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MI8.{1-2,4} | Genitourinary & Sexually Transmitted Infections — Practice Quiz
Practice
10 questions · Untimed · Unlimited attempts
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A 25-year-old sexually active woman presents with dysuria and frequency. Urine culture grows >10⁵ CFU/mL of a lactose-fermenting, indole-positive gram-negative bacillus. Which virulence factor of this organism specifically facilitates adhesion to urothelial cells?
A
Urease enzyme that alkalinises urine
B
P fimbriae (pili) binding to uroepithelial globoside receptors
✓
C
Coagulase that promotes fibrin deposition
D
Beta-lactamase conferring antibiotic resistance
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A 35-year-old male presents with cloudy urine and suprapubic pain. Midstream clean-catch urine reveals 10⁸ CFU/mL of a urease-positive, gram-negative rod with swarming motility on blood agar. Which complication is MOST directly linked to this organism's urease activity?
A
Glomerulonephritis via immune complex deposition
B
Struvite (triple phosphate) urinary stone formation
✓
C
Haematogenous spread to the vertebral column
D
Vesicoureteric reflux leading to hydronephrosis
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A 22-year-old woman has pyuria on urinalysis but her routine aerobic urine culture grows no organisms after 48 hours. She reports low-grade fever and flank discomfort for 6 weeks, with a history of treated pulmonary TB 3 years ago. What is the MOST appropriate next investigation?
A
Repeat midstream urine culture on routine blood agar
B
Urine culture on Löwenstein-Jensen medium from early morning samples × 3 days
✓
C
Urine ELISA for Chlamydia trachomatis antigen
D
Urine culture for anaerobes in Robertson's cooked meat medium
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A 28-year-old man presents with a painless, indurated, clean-based ulcer on the glans penis. Inguinal lymph nodes are enlarged but non-tender. Dark-field microscopy of ulcer exudate reveals motile corkscrew-shaped organisms. What is the MOST likely diagnosis?
A
Chancroid (Haemophilus ducreyi)
B
Primary syphilis (Treponema pallidum)
✓
C
Herpes genitalis (HSV-2)
D
Lymphogranuloma venereum (Chlamydia trachomatis)
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The VDRL (Venereal Disease Research Laboratory) test is a non-treponemal screening test for syphilis. Which statement about VDRL interpretation is CORRECT?
A
A positive VDRL is always diagnostic of syphilis and requires no further confirmation
B
VDRL titres rise with disease activity and fall with successful treatment, making it useful for monitoring
✓
C
VDRL detects anti-treponemal antibodies specific to T. pallidum outer membrane proteins
D
VDRL remains positive for life even after successful treatment of syphilis
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A 32-year-old woman presents with copious, frothy, offensive vaginal discharge with vulvar pruritus. Wet mount microscopy shows pear-shaped, flagellated, motile organisms. Which of the following regarding her condition and its management is CORRECT?
A
This infection is caused by a bacterium and responds to azithromycin
B
The organism is a flagellated protozoan and both partners must be treated with metronidazole
✓
C
This infection is caused by Candida albicans and managed with fluconazole
D
The organism is sexually transmitted but self-limiting — treatment is only for symptomatic patients
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Which combination of laboratory findings is MOST characteristic of uncomplicated genital herpes (HSV-2) as compared to primary syphilitic chancre?
A
Painless indurated ulcer + positive dark-field microscopy + positive VDRL
B
Painful vesicular ulcers + positive Tzanck smear (multinucleated giant cells) + negative VDRL
✓
C
Soft painful ulcer with ragged edges + Gram stain showing pleomorphic coccobacilli
D
Genital warts + koilocytes on cervical smear + HPV serology
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A 19-year-old college student develops painless inguinal swelling 2 weeks after an unprotected sexual encounter. The nodes are matted and fluctuant ('groove sign' — above and below Poupart's ligament). A brief, painless genital lesion was noted earlier but resolved spontaneously. What is the MOST likely causative agent?
A
Neisseria gonorrhoeae — gram-negative intracellular diplococcus
B
Chlamydia trachomatis serovars L1–L3 causing lymphogranuloma venereum
✓
C
Klebsiella granulomatis (Donovan bodies on crush smear)
D
Haemophilus ducreyi — gram-negative coccobacillus
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Syndromic management of STIs in India (NACO guidelines) is based on identifying symptom complexes and treating with broad-spectrum regimens. Which syndrome-treatment pair is CORRECTLY matched?
A
Urethral discharge syndrome → treat for gonorrhoea AND chlamydia simultaneously
✓
B
Genital ulcer syndrome → treat for syphilis only, as T. pallidum is the commonest cause
C
Vaginal discharge syndrome → treat with azithromycin monotherapy
D
Lower abdominal pain syndrome → treat with antifungal to cover Candida PID
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An antenatal woman at 28 weeks of pregnancy is found to have VDRL reactive 1:16 on routine screening. She has no genital lesions and denies symptoms. What is the PRIMARY reason for treating her immediately?
A
To prevent her from developing tertiary syphilis in the next 3 years
B
To prevent transplacental transmission of T. pallidum and congenital syphilis in the newborn
✓
C
To cure the ongoing secondary syphilitic rash before delivery
D
Mandatory treatment is required because VDRL is always a true positive in pregnancy
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