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HUMAN DEVELOPMENT: Sexual Health and HIV

Index

• General Outcomes for Sexual Health & HIV
• HIV Infection
• Genital Discharge
• Genital Ulcers and Lumps
• Pelvic Pain
• Testicular Pain

• General Outcomes for Sexual Health & HIV
  • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Male Reproductive Physiology
      1. Describe the lifetime changes of the prostate and its examination (GEP/HD, HD2)
      2. Discuss erectile dysfunction in relation to the relevant anatomy, physiology, biochemistry and pharmacology (GEP/HD, HD2)
  • Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
    • Sexually Transmitted Infections - General
      1. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
      2. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
      3. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
      4. List the major routes of transmission of HIV (I&I 4)
    • General Outcomes for HIV and AIDS
      1. To be able to explain pathogenesis of HIV
      2. Describe the structure of HIV and name the important constituent structures (I&I 4)
      3. Describe factors affecting rates of transmission following exposure to HIV-infected materials (I&I 4)
    • Sources of Infection and Routes of Transmission
      1. List the major routes of transmission of HIV (I&I 4)
  • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Contraception and HRT
      1. Describe to a patient methods of emergency contraception, indications and guidance for use (I&I 4)
      2. Demonstrate basic knowledge of currently available contraceptive methods and be able to communicate to patients the mechanisms of action and failure rate (I&I 4)
      3. Manage under supervision or refer as appropriate the contraceptive needs of a patient presenting with a medical condition which may contraindicate the method s/he is currently using (I&I 4)
  • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
    • General Outcomes for Sexually Transmitted Diseases
      1. Recognise the clinical presentations of Bechetís disease
      2. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum (I&I 4)
      3. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
      4. Recognise common presentations of patients with psychosexual factors affecting sexual function and / or relationships and know where to refer them. (I&I 4)
      5. Understand the pathogenesis, diagnosis, management and prevention of the following in the context of HIV: Pneumocystis jiroveci, Cryptococcus neoformans, Candidia albicans, Toxoplasma gondii, Cryptosporidium parvum, Mycobacterium tuberculosis (I&I 4)
      6. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoea, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
      7. Recognise the clinical presentations of primary HIV infection (seroconversion) and describe the management of a suspected case (I&I 4)
    • Sexual Assault
      1. Understand the management of male and female victims of sexual assault (I&I 4)
      2. To know where to refer patients who have been possible survivors of sexual assault (I&I 4)
      3. Identify symptoms and presentations that may indicate that patients have been survivors of sexual assault (I&I 4)
      4. Recognise presentations of Domestic Abuse and be able to refer appropriately (I&I 4)
      5. Identify and understand Female Genital Mutilation and be able to refer appropriately (I&I 4)
      6. Be aware of non-consensual sexual intercourse in male and females and appropriate referral pathways for further management and support (I&I 4)
    • HIV Infection
      1. Describe factors affecting rates of transmission following exposure to HIV-infected materials (I&I 4)
  • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH (TD 11 a-j)
    • Lifestyle and Disease
      1. To understand factors which lead to unwanted pregnancy
    • HIV/AIDS and Sexually Transmitted Infections
      1. To understand the ways in which Sexual Health services are different from general medical services, including access issues and public health role
      2. Explain the principles of safe sex and risk reduction, and identify at risk groups (I&I 4)
      3. To understand the process when a patient attends a GUM clinic (I&I 4)
      4. To identify opportunities for sexual health promotion including opportunities for early diagnosis of HIV in related and unrelated medical contexts (I&I 4)
  • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
    • General Issues
      1. To appreciate how sexual wellbeing and ill health, with reference to HIV and other STIs, impact on the individual and how that may impact on psychological and physical health and recognise and describe to patients the psychological interventions available
    • Bio-Psycho-Social Issues
      1. To appreciate the concerns a patient may have attending a GUM clinic and list three ways you might put patients at ease (I&I 4)
      2. Describe the stresses and psychological reactions associated with actual or perceived HIV infection, Hepatitis B and C or STDs, and the buffering effects of adaptive coping skills and social support (I&I 4)
  • Clinical skills: HISTORY (TD 13 a-b)
    • General
      1. Be able to obtain an appropriate sexual history, to assess risk for sexually transmitted infections and pregnancy and to communicate this risk to individual patients in a sensitive, non-judgemental manner (I&I 4)
