Your Name: Pallav Verma

Theme: Sexual Disease

OPTION LIST

A	AIDS	I	Syphilis
B	Chancroid	J
C	Chlamydia	K
D	Genital Herpes	L
E	Gonorrhoea	M
F	Hepatitis B	N
G	Hepatitis C	O
H	HIV associated Kaposi’s sarcoma	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 31 year old man presents to a GUM clinic complaining of pain on passing urine and a penile discharge. His history reveals that he had travelled to Bangkok 10 days earlier “on a business trip”. On examination he had a purulent urethral discharge and a swollen tender prostate. Gram negative diplococci were found in smears of the discharge and culture of the causative agent confirmed the presumed diagnosis.

2. A camp 37 year old male presents to the Chelsea and Westminster GUM clinic. He has been referred by his GP after complaining of fever and malaise, 6 weeks after noticing the presence of a hard ulcer on his penis. Examination reveals the ulcer is painless; the patient had lymphadenopathy and a rash on the palms and soles of his feet. Treponeme-specific antibody test was positive and proved diagnostic. Untreated, this patient is at risk of later cardiac and neurological complications.

3. An 18 year old man has recently returned from a “lad’s holiday” in Tenerife. He admits to multiple sexual partners whilst there but cannot remember many of them or whether he had unprotected sex at any point. He complains of fever, generally unwell and a painful rash on his penis (which he would like treated before he visits his girlfriend). On examination inguinal lymphadenopathy was noticed and the rash consisted of grouped vesicles and papules. Diagnosis was made by culture of this group of viruses.

4. A pregnant 24 year old woman suffered an ectopic pregnancy after her sexually transmitted infection (STI) remained asymptomatic (and therefore undiagnosed) for many years. After surgical intervention, an endocervical swab was taken and the intracellular bacteria C.trachomatis revealed the cause of the STI.

5. A 17 year old known female prostitute has presented to a walk-in clinic complaining of fever, being generally unwell, weight loss and joint pain. She admits to having unprotected sex with one of her clients. On examination a yellow discolouration of the sclera was found along with hepatomegaly, a rash which says is itchy, and needle “track marks”. Investigations proved positive for the surface antigen of the causative DNA virus

ANSWERS

1. E

2. I

3. D

4. C

5. F