Sexual and Reproductive Health(SBA -EMQ)- SRH Module_part2

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25-year-old woman is at 15 weeks gestation in her first pregnancy.
Booking syphilis screening is positive and the diagnosis is confirmed with the
Treponema pallidum particle agglutination assay. The patient is otherwise fit
and well, is on nomedication and is allergic to penicillin. What antibiotic
treatment would you suggest to treat this patient?

A) Amoxicillin and probenecid

B) . azithromycin

C) . erythromycin

D) .ceftriaxone

E) .metronidazole

Contraindications to the insertion of a Cu-IUD for EC are the same as those for
routine IUD insertion. Which of the following is a relative contraindication?

A) Between 48 hours and 28 days after childbirth

B) Risk of sexually transmitted infection

C) Previous ectopic pregnancy

D) Young age and nulliparity

E) less than 18 years

11)

Epileptic woman on Carbamazepine. Came for emergency contraception &
refused cupper IUC. What is the suitable alternative?

A) . UPA 30 mg.

B) .Levonelle 1.5 mg.

C) Levonelle 3 mg.

D) LNG IUS.

E) UPA 60 mg

15) The following facts about chlamydia are true except for which one?

A) . It is the most common sexually transmitted infection (STI) in the United Kingdom

B) 3%–7% of sexually active women under 24 years of age have this condition

C) 70% of women can be asymptomatic

D) Abnormal menstrual bleeding is not a symptom

E) If untreated, it can cause sexually acquired reactive arthritis (SARA)

16)

A 35yearold para3 comes to clinic for contraceptive advice. She was
advised to come off the combined pill as she developed migraines with aura
while taking it. She is now using the diaphragm but is looking for something
more reliable. With regards to duration of action of longacting reversible
contraception, which one of these statements is not correct?

A) . DepoProvera® injection is effective for 13 weeks

B) . Mirena coil is effective for 5 years

C) .Multiload copper coil is effective for 5 years

D) Nexplanon® is effective for 4 years TSafe®

E) .C u380A is effective for 10 years

19) A missed DSG pill (all brands) is one that is:

A) a) 4 hours late

B) b) More than 12 hours late

C) c) Taken 24 hours after the last pill was taken

D) d) Taken 48 hours after the last pill was take

20)

When counselling a man regarding vasectomy, which of the following is it
important to stress

A) Contraception should be used for a further 3 months with a negative semen analysis at the end of that time

B) . Reversal is readily available as an NHS procedure

C) The procedure is irreversible

D) There is a small increased risk of testicular cancer following the procedure

E) . Vasectomy has a higher failure rate than female sterilization

21)

Miss Y is a 22 year old nulliparous young woman who presents at her local
sexual reproductive health clinic having had unprotected sexual intercourse
on day 16 of a regular 28day cycle. She is in a new relationship, having had
intercourse last night with her 27 year old boyfriend who she met last week
at a party. She has not had any other episodes of unprotected intercourse
this cycle. She suffers from epilepsy and takes carbamazepine 400 mg twice
daily. She is otherwise well with no relevant family history. She looks well
and her measurements are as follows: height: 159 cm weight: 58 kg BP:
115/65 mmHg.

A) Insert a copper IUD as postcoital contraception and continue to use the IUD as her preferred method of contraception

B) Levonelle 1.5 mg immediately as postcoital contraception, repeated after 12 hours. Condoms and commence DepoProvera® to be administered every 12 weeks at the onset of her next period

C) Levonelle 1.5 mg immediately as postcoital contraception, repeated after 12 hours. Condoms and commence Cerazette progestogen only pill at the onset of her next period

D) Levonelle 1.5 mg immediately as postcoital contraception. Condoms and commence DepoProvera to be administered every 10 weeks at the onset of her next period

E) Levonelle 1.5 mg immediately as postcoital contraception. Condoms and commence Microgynon 30 combined oral contraceptive at the onset of her next period

22)

A 24 yearold woman attends and STI clinic with suspected Chlamydia
infection. What is the best technique for detecting Chlamydia?