      2. List the required competencies in The Fraser Ruling (I&I 4)
      3. Understand some of the difficulties patients might have in discussing issues regarding sex, sexuality and sexual practices and problems (I&I 4)
      4. Understand causes of genital warts and difference between low-risk and high-risk HPV types (I&I 4)
      5. To understand how to take a sexual history (I&I 4)
      6. Take a brief alcohol and recreational drug history and understand the relevance to high risk sexual behaviours (I&I 4)
      7. To gain an appreciation of some of the different types of sexual practices (I&I 4)
      8. Take a sexual history with regard to sexual preference, practice, and problems that is respectful of individual lifestyles and sensitive to social and cultural issues (I&I 4)
      9. Be able to obtain an appropriate sexual history, to assess risk for sexually transmitted infections and pregnancy and to communicate this risk to individual patients in a sensitive, non-judgmental manner (I&I 4)
  • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Examining the Patient
      1. To know how to examine female and male genitalia and be able to list 3 abnormal findings for each (I&I 4)
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Sexual Health Investigations
      1. Be able to explain candida infection and bacterial vaginosis (I&I 4)
      2. Understand treatment options for candida and bacterial vaginosis (I&I 4)
      3. Describe the range of microbiological/virological tests that are performed at GUM clincis (I&I 4)
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • General Outcomes for Sexual Health Diagnosis
      1. Understand the pathogenesis, diagnosis and management of Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans, Trichomonas Vaginalis, Bacterial Vaginosis and Non-Specific Urethritis (I&I 4)
      2. Understand the pathogenesis, diagnosis and management of Herpes Simplex Virus, Syphilis, Lymphogranuloma Venereum, (I&I 4)
      3. Understand approach to diagnosing genital sores (history and examination) (I&I 4)
      4. Understand the pathogenesis, diagnosis and management of Human Papilloma Virus, Molluscum contagiosum and Sarcoptes scabiei (I&I 4)
      5. List the diagnostic tests used for genital sores (Dark ground, PCR) (I&I 4)
      6. List a differential diagnosis for a male and female patient presenting with genital ulceration, focussing on Herpes Simplex and Syphilis infection (I&I 4)
      7. With reference to HIV, Hepatitis B and C and STDs the student should be able to: a) Identify the skills, roles and responsibilities of the health care team; b) To understand that a patient needs to give consent for an HIV test and that pre-test/post-test counselling are no longer performed routinely in order to reduce the stigma associated with HIV. (I&I 4)
      8. Recognise the clinical presentations of non-infective genital ulceration (eg Bechet’s disease) (I&I 4)
      9. Be able to explain asymptomatic shedding of HSV (I&I 4)
      10. Be able to explain incubation periods and transmission (I&I 4)
      11. Explain other aspects of management – e.g. Patient Information, Partner Notification issues, condom use (I&I 4)
      12. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
      13. To have an introduction to Sexually Transmitted Infection (STI) and their treatments (I&I 4)
  • Clinical skills: DIAGNOSTIC PROCEDURES (TD 18 a)
    • Pregnancy Test
      1. Be able to perform and interpret near patient pregnancy testing
  • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Management Sexual Health Disorders (Inc. HIV) - General
      1. To manage under supervision the following medical conditions which are not immediately life threatening but which require early treatment: female lower abdominal pain, genital ulceration / discharge / lumps, testicular pain
      2. Understand the management of psychosexual disorders in male and female patients. (I&I 4)
      3. With reference to HIV, Hepatitis B and C and STDs the student should be able to: a) Identify the skills, roles and responsibilities of the health care team; b) To understand that a patient needs to give consent for an HIV test and that pre-test/post-test counselling are no longer performed routinely in order to reduce the stigma associated with HIV. (I&I 4)
      4. List treatment options for genital warts (I&I 4)
      5. List treatments for NGU, Chlamydia, Gonorrohea and LGV (I&I 4)
      6. Offer STI & HIV testing as part of genital wart management (I&I 4)
      7. Offer STI & HIV testing as part of management (I&I 4)
      8. To understand the efficacy, side effects, drug interactions and contraindications of drugs used in the management of STIs (I&I 4)
      9. List treatments for HSV and Syphilis (I&I 4)
      10. Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
      11. Offer STI & HIV testing as part of genital sores management (I&I 4)
      12. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
      13. To have an introduction to Sexually Transmitted Infection (STI) and their treatments (I&I 4)
      14. Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
      15. To appreciate the importance of contact tracing and partner notification (I&I 4)
