|
46
|
Role-play.
1. Candidate’s instructions will be sent shortly
before the tutorial.
|
|
47
|
Role-play.
2. Ditto
|
|
48
|
Viva.
|
|
49
|
EMQ. Mycoplasma Genitalium
|
46. Role-play 1. Candidate’s instructions will be sent shortly before the tutorial.
47. Role-play 2. Candidate’s instructions will be sent shortly before the tutorial
48. Viva. Topic
revealed during the tutorial.
49. EMQ.
Mycoplasma Genitalium .
Many of the questions are not
true EMQs as they have more than one correct answer. I have tried to include
all the facts I think might feature in the exam and packing more than one into
a question reduces the total number of questions and makes the document a bit
more manageable. It also reduces the amount of typing I have to do.
Abbreviations.
MG: Mycoplasma genitalium.
MSSU: mid-stream specimen of urine.
NAAT: nucleic acid amplification test.
NCSP: National Chlamydia Screening Programme.
NHSCS: NHS Cervical Screening Programme
PID: pelvic
inflammatory disease.
STI: sexually-transmitted
infection.
Scenario 1.
Which, if any, of
the following statements are true in relation to Mg? This is not a true EMQ as there
may be more than one correct answer.
|
A
|
MG was first isolated in 2001
|
|
B
|
MG was first isolated from men with
non-gonococcal urethritis (NGU)
|
|
C
|
MG belongs to the Cutemollies class
|
|
D
|
MG is the smallest known yeast with the
ability to self-replicate
|
|
E
|
MG is the smallest known bacterium with the
ability to self-replicate
|
|
F
|
MG has an unusual, double-layered cell wall
|
|
G
|
MG has an unusual protrusion at one end
|
|
H
|
MG’s protrusion enables it to adhere to
epithelial cells
|
|
I
|
MG’s protrusion enables it to invade
epithelial cells
|
|
J
|
MG is best seen on a Gram stain
|
Scenario 2.
Which, if any, of
the following statements are true in relation to Mycoplasmas?
|
A
|
are the
largest known bacteria
|
|
B
|
have no cell
wall
|
|
C
|
have no nuclei
|
|
D
|
are resistant
to ß-lactam antibiotics
|
|
E
|
are resistant
to sulphonamides
|
|
F
|
colonies show
a ‘scrambled egg’ appearance on culture on agar
|
|
G
|
particularly
affect mucosal surfaces.
|
Scenario 3.
Which, if any, of
the following statements are true in relation to Mg?
|
A
|
when the
organism was originally found, culture took 50 days
|
|
B
|
Mg is
facetious
|
|
C
|
Mg is a
facultative aerobe
|
|
D
|
Mg is a facultative
anaerobe
|
|
E
|
Mg is a facultative
aerobe & anaerobe
|
|
F
|
Mg is
fastidious
|
Scenario 4.
Which, if any, of
the following are true in relation to the approximate prevalence of MG?
|
A
|
it is ~ 0.1%
|
|
B
|
it is ~ 1.0%
|
|
C
|
it is ~ 5.0%
|
|
D
|
it is ~ 5-10%
|
|
E
|
it is > 10%
|
|
F
|
none of the
above
|
Scenario 5.
Which, if any, of
the following is true in relation to screening for MG?
|
A
|
screening for MG
is now included in the NCSP
|
|
B
|
screening for MG
is now offered as part of the NHSCS
|
|
C
|
screening
should be offered to all sexually active women < 30 years old
|
|
D
|
screening
should only be offered to those with symptoms suggestive of infection
|
|
E
|
screening
should be offered to all partners of those with MG infection
|
|
F
|
none of the
above
|
Scenario 6.
Which, if any, of
the following are included in BASHHMG as risk factors for infection with MG?
|
A
|
Cigarette
smoking
|
|
B
|
Multiple
dancing partners
|
|
C
|
Multiple
sexual partners
|
|
D
|
Non-white
ethnicity
|
|
E
|
Younger age
|
|
F
|
None of the
above
|
Scenario 7.
Which of the
following statements is true in relation to MG and co-infection with other organisms?
|
A
|
MG excretes
bactericidal toxins and co-infection is rare
|
|
B
|
MG
co-infection is most often with chlamydia
|
|
C
|
MG
co-infection is most often with E. coli
|
|
D
|
MG
co-infection is most often with HIV
|
|
E
|
MG
co-infection is most often with TB
|
|
F
|
None of the
above
|
Scenario 8.
Which of the
following statements is true in relation to MG and men?
|
A
|
It is the most
common cause of NGU
|
|
B
|
It is the most
common cause of epididymitis
|
|
C
|
It is the most
common cause of prostatitis
|
|
D
|
It is a
well-recognised cause of male sub-fertility
|
|
E
|
Most men with MG
infection are asymptomatic
|
|
F
|
None of the
above
|
Scenario 9.
Which, if any, of
the following statements are true in relation to MG and women?
|
A
|
MG is linked to
an ↑ risk of cervicitis
|
|
B
|
MG is linked to
an ↑ risk of endometritis
|
|
C
|
MG is linked to
an ↑ risk of female infertility
|
|
D
|
MG is linked to
an ↑ risk of miscarriage
|
|
E
|
MG is linked to
an ↑ risk of otitis media
|
|
F
|
MG is linked to
an ↑ risk of pelvic inflammatory disease
|
|
G
|
MG is linked to
an ↑ risk of postcoital bleeding
|
|
H
|
MG is linked to
an ↑ risk of postmenopausal bleeding
|
|
I
|
MG is linked to
an ↑ risk of preterm birth
|
|
J
|
MG is linked to
an ↑ risk of damage to Fallopian tube cilia
|
|
K
|
MG is linked to
an ↑ risk of puerperal psychosis
|
|
L
|
MG is linked to
an ↑ risk of puerperal sepsis
|
|
M
|
Most infected
women are asymptomatic
|
|
N
|
None of the
above
|
Scenario 10.
