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Time to escape!

Use your sexual health knoweledge to complete the challenges and unlock the door!

GO!

Index

Collect all the numbers by completing each of the challenges, and enter them in order in the final section to finish the game.

Introduction

Escape!

01 Quiz

02 Find!

03 Correct image

04 True or false

NEXT

INTRODUCTION

Use your sexual health knowledge to answer all questions in each section correctly

At the end of each section, if you get all questions right, you will be provided with 1 number of a 4 number code. Remember all 4 numbers and enter them at the end to escape!

start

QUIZ

Complete the following quiz, and getthe first number towards your reward!

QUIZ

question 1/5

Which of the following is a feature of Bactieral Vaginosis

Strawberry cervix

Vaginal itching / discomfort

Thin grey-white vaginal discharge

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RIGHT!

QUIZ

Well done!Bacterial vaginosis is associated with a thin, grey-white vaginal discharge often with a fishy odour

question 2/5

Which of the following is the correct management for Chlamydia infection

Doxycycline 100mg BD for 7 days

1g IM Ceftriaxone STAT

Metronidazole 400mg BD for 5 days

QUIZ

NEXT

RIGHT!

QUIZ

Well done!Doxycycline 100mg BD for 7 days is the correct answer.1g IM Ceftriaxone STAT is the management of Gonorrhoea.Metronidazole 400mg BD for 5 days is the mangement for bacterial vaginosis

QUESTION 3/5

Which of the following is not a typical feature of Trichomonas vaginalisis

Cottage cheese discharge

Green / yellow frothy discharge

Strawberry Cervix

QUIZ

NEXT

RIGHT!

QUIZ

Well done!Cottage cheese discharge is more commonly seen with candida infection. Green / yellow frothy discharge and strawberry cervix are common features of Trichomonas vaginalis

QUESTION 4/5

In which of the following scenarios would PEP be offered

Unprotected sex (receptive) with a known HIV+ve individual with an unknown viral load, 1 week ago

Needlestick injury from a known HIV +ve individual with an unknown viral load, yesterday

Unprotected sex (receptive) with a known HIV+ve individual with an undetectable viral load, yesterday

QUIZ

NEXT

RIGHT!

QUIZ

Well done! PEP is offered when one of the following exposures has occured from an indiviudal with an unknown or detectable viral load: Receptive anal or vaginal sex, occupational exposure, contaminated needle sharing, considered in insertive sex

QUESTION 5/5

Which of the following is an example of an AIDS-defining illness

Vaginal candidiasis

Cytomegalovirus infection

Osteosarcoma

QUIZ

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RIGHT!

QUIZ

Well done!Examples of AIDS-defining illnesses are as follows:Kaposi’s sarcoma Pneumocystis jirovecii pneumonia (PCP) Cytomegalovirus infection Candidiasis (oesophageal or bronchial) Lymphomas Tuberculosis

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QUIZ

FIND!

From among all the statements you discover,click only on the correct ones

START

CLICK ONLY ON THE CORRECT STATEMENT 1/5

You can drag the light to search through the darkness

Pelvic inflammatory disease requires IV antibiotics to treat it

The most common causative organism for pelvic inflammatory disease is E.Coli

The mangement for pelvic inflammatory disease is Doxycycline 100mg BD for 7 days and 1g IM ceftriaxone stat

Pelvic inflammatory disease can lead to a tubo-ovarian abscess

CLICK ONLY ON THE CORRECT STATEMENT 2/5

You can drag the light to search through the darkness

Primary syphilis is treated with 2.4M IU Penicillin V, STAT

Condylamata lata are a feature of tertiary syphilis

Syphilis is caused by S. Syphilisius

Gumma are a feature of tertiary syphilis

Chancre are only found on the genitals

RIGHT!

CLICK ONLY ON THE CORRECT STATEMENT 3/5

You can drag the light to search through the darkness

HIV can be transmitted through saliva when kissing an HIV+ve positive individual with a detectable viral load

AIDS-defining illnesses are seen when CD4 count drops below 50

The higher the viral load, the higher the CD4 count

Viral load is said to be undetectable when it drops below 50

Window period refers to the length of time it takes a test to become negative

RIGHT!

CLICK ONLY ON THE CORRECT STATEMENT 4/5

You can drag the light to search through the darkness

Cryotherapy is the only managment option for genital warts

If genital warts are left untreated they will spontaneously resolve

The diagnosis of gential warts is confirmed by doing a PCR swab

Genital warts are caused by HPV 16 & 18

Genital warts are often painful

CLICK ONLY ON THE CORRECT STATEMENT 5/5

You can drag the light to search through the darkness

Bacterial vaginosis is is caused by Staph and Strep species

Bacterial vaginosis causes vulval itching and discomfort

Bacterial vaginosis causes green frothy discharge

Bacterial vaginosis can be managed with oral metronidazole 2g STAT

ERROR!

Wrong!That statement is incorrect, time to start again!

