Genitourinary Medicine 💊

A 25 year old woman presents to the sexual health clinic with the complaint of an increasing amount of vaginal discharge. She describes the discharge as being greenish- yellowish in colour. She denies any abdominal pain. She is sexually active and takes the combined oral contraceptive pill for contraception. Direct questioning reveals that she is with a new sexual partner and has not used barrier methods of protection. A pregnancy test comes up negative. She is concerned about a sexually transmitted infection. Which is the SINGLE most appropriate investigation(s) for this patient?

A 33 year old woman has vaginal discharge and bleeding. An endocervical swab was taken which tested positive for Chlamydia. What is the SINGLE most appropriate antibiotic to give?

A 27 year old woman attends the sexual health clinic with painless vulval lesions that appeared a few weeks ago. They are growths of varying sizes. She is sexually active and uses the combined oral contraceptive pill. What is the SINGLE most likely organism causing her vulval lesions?

A 28 year old woman pays a visit to her general practitioner with the complaint of vaginal discharge. She requires some prompting before revealing that she first noticed the discharge a few weeks ago but was too embarrassed to come in for help. She describes the discharge as being yellow and frothy and admits to a degree of vaginal itching but denies any abdominal pain. She is sexually active and takes oral contraceptive pills for contraception. She has a regular 28-day menstrual cycle. Her last menstrual period was a week ago. She is currently in an open relationship and has two frequent sexual partners. A pelvic examination reveals no abnormalities aside from slightly inflamed vulvae and a thin, yellowish discharge. A pregnancy test comes up negative and her vaginal pH is measured at 4.8. A wet mount demonstrates the presence of motile flagellates. Which is the SINGLE most appropriate treatment for this patient from the list below?

A 25 year old man complains of penile pain and dysuria. There are several tender penile ulcers which he noticed a few days ago. He has been experiencing muscle pains and a mild fever over the past few days. He is sexually active with multiple sexual partners and does not use any protection. On examination, he has numerous indurated ulcers on the foreskin and the shaft of the penis, which measures around 1 to 2 mm in diameter. What is the SINGLE most likely diagnosis?

A 40 year old man develops a rash on his palms and trunk over the past 10 days. He has had a mouth ulcer which healed a week ago and a painless penile ulcer that healed a month ago. He admits to having oral sex and intercourse with a new partner. On examination, a maculopapular rash is seen on both his arms and his trunk and there are no visible lesions on the penis. What is the SINGLE most appropriate investigation?

A 24 year old woman presents the sexual health clinic with offensive vaginal discharge. She is sexually active with a single partner. A vaginal pH was taken and reads 5.6. High vaginal swabs were taken and sent for culture. What is the SINGLE most likely causative organism?

A 34 year old woman attends the GP surgery with vaginal itching and soreness which started 2 months ago. She describes white non-malodorous vaginal discharge. She is sexually active with a single stable male partner. A speculum examination reveals localized erythema at the vagina with a white thick discharge. What is the SINGLE most appropriate treatment?

A 35 year old lady presents with recurrent extremely painful ulcers on her vulva. Viral culture and DNA detection using polymerase chain reaction (PCR) of a swab from the ulcer has come back as negative. What is the SINGLE most appropriate investigations which will lead to the diagnosis?

A 38 year old man presents with complaints of a rash and growths in his mouth. A maculopapular rash is noted over the palms of his hands, soles of his feet and he has ulcers in his mouth. He mentions that a few weeks ago he had an ulcer on his penis which has since disappeared. What is the SINGLE most appropriate test to make a diagnosis?

A 24 year old male has a history of urethral discharge and dysuria. He is sexually active with other men and has had four sexual partners in the last year. He does not practice safe sex. Urethral swabs were taken which results came back positive for chlamydia. What is the SINGLE most likely complication if left untreated?

A 28 year old woman presents with a 3 day history of painful ulcers on her vulva and a flu-like prodrome. She has pain when urinating. She is sexually active and has had a few male partners over the past few months. On examination, there are multiple ulcers on the vulva and vagina. Which investigation is likely to show the causative organism?

A 28 year old man presents with a widespread maculopapular rash over his soles and palms. He also has mouth ulcers. He had a penile ulcer which healed six weeks ago. What is the SINGLE most likely organism responsible?

An 18 year old female presents to her GP with the complaint of a vaginal discharge. She complains of the discharge being present for the past three weeks. When asked about her sexual history, she mentions that she is now in a new relationship. When prompted further, she also admits that she experiences post-coital bleeding. The patient has no significant past medical or gynaecological history. She is currently using the combined oral contraceptive pill as a method of contraception. Her last menstrual period was two weeks ago. On clinical examination, the vulva and the cervix appear to be red and inflamed. Examination of the pelvis elicited tenderness however an abdominal examination was normal. What is the SINGLE most likely diagnosis in this patient?

