Sexual health

Question 1

Emergency contraception < 72 hours

Answer 1

Levonelle (levonorgestrel)`

Question 2

Emergency contraception < 120 hours

Answer 2

EllaOne (ulipristal)

Question 3

Emergency contraception >5d and up to 5d after likely ovulation date

Answer 3

Copper coil

Question 4

Candida albicans symptoms

Answer 4

Discharge (white, cottage cheese) + superficial dyspareunia

Question 5

Candidiasis diagnosis

Answer 5

High-vaginal charcoal swab (pH <4.5)

Question 6

Candidiasis diagnosis management

Answer 6

Clotrimazole pessary in pregnancy or fluconazole

Question 7

Trichomonas vaginalis symptoms

Answer 7

Discharge (yellow/green, frothy with musty odor), strawberry cervix

Question 8

Trichomonas vaginalis investigation

Answer 8

High-vaginal charcoal swab (pH >4.5)

Question 9

Trichomonas vaginalis treatment

Answer 9

Metronidazole

Question 10

Bacterial Vaginosis pathogen

Answer 10

Gardnerella vaginalis (clue cells)

Question 11

BV symptoms

Answer 11

Discharge (white, thin, homogenous with fishy odor)

Question 12

BV treatment

Answer 12

Metronidazole

Question 13

Pelvic Inflammatory Disease (PID) causes

Answer 13

CT, NG, or Mycoplasma genitalium

Question 14

Pelvic inflammatory disease symptoms

Answer 14

Discharge, pelvic pain, deep dyspareunia, oligomenorrhea, intermenstrual bleeding, post-coital bleeding

Question 15

Pelvic inflammatory diagnosis

Answer 15

Double or triple swabs + bimanual exam

Question 16

Pelvic inflammatory management

Answer 16

Doxycycline or ofloxacin + metronidazole + ceftriaxone IM stat

Question 17

Chancroid pathogen

Answer 17

Haemophilus ducreyi

Question 18

Chancroid symptoms

Answer 18

Papule → pustule → painful ulcer, inguinal lymphadenopathy

Question 19

Chancroid management

Answer 19

Azithromycin

Question 20

Anogenital Warts pathogens

Answer 20

HPV-6, HPV-11

Question 21

Anogenital Warts management

Answer 21

Podophyllotoxin cream or cryotherapy

Question 22

Syphilis pathogen:

Answer 22

Treponema pallidum

Question 23

Syphilis symptoms

Answer 23

1° - Painless ulcer; 2° - Rash, general lymphadenopathy, tingling

Question 24

Syphilis treatment

Answer 24

Benzathine benzylpenicillin IM stat

Question 25

Complications of benzathine benzypenicillin in syphilis treatment

Answer 25

Jarisch-Herxheimer reaction

Question 26

Herpes pathogen

Answer 26

HSV-1, HSV-2

Question 27

Herpes symptoms

Answer 27

Painful ulcer, dysuria, pyrexia, inguinal lymphadenopathy

Question 28

Herpes treatment

Answer 28

Aciclovir until birth via C section (if in pregnancy)

Question 29

How are herpes and syphilis diagnosed

Answer 29

Swab ulcers for PCR

Question 30

How are chlamydia and NG diagnosed

Answer 30

Endocervical / first pass urine NAAT

Question 31

Neisseria gonorrhoea treatment

Answer 31

Azithromycin + Ceftriaxone

Question 32

Neisseria gonorrhoea complications

Answer 32

PID (with Fitz-Hugh-Curtis syndrome), Bartholin’s abscess, urethral strictures; Urethral strictures, septic arthritis

Question 33

Chlamydia treatment

Answer 33

Azithromycin or doxycycline

Question 34

Symptoms of chlamydia or NG

Answer 34

Asymptomatic (mainly), discharge, dysuria, cervicitis, bleeding, pelvic pain

Question 35

What causes chancroid

Answer 35

Haemophilus ducreyi

Question 36

Symptoms of chancroid

Answer 36

Painful genital ulcers which leak pus

Question 37

How do chancroid sores progress

Answer 37

Sores / ulcers spread and join into larger sores

Question 38

1st line chlamydia management

Answer 38

PO doxycycline

Question 39

1st line gonorrhoea management

Answer 39

IM ceftriaxone

Question 40

1st line syphylis management

Answer 40

IM benzathine penicillin

Question 41

1st line herpes management

Answer 41

PO aciclovir

Question 42

1st line trichomonas vaginalis management

Answer 42

PO metronidazole

Question 43

Common STIs and their 1st line management

Answer 43

Chlamydia - PO doxycycline NG - IM ceftriaxone Syphylis - IM benzathine penicillin Chancroid - PO azithromycin Herpes - PO aciclovir Trichomonas vaginalis - PO metronidazole

Question 44

Which buzzword indicates presence of trichomonas vaginalis

Answer 44

"Strawberry cervix"

Question 45

Risk factors for testicular cancer

Answer 45

White, subfertility, cryptorchidism, Kleinefelters, mumps, FHx

Question 46

Name the 2 types of testicular cancer and which one has a better prognosis

Answer 46

Seminoma (better prognosis) and Non-seminoma germ cell tumour (NSGCT)

Question 47

Tumour markers in seminoma and NSGCT

Answer 47

Seminoma = LDH, NSGCT = AFP

Question 48

Epididymorchitis signs on examination

Answer 48

Erythema, warmth, scrotal sac involvement; Prehn's sign

Question 49

Which type of swab is needed for NAAT in women?

Answer 49

Vulvo-vaginal swab

Question 50

Causative organism of syphylis

Answer 50

Treponema Pallidum

Question 51

How may a male present with chlamydia

Answer 51

Mainly asymptomatic; dysuria, urethral discharge, epididymo-orchitis, reactive arthritis, testicular pain

Question 52

Which zone of the prostate is primarily affected in prostate cancer?

Answer 52

Peripheral zone

Question 53

What scoring system is used in prostate cancer?

Answer 53

Gleason score

Question 54

How is the Gleason score calculated?

Answer 54

The two most common tumour patterns across all samples are graded based on their differentiation The sum of the two grades is the Gleason score

Question 55

Which 2 serological markers are used initially in hepatitis B screening?

Answer 55

HBsAg and anti-HBc / hepatitis B surface antigen and hepatitis B core antibody

Question 56

Symptom progression of lymphogranuloma venereum

Answer 56

Painless genital pustule → ulcer → painful inguinal lymphadenopathy → proctocolitis