    • Management of general O&G problems
      1. Understand the range of psychological responses to the actual or perceived physical illness and the disease process in relation to the health care experience (I&I 4)
  • Clinical skills: SUPPORTING PATIENTS and IDENTIFYING ABUSE and NEGLECT (TD 14 h-i)
    • Preventative care and Screening
      1. To explain principles of safer sex and risk reduction and be able to demonstrate correct condom technique
    • General Outcomes for Integrated Health
      1. Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
  • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Interacting with Patients - General
      1. Be able to obtain an appropriate sexual history, to assess risk for sexually transmitted infections and pregnancy and to communicate this risk to individual patients in a sensitive, non-judgmental manner (I&I 4)
  • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
    • Pharmacological Therapy - Sexual Health (General)
      1. To understand the efficacy, side effects, drug interactions and contraindications of drugs used in the management of STIs (I&I 4)
      2. Understand the indications for PEPSE (I&I 4)
      3. Discuss erectile dysfunction in relation to the relevant anatomy, physiology, biochemistry and pharmacology (GEP/HD, HD2)
  • Professional issues: WORKING IN TEAMS (TD 22 a-c)
    • Multi-disciplinary Team Work (MDT)
      1. Understand the need for a multi-disciplinary approach to HIV and other infectious diseases encountered in the Immunology and GUM clinics (I&I 4)
      2. To understand the multidisciplinary team working in a GUM clinic (I&I 4)
  • Professional issues: ETHICS and LAW (TD 20 a-g)
    • Ethics in Obstetrics and Gynaecology
      1. To understand and practise confidentiality and be aware of current legislation concerning confidentiality with particular reference to sexual and reproductive health & HIV medicine
      2. To understand and practice legal responsibilities of health care workers who are HIV positive
    • Legal, Moral, Ethical Responsibilities of Patient Care
      1. Be aware of Child Protection issues (I&I 4)
  • Professional issues: RISK MANAGEMENT and PATIENT SAFETY (TD 23 d)
    • Human Factors
      1. Explain the principles of safe sex and risk reduction, and identify at risk groups (I&I 4)
    • Principles of Risk Management
      1. Be able to obtain an appropriate sexual history, to assess risk for sexually transmitted infections and pregnancy and to communicate this risk to individual patients in a sensitive, non-judgmental manner (I&I 4)
• HIV Infection
  • General Outcomes for HIV Infection
    1. Engage in relevant HIV pre-test discussions to assess relative risk of infection and enable patients to make an informed decision on testing (both in GU setting and outside of GU) (I&I 4)
    2. To outline national screening programs relevant to sexual and reproductive health and HIV (currently cervical screening, Chlamydia screening and antenatal HIV testing)
    3. To understand and practise legal responsibilities relevant to sexual activity and sexual health and HIV care (e.g. issues of consent, disclosure, providing care for minors, people with learning difficulties, suspected abuse, rape)
    4. Understand the pathogenesis, diagnosis and management of the following in the context of HIV: Kaposi’s sarcoma, Non-Hodgkin’s B cell Lymphoma, Primary cerebral lymphoma, Burkitt’s lymphoma and squamous cell carcinoma
    5. To understand the basic epidemiology of STIs and HIV and public health issues for control of spread of infection locally and globally (I&I 4)
    6. List the opportunistic infections that commonly cause clinical disease in HIV infection
    7. Epidemiology HIV worldwide
    8. Be able to engage in relevant HIV pre-test discussions to assess relative risk of infection and enable patients to make an informed decision on testing
    9. Understand the pathogenesis, diagnosis, management and prevention of the following in the context of HIV: Pneumocystis jiroveci, Cryptococcus neoformans, Candidia albicans, Toxoplasma gondii, Cryptosporidium parvum, Mycobacterium tuberculosis, atypical My (I&I 4)
    10. To recognise medical presentations of primary or established HIV infection
    11. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
    12. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
    13. Describe the spectrum of clinical problems associated with HIV infection: primary HIV infection, asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome (I&I 4)
    14. Recognise the major clinical presentations of neurological complications of HIV (I&I 4)
    15. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
    16. Recognise the significance and list possible causes for the following symptoms in an HIV infected person: Generalised seizures, loss of vision, focal neurological deficit, change in affect, shortness of breath, rash
    17. Be aware of, and have an understanding of a patient's feelings when diagnosed with HIV / AIDS
    18. To be able to explain pathogenesis of HIV
    19. To describe available Post Exposure Prophylaxis regimens for HIV and how best to access these regimens
    20. Recognise the significance and list possible causes for the following symptoms in an HIV infected person: Generalised seizures; Loss of consciousness; Focal neurological deficit; Change in affect; Shortness of breath; Rash; Fever (I&I 4)
