POSTGRADUATE INSTITUTE OF MEDICINE
IUNIVERSITY OF COLOMBO
POSTGRADUATE DIPLOMA IN VENEREOLOGY EXAMINATION
MAY / JUNE 2010
Date : 31st May 2010 Time : 1.00 p.m. – 4.00p.m.
(ESSAY TYPE QUESTIONS)
Answer all questions.
Each question to be answered in a separate book.
1. A 25 year old woman with a period of amenorrhoea (POA) of eight
weeks presented to Central STD clinic with multiple, superficial and
painful vulval ulcers for 2 days which were preceded by blisters. She
has no past history of similar lesions.
1.1. How would you arrive at a diagnosis in this patient ? (30 marks)
1.2. Discuss the management of this patient. (70 marks)
2.1. Describe the differences between monitoring and evaluation.
2.2. Discuss the usefulness of routinely collected data for monitoring
and evaluation of services provided by STD clinics in Sri Lanka.
3. A 28 year-old married HIV positive man attended the Central STD
Clinic with pruritus and scars all over the body. His CD4 count was
180 cell/μL and the full blood count was normal except for the
Hb 6.5 g/dL. He admitted having several sexual encounters in the
past with male partners with and without condoms.
3.1. What further investigations would you request before deciding
on antiretroviral (ARV) treatment for this patient ? (30 marks)
3.2. Give a first line ARV regimen for this patient, with reasons.
3.3. Discuss the issues you would address in counseling this patient.
4. In a study among sexually active men, 30 out of 100 condom users
were found to have STIs, compared to 20 out of 100 non-condom users.
4.1. Give three (03) explanations for this observation. (30 marks)
4.2. Interpret the study finding using a statistical test. Give all relevant
steps. (Statistical tables and equations are provided.) (70 marks)
5. A 30 year old male presented to the Central STD clinic with tenesmus
and mucoid rectal discharge for last 3 weeks. He gave a history of
sexual exposures with several men during last 2 years.
5.1. List the possible causes for his presentation. (20 marks)
5.2. How would you arrive at a diagnosis ? (30 marks)
5.3. Describe the management of this patient. (50 marks)