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CORRECT IMAGE

Choose the correct image

start

Which microscopy image represents bacterial vaginosis

RIGHT!

which of the following patients needs treatment with aciclovir

RIGHT!

Which picutre shows chancre

RIGHT!

Which of the following conditions displayed on microscopy would need treating with 1g ceftriaxone im stat?

RIGHT!

WHich of the following is a normal anatomical variant

ERROR!

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START

TRue or false

Select the correct answer for each statement

True or false

True

False

Oral imadazoles are contraindicated in pregnancy

next

TRUE!

QUIZ

Well done!Oral imidazoles, such as Clotrimazole, are contraindicated in pregnancy. Alternative routes are usually used, for example Clotrimazole 500mg Pessary for the treament of vaginal candida in pregnancy

True or false

True

False

The Fraser Guidelines allow provision of sexual health advice, treatment and contraception advice to <16-year-olds, providing their parents consent

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FALSE!

QUIZ

Well done!The Fraser Guidelines (previously Gillick competence) enable the provision of sexual health advice, treatment and contraception to be given to those under 16 without parental consent, providing the following conditions are met1. Sufficient maturity to understand implications2. Cannot be persuaded to tell parents3. Likely to continue having sex4. Physical / mental health likely to suffer if treatment / advice withheld5. Advice / treatment in best interests

True or false

True

False

Screening for Chlamydia / Gonorrhoea in males is done by taking a urethral swab

next

FALSE!

QUIZ

Well done!All individuals accessing sexual health services will be offered screening for Chlamydia, Gonorrhoea, HIV and syphilis HIV and syphilis are tested using serology (blood tests) for both sexesChlamydia and Gonorrhoea are screened for using a NAAT testIn males, this is taken from a first catch urine sampleIn females, this is taken via a vulvovaginal swab

True or false

True

False

Lymphogranuloma venereum is a complication of untreated Chlamydia infection

next

True!

QUIZ

Well done!Lymphogranuloma venereum is a complication of specific strains of Chlamydia which affects lymph tissue around the original site of infection. It commonly affects MSM, rare in females. It occurs in 3 stages: 1. Painless ulcer (male: penis, female: vaginal wall, rectum after anal sex) 2. Lymphadenitis (usually inguinal / femoral) 3. Proctitis / proctocolitis causing pain, change in bowel habit, discharge, tenesmus, PR bleedingIn a lot of cases, it isn't detected until stage 3, and patients often end up going for uncessary invasive investigations like colonoscopies Management: doxycycline 100mg BD for 21 days

True or false

True

False

Herpes simplex virus cannot be spread when an infected individual does not have any active disease

next

FALSE!

QUIZ

Well done!Herpes simplex virus comes in 2 strains – HSV-1, HSV-2 After initial infection, the virus lays dormant in sacral nerve ganglia, it is never fully curedIt is spread through direct contact with mucous membranes by viral shedding in mucous secretions – meaning it can be spread when asymptomatic Treatment is with Aciclovir 400mg TDS for 5 days, as well as salt water bathing to help lesions heal, and topical anaesthetic to help with discomfort

True or false

True

False

Molluscum contagiosum can be treated with immune modulators

next

FALSE!

QUIZ

Well done!Molluscum contagiousum is often managed conservatively, however it can take 12-18m to resolve fully Topical steroid / emollients can be used for symptomatic reliefTopical Podophyllotoxin (immune modulator) can be used to try and resolve the lesions faster Topical liquid nitrogen (no evidence) Avoid shaving / waxing to prevent spread, avoid sharing towels etc as molluscum is highly infectious

True or false

True

False

Partner notification is required for any genital infection presenting to sexual health

next

FALSE!

QUIZ

Well done!Partner notification is only required for sexually transmitted infections

True or false

True

False

Ciprofloxacin can be used to treat gonorrhoea

next

FALSE!

QUIZ

Well done!Ciprofloxacin is the management for gonorrhoea infection when sensitivies are known (and the strain is sensitive to ciprofloxacin)

True or false

True

False

Pelvic inflammatory disease is managed with a combination of ceftriaxone, doxycycline and fluconazole

next

FALSE!

QUIZ

Well done!Pelvic inflammatory disease is managed with Ceftriaxone (to treat gonorrhoea), Doxycycline (to treat chlamydia) and Metronidazole (to treat TV / anaerobes)

True or false

True

False

The management for Trichomonas vaginalis is metronidazole 500mg BD for 7/7

next

FALSE!

QUIZ

Well done!The management for TV is metronidazole 400–500 mg twice daily for 7 days. An alternative option is Metronidazole 2 g orally in a single dose (but there's less good evidence for this).

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7

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0

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THE SECOND NUMBER IS:

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9

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THE THIRD NUMBER IS:

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2

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ENTER THE SECRET CODE

Congratulations!

Your excellent knowledge in sexual health has allowed you to answer all questions correctly and reveal the secret code. Well done!