A 33 year old man complains of dysuria and three tender penile ulcers which he noticed 2 weeks ago. He is sexually active and does not use any protection. He has recently returned from Spain 2 weeks ago after having a few sexual encounters. On examination, he has 2 ulcers on the foreskin and 1 ulcer on the shaft of the penis which measures around 1 to 2 mm in diameter. What is the SINGLE most likely diagnosis?

A 24 year old man presents to the sexual health clinic after a history of peno-anol intercourse with another man a week ago. This is the first time he has been involved in receptive anal intercourse. There is no history of insertive intercourse. Apart from HIV and hepatitis B serology, which other screening tests are important for this man?

A 28 year old woman has intercourse with her new sexual partner. She is concerned about a sexually transmitted infection. She does not complain of intermenstrual bleeding or deep dyspareunia. Which is the SINGLE most sensitive test for chlamydia and gonorrhoea?

A 28 year old woman has foul-smelling vaginal discharge and vaginal itching. She describes her vagina as feeling sore. She has a new sexual male partner. On examination, there is an increased amount of foul-smelling discharge, the cervix looks normal but there are signs of vulvovaginitis. The vaginal pH is 5.2. What is the SINGLE most likely causative organism?

A 26 year old woman presents with a “fishy vaginal discharge. On examination, a homogenous grey-white vaginal discharge is seen. Vaginal pH is 5.8. What is the SINGLE most appropriate management?

A 23 year old heterosexual man presents to the sexual health clinic with a 1 cm in diameter painless ulcer with a moist base and indurated margin at the mucosal surface of the penis. He is otherwise asymptomatic. There are local painless lymphadenopathies. He reports having unprotected sex with a stranger 3 weeks ago. What is the SINGLE mast likely causative organism?

A 34 year old female presents with a very strong foul-smelling vaginal discharge. What organism(s) could cause such a symptom?

A 19 year old woman attends the genitourinary medicine clinic with a few cauliflower-like growths of varying size at the vulva after returning from Spain several weeks ago. She is concerned and would like treatment. She has no previous medical conditions. What is the SINGLE most appropriate treatment?

A 25 year old woman has vaginal discharge, intermenstrual bleeding and post coital bleeding. A vulvovaginal swab was taken which tested positive for Neisseria gonorrhoeae which genotypic antimicrobial susceptibility data indicates susceptibility to ciprofloxacin. What is the most appropriate management?

A 35 year old woman has numerous painful blisters and sores on her vulva. She also complains of a flu-like illness with mild fever starting a few days ago. The pain in the vulva is so severe that she refuses to go to the toilet to urinate. She is prescribed pain relief. What other treatment should be offered?

A 23 year old woman has vaginal discharge and bleeding. An endocervical swab was taken which tested positive for Chlamydia. What is the SINGLE most appropriate antibiotic to give?

A 25 year old heterosexual man attends the genitourinary medicine clinic with a 3-day history of urethral discharge. He fears that he may have a Chlamydia infection and would like to know the complications and his treatment options. Which of the following is a complication of untreated genital chlamydia infection?

A 23 year old homosexual man presents to the genitourinary medicine clinic with urethral discharge. A few weeks ago, he had a painless ulcer on his penis which healed. He is sexually active. What is the SINGLE most appropriate investigation to confirm the diagnosis?

A 27 year old man presents with complaints of a rash over his palms and soles. He has a few ulcers in his mouth. He mentions that several weeks ago he had an ulcer on his penis which has since disappeared. What is the SINGLE most appropriate test to make a diagnosis?

A 23 year old woman has vaginal discharge and bleeding. An endocervical swab was taken which tested positive for Neisseria gonorrhoeae. What is the SINGLE most appropriate management?

A 34 year old pregnant woman in her first trimester complains of a thick white vaginal discharge 3 days after starting antibiotics which were prescribed by her dentist for a dental abscess. What is the SINGLE most likely causative organism?

A 27 year old man attends the genitourinary medicine clinic with a 4-day history of urethral discharge. His sexual partner has recently been diagnosed with a chlamydia infection. He fears that he may have a Chlamydia infection and would like to know the complications associated with the diagnosis. Which of the following is a complication of untreated genital chlamydia infection?

A 38 year old man presents to the sexual health clinic with anal warts. What is the SINGLE most likely virus causing his symptoms?

A 33 year old woman has a 2 day history of numerous painful ulcers on her vulva. She is sexually active and has multiple partners in the past. What is the SINGLE most likely cause of her ulcers?

A 23 year old woman presents with offensive, homogenous grey-white vaginal discharge. Clue cells are demonstrated on a saline smear. What is the SINGLE most likely diagnosis?

A 32 year old man attends the sexual health clinic with painful ulcers on his penis which he noticed 3 days ago. He has penile pain when he urinates. He has no past medical history. He is sexually active and met a new partner 3 months ago. On examination, there are 4 tender indurated ulcers on his glans penis which are an average of 1 to 2 mm in diameter. What is the SINGLE most likely diagnosis?