What’s cause of bacterial vaginosis?

Answer 5

Imbalance in normal flora

Question 6

What’s the clinical manisfeststions of Bacterial vaginosis?

Answer 6

Greyish-white or milky thin watery discharge with unpleasant FISHY ODOR

Less common in women- itchy/burning near vagina

Up to 50% asymptomatic

Question 7

Bacterial vaginosis is associated with what

Answer 7

Increase susceptibility to STDs e.g HIV and PID
Pregnacy can cause preterm birth

Question 8

Vulvovaginal candidiasis

Answer 8

Cause by candida and 75% women will experience it in life time

Question 9

What’s the clinical manifestation of vulvovaginal candidiasis

Answer 9

White thick clumpy COTTAGE CHEESE like vaginal discharge. Sometimes adhering to wall of cervix and vagina

VULVAR PRURITUS dorminant feature

Small vulvar fissures- burning, soreness, dyspareunia and dysuria

Question 10

Genital herpes is it sexually transmitted

Answer 10

Yes, more prevalent if 14-59yrs

Question 11

What the classical symptom of genital herpes

Answer 11

Clusters of vesicles or pustules on an erythematous base

Question 12

What’s the clinical manifestation of primary infection with herpes

Answer 12

Severe and multiple bilateral genital ulcers, dysuria, fever, tender local inguinal lymphadenopathy flu like symptoms (malaise myalgia)

Question 13

What’s the manifestation of recurrent herpes episode?

Answer 13

Tingling, burning or shooting pain <24hrs before symptoms

Less severe and unilateral

Question 14

What’s the most commonly reported bacterial STI in Canada?

Answer 14

Chlamydia trachomatis

Question 15

What are the clinical manifestations of chlamydia infection?

Answer 15

Mucopurulent vaginal discharge
Dysuria
Dyspareunia
Bleeding during sexual intercourse, abnormal spotting or bleeding btw periods
Pelvic pain
70% women and 50% men infected are asymptomatic

Question 16

Bacterial vaginosis is caused by what?

Answer 16

Grardnerella vaginalis and mucoplasma hominis

Discharge grey, thin watery profuse with fishy odor

Question 17

Trachomoniasis is cause by what and what’s the definition symotom

Answer 17

T. Vaginalis

Strawberry cervix

Frothy yellow or white discharge

Question 18

Classical defining symptoms of vulvovaginal candidiasis

Answer 18

Defining signs= itchy, burning erythema/edema of vulva/vagina

White thick cottage cheese discharge

Question 19

Why is the presence or absence id type specific antibodies to herpes important in pregnacy?

Answer 19

It help differentiate between primary and non primary infection and help
Determine vertical transmission when herpes is acquired late in pregnancy

Question 20

Why should type specific serology (TSS) not used in asymptomatic people

Answer 20

High false positive rates

Question 21

What’s the first line treatment of trachomoniasis (T. Vaginalis) in adults and pregnant (symptomatic)

Answer 21

Metronidazole oral. Intravaginal metronidazole gel not effective

Note
Treat all cases and sexual partners

Question 22

Is treatment recommended in asymptotic women in pregnancy for triachomoniasis?

Answer 22

No

Question 23

Is treatment with Metronidazole contraindicated in lactation

Answer 23

No.
It can get into milk and affect taste. So hold 12-24hrs

Question 24

Asymptomatic bacterial vaginosis do you need to treat?

Answer 24

No.
Unless high risk (e.g prior to preterm delivery)
Prior IUD insert
Gyn surgery
Induced abortion
Upper tract instrumentation

Question 25

What is the treatment for symptomatic adult not pregnant

Answer 25

1st line metronidazole’ oral or gel Clindamycin cream 2nd line Metronidazole oral single dose Clindamycin oral

Question 26

Recurrent bacterial vaccines is caused by overgrowth of G. Vaginalis M. Hominis anaerobes first line treatment is?

Answer 26

Metronidazole oral or gel

Question 27

1st line Treatment of bacterial vaginosis

Answer 27

Metronidazole oral or gel Or Clindamycin

Question 28

Second line treatment for bacterial vaginosis is

Answer 28

Metronidazole single dose 2g Or Clindamycin oral

Question 29

Recurrent bacterial vaginosis treatment is what

Answer 29

Metronidazole oral or gel

Question 30

Should bacterial vaginosis be treated in pregnancy

Answer 30

Yes to avoid adverse outcome Avoid oral metronidazole in 1st trimester Use topical in 1 and 2nd trimester - no oral. After 7th month use oral.

Question 31

Asymptomatic candidiasis, is treatment necessary

Answer 31

No

Question 32

What’s the first line for candidiasis in non pregnant people

Answer 32

Cotrimazoke intravaginal Cotrimazole cream Miconazole intravaginal Fluconazole oral Tercomaze cream - intravaginal

Question 33

What are the preferred treatment of candidiasis in pregnacy

Answer 33

Topical agents Avoid Azoles (fluconazole)

Question 34

What the first line treatment of chlamydia in none pregnant and non lactating people

Answer 34

Doxycycline and azithromyxine

Question 35

What’s the treatment of chlamydia in pregnancy

Answer 35

Azithromycin- single dose Amoxicillin- 7days Erythromycin’s

Question 36

Is doxycycline and quinolone contraindicated in pregnacy and lactation

Answer 36

Yea

Question 37

If an individual is positive for chlamydia do you report

Answer 37

Yes. Contract tracing and treatment of all partners in last 60days

Question 38

Cervicitis is caused by what organisms?

Answer 38

C. Trachomatis N. Gonorrohea

Question 39

When is treatment if candidiasis in male partner indicated

Answer 39

If causative organisms is candida bamantitis Xtic presentation: erythematous glans + pruritus or irritation

Question 40

What’s the causative agents of cervicitis and the presentation

Answer 40

C. Trachomatis N. Gonorrhoea Presentation is inflamed cervix Purulent or mucopurulent exudate Induced or sustain bleeding Friability of the endocervical is

Question 41

Treatment of cervicitis

Answer 41

Ceftriaxonr or cefixime + Azithromycin or Doxycycline

Question 42

Undiagnosed cervicitis can result in what

Answer 42

Pelvic Inflammation Disease which can cause infertility and chronic pelvic pain

Question 43

What’s the treatment for first symptomatic genital herpes?

Answer 43

Acyclovir Or Femiciclovir Or Valacyclovir

Question 44

Herpes simplex in adults first symptomatic episodes, acute recurrent <6/yr or chronic suppressive >6/yr

Answer 44

First line is Acyclovir Or Femicclovir Or Valacyclovir

Question 45

Treatment of herpes simplex in pregnacy, first symptomatic episode

Answer 45

First line is acyclovir

Question 46

What is PID

Answer 46

Infectious and inflammatory disorder of upper female genital tract and adjacent t pelican structures

Question 47

What’s the clinical presentation of PID

Answer 47

Lower abdominal pelvic pain, bilateral dull aching worse with physical activity/sex Abnormal vaginal discharge, fever chill Dysuria intemenstural/post coital bleed Fever > 38 cervidal motion tenderness, adnexal tenderness

Question 48

PID first line treatment

Answer 48

Cefixime or ceftriaxone IM + doxycycline +|- metronidazole