A) . First void urine culture

B) . First void urine enzyme immunoassay

C) First void urine nucleic acid amplification test

D) .Self administered low vaginal swab (LVS) nucleic acid amplification test

E) Self administered high vaginal swab (HVS) culture

23) Concerning progestogen only pills (POPs), which of the following is true? .

A) .Additional contraceptive precautions should be taken during antibiotic treatment

B) In women undergoing treatment for breast cancer, POPs increase the rate of disease recurrence

C) . They are associated with an increased risk of thromboembolic disease

D) They are contraindicated in women with insulin dependent diabetes

E) They should be discontinued 4 weeks prior to major surgery

25) Regarding management of gonorrhea,which of the following is correct

A) monotherapy with ceftriaxone 1g intramuscularly

B) monotherapy with ceftriaxone 500 mg intramuscularly

C) polytherapy of ceftrixone and doxycycline

D) For those presenting after 14 days of exposure give empirical treatment

E) metronidazole is must add

29)

A 25-year-old woman presents to A&E with painful vulva. Examination
reveals multiple ulcers (around the fourchette) with ragged undermined edges
with necrotic base and purulent exudate. There was contact bleeding. Also
noted were enlarged tender left inguinal lymph modes.
The like diagnosis in her case is which of the following?

A) . Lymphogranuloma venerum

B) . Syphillis gummata

C) Chancroid

D) . Donovanosis

E) Type 2 herpes simplex infection

31)

A woman who is 14 weeks pregnant presents with a thin vaginal discharge
and fishy odour. She gives history of this getting worse before her periods and with
sexual intercourse. On examination, the vulva and vagina looked normal and
not inflamed.
The diagnosis in her case is which of the following?

A) . Tricomoniasis

B) Candidiasis

C) . Bacterial vaginosis

D) Chlamydia

E) Donovanosis

32) Which of the following is true about antibiotic resistance and gonorrhoea?

A) . Due to resistance, ceftriaxone monotherapy is now recommended where sensitivities are unknown. This is double the dose of ceftriaxone that was previously recommended

B) . Due to resistance, dual therapy is now recommended

C) Due to resistance, ciprofloxacin or ceftriaxone should be used with doxycycline as dual therapy

D) Due to increasing resistance to azithromycin, ciprofloxacin is now first-line treatment for gonorrhoea where sensitivities are unknown

34)

0. A 19yearold attends A&E with acute urinary retention. She also describes
myalgia, feeling feverish and headache, as well as pain when she urinates.
When the nurse catheterizes her she notices widespread labial blisters. What
is the most likely diagnosis?

A) .Coxsackiae virus

B) .Herpes simplex virus

C) Human papillomavirus

D) .Syphilis

E) Varicella zoster virus

37)

For which of the following conditions would you consider a hospital setting for
the insertion of an intrauterine device?

A) . Fontan’s circulation

B) Un complicated PDA

C) Repaired VSD

D) Uncomplicated Pulmonary stenosis

E) ASD

38)

32 years old G2P1 First time attending antenatal clinic at 20weeks. C/o
Mucocutaneous rashes on palms. Papule on vulva. Scan- fetal ascites .RPR test
positive at booking What is the Treatment?.

A) ceftriaxone 500mg intramuscularly, daily for 7 days

B) Oral amoxicillin 500 mg and probenecid 500 mg four times per day for 10 days.

C) . Intramuscular benzathine penicillin G 2.4 million units single dose

D) . T azithromycin

E) . Intramuscular benzathine penicillin G 2.4 million units 2 doses weekly

40)

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

A) . 5-fluorouracil.

B) . Cryotherapy.

C) . Imiquimod.

D) Podophylline.

E) Trichloracetic acid.

41)

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.

