DIP JUNE, 2005

POSTGRADUATE INSTITUTE OF MEDICINE
UNIVERSITY OF COLOMBO
DIPLOMA IN VENERELOGY EXAMINATION
JUNE, 2005
Date : 7th June, 2005 Time : 9.30 a.m. – 12.30 p.m.
PAPER II
(ESSAY TYPE QUESTIONS)
Answer All questions.
Each question to be answered in a separate book.
1.
A 32 year old anxious looking man presents to the STD clinic with a problem. He
is married for 6 years. He is asymptomatic but his wife who is 6 months pregnant
.had developed warty lesions in the vulva 2 weeks back. The lesions are gradually
increasing in size. He indicates suspicion about his wife as he is asymptomatic.
On questioning he admits having had sexual contacts with two known partners 6
and 9 months back. According to him all his partners are well known to him and
perfectly healthy.
1.1. What are the important points you would cover in counselling
this man ? (40 marks)
1.2. How would you manage this man ? (30 marks)
1.3. How would you manage his marital partner? (30 marks)
2. A case control study was conducted to test the hypothesis that regular/consist
condom use protects against sexually transmitted infections (STIs ). One hundred
patients diagnosed as having an STI and one hundred controls with no evidence of
STI were selected from the STD clinic. The following table is based on the data
from this study.
Relationship between condom use and STI,
__________________________________________________________________
Cases Controls
__________________________________________________________________
Regular/ Consistent condom use
Yes 40 60
No 60 40
Total 100 100
Chi square = 8.0 DF = 1
Odds Ratio (OR) = 0.44
P value = 0.005
2.1 Explain the three terms that are underlined. (30 marks)
2.2 How would you explain these findings to lay person ? (40 marks)
2.3 Describe briefly 3 different approaches that can be used to
increase condom use. (30 marks)
3. A 35 year old married man has urethritis after an unprotected exposure 5 days
ago. He had taken some unspecified medication given by a pharmacist. He is
flying to Holland tomorrow to join his spouse with whom he has a very active sex
life. Condoms are not an option in their sex life.
3.1 List the investigations you will carry out in the short time available to you.
(30 marks)
3.2 How will you manage this case ? (30 marks)
3.3 How will you counsel him ? (40 marks)
4.
4.1 STD AIDS is a preventive programme with a curative component.
Discuss the above statement in the context of primary and secondary
prevention. (50 marks)
4.2 Why is primary prevention more important today than ever before?
(20 marks)
4.3. List the measures that should be adopted to strengthen primary
prevention. (30 marks)
5.
5.1. Enumerate the features that make HIV / AIDS surveillance different from
the surveillance of other common communicable diseases. (35 marks)
5.2 Compare and contrast the sero-surveillance and behavioural
surveillance for HIV infection. (35 marks)
5.3. List the different strategies recommended for HIV antibody testing in
various scenarios. Briefly indicate the rationale in each strategy.
(30 marks)