POSTGRADUATE INSTITUTE OF MEDICINE
UNIVERSITY OF COLOMBO
DIPLOMA IN VENEREOLOGY EXAMINATION
Date : 21st April 2008 Time : 1.00 p.m. - 4.00 p.m.
(ESSAY TYPE QUESTIONS)
Answer all questions.
Each question to be answered in a separate book.
1. Describe important aspects of the epidemiology of HIV / AIDS in Sri
Lanka. (100 marks)
2. A 30-year-old female presented to the STD clinic with multiple genital warts
(vulval warts) at a period of gestation of 20 weeks. Her last sexual exposure with
husband, who is working away from home, was three months back. She has had
unprotected sexual exposures with two casual male partners during the last three
2.1. Discuss the implications of genital warts in pregnancy .(50marks)
2.2. Outline how you would manage this patient. (50 marks)
3.1. Describe briefly the natural history of HIV infection. (30 marks)
3.2. Define client initiated and provider initiated HIV testing. (30 marks)
3.3. Discuss the applications of these two options in the natural
history of HIV infection. (40 marks)
4. A 26-year-old female presented to an STD clinic with a contact slip
from the marital partner which contained the diagnosis of gonococcal infection.
She did not have any complaints. She is on oral contraceptive pills. She is married
for 2 years and her last unprotected sexual exposure with husband was 2 days
ago. She has had extramarital unprotected sexual exposures with two known male
partners during last 3 months and the last exposure was 2 weeks ago.
On examination she had 2 lumpy lesions of 0.5 x 0.5 cm in perineum, whitish
thick discharge at introitus, scratch marks on vulva and groin. Speculum
examination revealed thick whitish vaginal discharge and an erythematous and
vaginal smears - hyphae and spores present, clue cells present
cervical smear - more than 30 pus cells/per high power field
4.1. Outline the management of this patient giving reasons. (35 marks)
4.2. When she presented for follow up, results of the tests done in the first visit
Chlamydia Elisa test - positive
VDRL - R (32)
TPP A - positive
Discuss the management of this patient. (65 marks)
5.1. Discuss the shortcomings in the notification and investigation of
communicable diseases in Sri Lanka. (50 marks)
5.2. Briefly describe the measures that can be taken to rectify the
situation. (50 marks)