43) 25 year old woman had a normal delivery at term 4 months ago. She is exclusively breast feeding and had an episode of UPSI.

she takes ulipristal acetate for emergency contraception. What breast feeding advice would you give her?

A) Continue breast feeding as before

B) . Express and discard breast milk for 24 hours after the dose

C) Express and discard breast milk for 72 hours after the dose

D) Express and discard breast milk for 7 days after the dose

E) Stop breast feeding

44)

A 27yearold nulliparous woman comes to the outpatient clinic requesting
Depo Provera injection. She wants to know about the no contraceptive
benefits and risks with injectable progesterones. Which of the following is
incorrect?
B.

A) . Anaemic women may benefit from using injectable progestogens

B) Depot medroxy progesterone acetate is associated with increase in bodyweight

C) Injectable contraceptives have been associated with an increased risk of developing venous thromboembolism in women with a previous history of venous thromboembolism after immobilization

D) . It can reduce pain due to endometriosis

E) Women with sickle cell disease may notice a decrease in pain during sickle cell crisisf

45) Rate of uterine perforation in IUC insertion is

A) 1 in 1000

B) . 2 in 1000

C) 3 in 1000

D) 4 in 1000

E) 5 in 1000

46)

A 35-year-old woman presented with a offensive frothy vaginal discharge
On speculum examination, the cervix was red, punctate and inflamed.
The wet mount shows the mobile organism.
What is a likely diagnosis in her case?

A) Trichomoniasis

B) . Candidiasis

C) Bacterial vaginosis

D) Chlamydia

E) Donovanosis

47)

. Mrs P, a 32yearold para 4+0, has just delivered a baby boy (SVD) following
an unplanned pregnancy, having recently separated from her husband and
entered into a new short term relationship. She is a week postpartum and
requesting a reliable form of contraception. She has a family history of VTE in
a first degree relative and is known to carry a protein S deficiency but has
never had a VTE episode herself. She is bottle feeding, her puerperium has
been uncomplicated and she is keen to start contraception as soon as
possible. Height: 160 cm Weight: 65 kg BP: 135/80

A) Advise regarding STI and condom use, follow up appointment to discuss male or female sterilisation

B) Immediate insertion of copper IUD (TSafe® Cu380A), advise regarding STI and condom use

C) Commence progestogen only pill (Cerazette®) immediately, advise regarding STI and condom use

D) Commence combined oral contraceptive (Microgynon® 30) 4 weeks postpartum, advise regarding STIs and condom use

E) Advise regarding STI and condom use, and injection of DepoProvera® after 6 weeks

48)

Which one of the following statements regarding CHC and migraine is
correct?

A) CHC users with migraine with aura are at greater risk of haemorrhagic stroke than CHC users without migraine

B) Starting CHC for a woman who has pre-existing migraine without aura, is UKMEC 2

C) If >5 years have elapsed since a woman’s last migraine with aura, benefits of CHC use

D) If a woman suffers from migraine without aura in the HFI, using an extended cycle regimen will not be beneficia

49)

A woman taking lamotrigine is using the combined hormonal transdermal
patch (CTP). Which one of the following statements is correct?

A) Lamotrigine is a liver enzyme inducer and will reduce hormone levels

B) Serum lamotrigine levels can be reduced by CTP

C) Lamotrigine levels are unchanged in the hormone free interval (HFI)

D) The benefits of using CTP with lamotrigine usually outweigh the risks answer

E) lamotrigine level is unchanged always .

50)

Which one of the following statements about venous thromboembolic (VTE)
risk with CHC is correct?

A) VTE risk when using CHC is lower than VTE risk during pregnancy/after delivery

B) Taking breaks from the pill is recommended as this reduces VTE risk

C) VTE risk is higher with LNG- and norethisterone-containing COC compared to those containing desogestrel

D) A thrombophilia screen is recommended before starting combined hormonal contraception (CHC)

E) VTE risk is 4 times more

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