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

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A sexually transmitted infection commonly presenting with vulval discharge and itching,
dysuria and offensive odour. Overall, 10–50% of women are asymptomatic. Of women that are
infected, the urethra is colonised in 90%, and 2% of women will have a ‘strawberry cervix’.


A 19-year-old girl requests emergency contraception. She gives a history of
unprotected sexual intercourse 40 hours ago. She is unsure of when her last menstrual
period was as her periods are irregular. Her regular contraceptive method
is the male condom. What is the first step in management?


A 23-year-old female teacher has been on a low-dose (20 mg ethinylestradiol) combined
oral contraceptive pill for the past 3 years.
Unfortunately, she forgot to take two of her pills. She has four pills
left in the pack.

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


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 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?


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 23-year-old university student complains of persistent purulent vaginal discharge. On
vaginal examination, there is contact bleeding from the cervix. Microscopy of a Gram-stained
endocervical swab specimen showed monomorphic Gram-negative diplococci within
polymorphonuclear leucocytes.


A young woman attends the family planning clinic for contraception.
She has had two terminations of unwanted pregnancies which have
been secondary to missed oral contraceptive pills. She is in a steady
relationship and her partner is considering using a barrier method.


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


Depomedroxy progestogen acetate can be prescribed for women who are taking liver
enzymeinducing medication


A 37-year-old mother of three, who is on Cerazette (a progestogenonly
contraceptive), attends because she had forgotten to take her pill
10 hours ago. She had sexual intercourse the night before

13) 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 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


A 26-year-old lady gave birth to a baby a month ago and is breast-feeding the
baby. She was on the combined pill before and had no complaints with that. She
has needle phobia and requests a short-term contraceptive. What is the most
appropriate option?


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

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


A 29-year-old lady with a BMI of 37 who is para 4 is requesting permanent contraception.
She fell pregnant on the combined oral contraceptive pill, and her
periods are normal and last for 5 days. She had an intrauterine contraceptive
device in the past and did not like it. She is worried about weight gain with Implanon
and depot progesterone. What is the most appropriate option?


. 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


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


A 26-year-old woman attends the gynaecology emergency services complaining of painful
blisters and ulceration on her vulva for last 2 days. She has dysuria and vaginal discharge. On
examination, there is bilateral tender inguinal lymphadenitis.


A 20-year-old woman attends as an emergency having had
unprotected sexual intercourse 3 days ago. She is quite anxious about
an unwanted pregnancy.

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


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?

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


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

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


A 34-year-old lady requests contraception. Her body mass index (BMI) is 35. She
suffers from painful heavy periods. She thinks she has completed her family. She
smokes 10 cigarettes a day. What is the most appropriate option?


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 large DNA pox virus that causes a benign epidermal eruption of the skin. The lesions are
usually characteristic, presenting as smooth-surfaced, firm, domeshaped papules with central


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 49-year-old menopausal diabetic woman presents with vulval soreness and pruritus, and
a non-offensive thick white vaginal discharge. She gives a history of at least three past similar
episodes over the last 12 months and suffers from superficial dyspareunia. On examination,
there is erythema and some fissuring of the vulval skin


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 27-year-old lady attends the family planning clinic 7 days after unprotected sexual
intercourse. Her menstrual cycles are very regular (K3–4/28). Her last menstrual
period was 2 weeks ago. What is the most appropriate option?


Which one of the following statements regarding CHC and migraine is


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


A 42-year-old lady who is para 3 requests contraception. She has been on the combined
oral contraceptive pill for many years. She has recently become forgetful
and requests an alternate non-hormonal long-term method. What is the most
appropriate option?

39) Rate of uterine perforation in IUC insertion is


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 couple attend for counselling about contraception. They have
completed their family and have so far been using the natural method
of family planning. The woman is severely asthmatic and her BMI is
29 kg/m2


A 21-year-old woman who suffers with alcohol dependence attends the gynaecology clinic
complaining of a persistent watery vaginal discharge. There is no history of irritation or pruritus.
She smokes ten cigarettes a day. On vaginal examination, there is an offensive fishy-smelling
vaginal discharge.


A 20-year-old girl attends the family planning clinic 6 hours after unprotected
sexual intercourse. Her periods are regular and the first day of her last menstrual
period was 3 weeks ago. Her current contraceptive method is male condoms. She
also recalls another episode of condom split 10 days ago. Her pregnancy test is
negative. What is the most appropriate advice?


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


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 22-year-old woman, who is on a 30 mg ethinylestradiol combined
oral contraceptive pill, attends because she has missed three of her
pills. She has only taken four pills in this pack and had unprotected


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


A 23-year-old nulliparous woman attends Accident and Emergency. She gives a
history of unprotected sexual intercourse the previous night. Her periods are
regular (3–4/30). She had sexual intercourse with a stranger. Her last menstrual
period was 2 weeks ago. What is the most appropriate step?


A 37-year-old woman attends the clinic 6 hours after unprotected sexual intercourse.
She suffers from idiopathic thrombocytopenic purpura and is on longterm
steroids. Her periods are regular but heavy, and the first day of her last
menstrual period was 2 weeks ago. What is the most appropriate option?


An 18-year-old female student is taking Femodene ED (30 mg
ethinyl-estradiol) but has missed two pills. She now has eight pills left
in the packet.

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