|
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.
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?
|
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 |