Which, if any, of
the following statements are true in relation to current concerns about Mg?
|
A
|
It could
become a ‘superbug’, resistant to most antibiotics, within a decade
|
|
B
|
Infection is
often misdiagnosed as chlamydia with ↑ risk of antibiotic resistance
|
|
C
|
‘superbug’
status would be likely to lead to an ↑ in renal failure
|
|
D
|
‘superbug’
status would be likely to lead to an ↑ in female infertility
|
|
E
|
‘superbug’
status would be likely to lead to an ↑ in male infertility
|
Scenario 11.
Which, if any, of
the following are used in the recommended test for MG infection in women?
|
A
|
blood testing
for MG IgG
|
|
B
|
blood testing
for MG IgM
|
|
C
|
cervical
smears checked microscopically for the diagnostic intracellular inclusion
bodies
|
|
D
|
culture and sensitivity
of cervical swab specimens using MG-specific culture medium
|
|
E
|
culture and
sensitivity of 1st. void MSSU using MG-specific culture medium
|
|
F
|
culture and
sensitivity of vaginal swab specimens using MG-specific culture medium
|
|
G
|
NAATs that detect
the MG G-antigen
|
|
H
|
NAATs that
detect MG DNA
|
|
I
|
NAATs that
detect MG RNA
|
|
J
|
serum testing
for MG-specific antigen
|
|
K
|
vaginal swabs
taken by the woman
|
|
L
|
none of the
above
|
Scenario 12.
Which, if any, of
the following statements are true in relation to testing for antibiotic resistance after initial tests are +ve for MG?
|
A
|
test for resistance to cephalosporins
|
|
B
|
test for resistance to macrolides
|
|
C
|
test for resistance to penicillin
|
|
D
|
test for resistance to quinolones
|
|
E
|
test for resistance to macrolides
|
|
F
|
test for resistance to streptomycin
|
|
F
|
test for resistance to sulphonamides
|
|
F
|
test for resistance to tetracyclines
|
|
G
|
None of the above
|
Scenario 13.
Which, if any, of
the following statements are true in relation to estimates of
antibiotic
resistance in current strains of MG in the UK?
|
A
|
20% are resistant to cephalosporins
|
|
B
|
40% are resistant to macrolides
|
|
C
|
50% are resistant to penicillin
|
|
D
|
50% are resistant to quinolones
|
|
E
|
10% are resistant to streptomycin
|
|
F
|
90% are resistant to sulphonamides
|
|
F
|
40% are resistant to tetracyclines
|
|
F
|
None of the above
|
Scenario 14.
Which, if any, of
the following is BASHHMG’s recommended 1st. line treatment of uncomplicated MG?
|
A
|
azithromycin 1
gram daily for 7 days
|
|
B
|
doxycycline
100 mg twice daily for 7 days
|
|
C
|
doxycycline
100 mg twice daily for 10 days
|
|
D
|
doxycycline
100 mg twice daily for 7 days
|
|
E
|
doxycycline
100 mg twice daily for 7 days then azithromycin 1 gram daily for 2 days
|
|
F
|
moxifloxacin
400mg orally once daily for 7 days
|
|
G
|
moxifloxacin
400mg orally once daily for 10 days
|
|
H
|
none of the
above
|
Scenario 15.
Which, if any, of the
following is BASHHMG’s recommended 1st. line treatment of complicated MG?
|
A
|
doxycycline
100 mg twice daily for 10 days
|
|
B
|
doxycycline
100 mg twice daily for 14 days
|
|
C
|
moxifloxacin
400mg orally once daily for 10 days
|
|
D
|
moxifloxacin
400mg orally once daily for 14 days
|
|
E
|
none of the
above
|
Scenario 16.
This is not an EMQ
or SBA! Fill in the gaps in the table below, using option list.
|
Drug name
|
Category of
drug
|
|
azithromycin
|
|
|
doxycycline
|
|
|
moxifloxacin
|
|
Option List.
|
Category of
drug
|
|
macrolide
|
|
tetracycline
|
|
quinolone
|
Scenario 17.
Which, if any, of
the following statements is true in relation to test of cure (TOC) after treatment of MG?
|
A
|
TOC should be
offered to everyone who has been treated for MG
|
|
B
|
TOC should
only be offered to those who had signs of infection before treatment
|
|
C
|
TOC should
only be offered to those who had symptoms of infection before treatment
|
|
D
|
TOC should
only be offered to those who had signs and symptoms before treatment
|
|
E
|
TOC should
only be offered to those who continue to have signs or symptoms two weeks or
more after the start of treatment
|
|
F
|
none of the
above
|
Scenario 18.
Which, if any, of
the following statements are true in relation to the timing of test of cure (TOC) after treatment of MG?
|
A
|
TOC is best
done at 3 weeks after start of treatment
|
|
B
|
TOC is best
done at 4 weeks after start of treatment
|
|
C
|
TOC is best
done at 5 weeks after start of treatment
|
|
D
|
TOC is best
done at 6 weeks after start of treatment
|
|
E
|
TOC should not
be done < 2 weeks from the start of treatment
|
|
F
|
TOC should not
be done < 3 weeks from the start of treatment
|
|
G
|
TOC should not
be done < 4 weeks from the start of treatment
|
