1. Investigate & manage a chase of genital discharge 2. (a) PEP in HIV (b) Leprosy Vaccine 3. Mucocutaneous manifestations of HIV/AIDS 4. (a) Deformities in leprosy (b) Protease inhibitors 5. Classify trophic ulcers, its etiology and pathophysiology. How will you manage them & describe preventive measures? 6. (a) Newer drugs in leprosy (b) Bedside tests in STI 7. Diff relapse from reaction in leprosy. Mx of relapsed case of leprosy 8. Mx of HIV infection in women. Mx of ADRs to antiretroviral drugs 9. (a) Nail changes in leprosy (b) Inguinal bubo 10.Role of sex education with reference to STDs. How will you counsel a suspected case of HIV? In 10 marks format for 3rd yr post graduate theory examination
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All 10 questions have been answered in full PG examination format. Here is a quick summary of what is covered:
Summary of Answers
| Q | Topic | Key Points Covered |
|---|---|---|
| 1 | Genital Discharge - Investigation & Management | Causes (GC, chlamydia, BV, trichomonas, candida), clinical features table, bedside and lab investigations, syndromic + etiological management, partner notification |
| 2a | PEP in HIV | Definition, indications, 72-hour window, TDF+3TC+DTG x28 days regimen, risk table, pre-initiation workup, follow-up |
| 2b | Leprosy Vaccine | BCG (geographic paradox), Mw vaccine, ROM regimen, candidate vaccines, SDR chemoprophylaxis |
| 3 | Mucocutaneous Manifestations of HIV | Viral (acute exanthem, HSV, VZV, molluscum, OHL), fungal (candida, cryptococcus), bacterial (bacillary angiomatosis), seborrheic dermatitis, PPE, drug reactions, KS |
| 4a | Deformities in Leprosy | Nerve-deformity table (ulnar, median, radial, peroneal, posterior tibial, facial), specific deformities by region, WHO grading, prevention |
| 4b | Protease Inhibitors | Mechanism (HIV protease), boosting concept, drug table with doses, class ADRs (metabolic syndrome, lipodystrophy), drug-specific ADRs, drug interactions |
| 5 | Trophic Ulcers | Classification (neuropathic/vascular/mixed/pressure; Wagner's grade), etiology, 5-step pathophysiology, management (offloading, debridement, surgery), prevention (MCR footwear, daily foot inspection) |
| 6a | Newer Drugs in Leprosy | Fluoroquinolones (ofloxacin, moxifloxacin), minocycline, ROM regimen, clarithromycin, thalidomide (ENL), rifabutin, SDR prophylaxis |
| 6b | Bedside Tests in STI | DFM (syphilis), wet mount, whiff test, vaginal pH, gram stain, Tzanck smear, VDRL/RPR |
| 7 | Relapse vs Reaction + Management | Detailed comparison table (timing, onset, BI, histology, steroid response), confirmation of relapse, MDT re-treatment, MDR-leprosy regimen |
| 8 | HIV in Women + ARV ADRs | PMTCT (Option B+), DTG in pregnancy, women-specific issues (cervical cancer, VVC, contraception interactions), ADR management table (NRTI, NNRTI, PI), severity grading, switch strategies |
| 9a | Nail Changes in Leprosy | 10 nail changes (onychoschisis, onycholysis, pterygium, onychomycosis, brachyonychia, anonychia, etc.), mechanisms |
| 9b | Inguinal Bubo | Etiology table (LGV, chancroid, syphilis, donovanosis, herpes), groove sign, clinical approach, management per STI, needle aspiration |
| 10 | Sex Education + HIV Counseling | Components of comprehensive sex education, primary/secondary/tertiary prevention, pre-test and post-test HIV counseling steps, disclosure, ART referral, PLHIV support |
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