Introduction:
What is an STI?
Name some common STI’s.
Why is treatment of STI’s so difficult?
Dr Syed Irfan Ali
Organs, Pathology & Syndromes:
Organs:
Pathology & Syndromes
Dr Syed Irfan Ali
Causative Organisms & Symptoms:
Organism Predominant Symptom
Organism Syndrome
Dr Syed Irfan Ali
Organism & Drug of Choice:
Organism Drug of Choice
Syndromes and possible Drugs
Syndromes Drugs
Dr Syed Irfan Ali
The Drug Kits
The Drug Kits & the syndromes
Syndromes Drug Kits
Dr Syed Irfan Ali
1. Mr XYZ, A truck driver by profession presents at suraksha clinic with symptoms of fever, malaise and pain in the
inguinal region. Through history you elucidated that Mr XYZ was involved with multiple sexual partners. On
examination you could see a painful superficial ulcer in phallus region. While examining the inguinal lymph
nodes, you noticed that they were tender, swollen and had multiple sinuses.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. What is the drug of choice for such a case? (1 Mark)
d. If the partner also has similar ulcers and is pregnant, which drug would you recommend? (1 Mark)
e. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
f. Three advises which you would give to Mr XYZ. (1 Mark)
C
D
E
F
2. Mr XYZ, A commercial sex worker by profession presents at suraksha clinic with symptoms of fever and malaise
and swollen right leg. Through history you elucidated that Mr XYZ was involved in anal sex. On examination you
did not see any ulcers however you noticed swollen flocculent unilateral inguinal lymph nodes. He complains of
proctitis.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. What is the drug of choice for such a case? (1 Mark)
d. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
e. If the partner also has similar ulcers and is pregnant, which drug would you recommend? (1 Mark)
f. Three advises which you would give to Mr XYZ. (1 Mark)
C
D
E
F
Dr Syed Irfan Ali
Dr Syed Irfan Ali
3. Miss XYZ, A college student presents at suraksha clinic with symptoms of fever and malaise and painful vesicles
in the inguinal region . Through history you elucidated that Miss XYZ was sexually active, and has regular bouts of
painful vesicles which keep appearing and disappearing. On examination you noticed multiple vesicles and ulcers
which were red, tender and painful to touch. No lymph nodes were involved.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. What is the drug of choice for such a case? (1 Mark)
d. Which treatment kit will you prescribe for Miss XYZ? (1 Mark)
e. If Miss XYZ is pregnant, which mode of delivery would you prefer? (1 Mark)
f. Three advises which you would give to Miss XYZ. (1 Mark)
A
C
D
E
F
4. Mr XYZ, A college student presents at suraksha clinic with complains of discharge, ulcer in the phallus and
swollen inguinal lymph nodes . Through history you elucidated that Miss XYZ was sexually active. On
examination you noticed a single painless ulcer with indurated margins on the phallus. The inguinal lymph nodes
were palpable and had shotty appearance.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. What is the drug of choice for such a case? (1 Mark)
d. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
e. If Mr Xyz reacts anaphylactically to the 1st choice drug kit, Which kit will you use (1 mark)
f. Which diagnostic test will you employ to confirm your diagnosis? (1 Mark)
g. Three advises which you would give to Mr XYZ. (1 Mark)
C
D
E
F
Dr Syed Irfan Ali
Dr Syed Irfan Ali
5. Mrs ABC presents with complains of Fever, Lower abdominal pain, dysmenorrhoea, dyspareunia, dysuria,
tenesmus and lower back pain.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. Name two Clinical examinations will you carry out in these patients and why (2 mark)
d. Name two lab investigations you will carry out in these patients and why (2 mark)
e. Which treatment kit will you prescribe for Mrs ABC? (1 Mark)
f. When will you recommend Mrs to come back for follow-up? (1 mark)
g. Three advises you will give to Mrs Abc (1 Mark)
C
D
E
F
6. Mr XYZ, A college student presents at suraksha clinic with complains of painful swollen testes. He is sexually
active and states that he also notices urethral discharge which is whitish in colour. On examination, you do not find
any ulcers, vesicles or palpable lymph nodes. The scrotal skin looks red and tender. There is tenderness of
epididymis and Vas.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. How will you diagnose the causative agent? (1 Mark)
d. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
e. If his sexual partner is pregnant, which drug would you recommend to her? (1 mark)
f. Three advises you will give to him. (1 Mark)
C
D
E
F
Dr Syed Irfan Ali
Dr Syed Irfan Ali
7. Miss Abc is 20-year-old college student who has been sexually active since last year. She complains of painful
burning micturition. On examination, you noticed white coloured urethral discharge. Per speculum examination
showed normal cervix, vagina, with no ulcers or selling of lymph nodes were noticed.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
d. If Miss ABC does not improve with initial kit, which kit would you recommend? (1 Mark)
e. If she is pregnant, which drug would you recommend to her? (1 mark)
f. Three advises you will give to her. (1 Mark)
C
D
E
F
8. Miss Abc is 20-year-old college student who has been sexually active since last year. She complains of painful
burning micturition. On examination, you noticed green frothy discharge. Per speculum examination showed eroded
red cervix, with no ulcers or selling of lymph nodes were noticed.
a. List three possible differential diagnosis. (1 Mark)
b. What is the possible diagnosis of this case? Give justification. (2 Mark)
c. Name the three causative organisms often associated with these presentations. Name the tests used to
diagnose the presence of each organism (3 mark)
d. Which treatment kit will you prescribe for Mr XYZ? (1 Mark)
e. If she is pregnant, which drug would you recommend to her? (1 mark)
f. Three advises you will give to her. (1 Mark)
C
D
E
F
Dr Syed Irfan Ali
Dr Syed Irfan Ali