    21. To describe principles of partner notification for STIs and HIV (I&I 4)
    22. Understand the concept of opt-out testing and the settings in which opt-out testing are conducted. (I&I 4)
    23. Know the mode of transmission of HIV, AIDS
    24. Understand the changing significance neurological complications of HIV, in particular, HIV-associated neurocognitive disease (I&I 4)
    25. Assess risk of HIV transmission in individual presenting after occupational and non-occupational potential exposure to HIV (I&I 4)
    26. Demonstrate knowledge of the CDC classification system for HIV infection (I&I 4)
    27. Explain the functions of the various parts of the HIV virus particle (I&I 4)
    28. Identify barriers to testing (from patients and healthcare professionals) (I&I 4)
    29. Correlate the degree of immunosuppression of an individual patient with the likely clinical problems (I&I 4)
    30. Describe the genome of HIV with reference to the regulatory proteins produced and their functions. (I&I 4)
    31. Identify neurological clinical presentations that may indicate undiagnosed HIV infection (I&I 4)
    32. Describe the tests used in the diagnosis and monitoring of HIV infection including: tests for antibodies to HIV-1 and HIV-2; Tests for the virus itself (viral antigen, viral DNA and RNA, viral subtypes and genetic analysis for resistance mutations); Tests of the immune system (lymphocyte subsets) (I&I 4)
    33. Understand a range of testing methods (I&I 4)
    34. Describe available PEP regimens and how best to access these regimen (I&I 4)
    35. Formulate a plan for the treatment and prevention of neurological disease in HIV (I&I 4)
    36. Describe how widespread HIV is; know what is meant by clades (CSP3)
    37. Understand the circumstances in which HIV testing can be performed with out the patient’s consent (I&I 4)
    38. Critically evaluate the utility of individual tests in specific clinical situations including: Diagnosis in chronically infected individual; HIV seroconversion; pregnancy; neonates and children less than 2 years old; patients on antiretroviral therapy (I&I 4)
    39. Describe the management of a person who has sustained a needlestick injury from a known HIV positive source (I&I 4)
    40. Demonstrate the events that occur at a cellular level during acute HIV infection (I&I 4)
    41. Be able to explain the events within the immune system which result from HIV infection (I&I 4)
    42. Describe the specific immune responses to HIV (I&I 4)
    43. Correlate the changes in the immune system at a cellular level with the clinical consequences for the patient with HIV infection (I&I 4)
    44. Explain the factors that may confer resistance to HIV (I&I 4)
    45. Define the term long-term non progressor (I&I 4)
    46. Describe the potential uses of vaccination and immunotherapy in HIV (I&I 4)
  • Infections and Disorders Associated with HIV
    1. To recognise the presentations of HIV infected patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposiís Sarcoma, Lymphoma, Hepatitis B and C
    2. List the opportunistic infections that commonly cause clinical disease in HIV infection
    3. Describe the spectrum of clinical problems associated with HIV infection: primary HIV infection, asymptomatic HIV infection, persistent generalised lymphadenopathy, symptomatic HIV infection and Acquired Immunodeficiency Syndrome (I&I 4)
    4. Describe the epidemiology and natural history of Hepatitis A, B, C and D (I&I 4)
    5. List the fungi and protozoa that commonly cause clinical disease in the context of HIV infection (I&I 4)
    6. Understand the effect of co-infection with HIV and Hepatitis B and C on the natural history of HIV and Hepatitis B and C (I&I 4)
    7. List the bacteria and viruses that commonly cause clinical disease in the context of HIV infection (I&I 4)
    8. Describe the methods of diagnosis and monitoring of Hepatitis B and C infection (I&I 4)
    9. Recognise the major clinical presentations of: Pneumocystis jiroveci; Cryptococcus; Candidiasis; Toxoplasmosis; Cryptosporidium; Herpes viruses (Herpes Simplex, Herpes Zoster, Cytomegalovirus); Human papilloma virus; Papovavirus; Salmonella; Mycobacteria; Haemophilus; Pneumococcus (I&I 4)
    10. Describe the investigation of abnormal liver function tests / hepatomegaly in an HIV-infected individual (I&I 4)
    11. Describe the treatment of Hepatitis B and C and how this differs in the context of HIV co-infection (I&I 4)
    12. Describe prevention strategies, including vaccination, for Hepatitis A, B and C (I&I 4)
    13. Describe the spectrum of renal disease in HIV (I&I 4)
    14. Describe the investigation and management of abnormal renal function in an HIV-infected individual (I&I 4)
  • Treatment of HIV Infection
    1. To describe the basic principles of anti-HIV therapy, including major side-effects and interactions of therapy (I&I 4)
    2. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
    3. Understand the pathogenesis, diagnosis and management of HIV infection (I&I 4)
    4. To manage under supervision or refer as appropriate the presentations of HIV positive patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposi’s Sarcoma, Lymphoma, Hepatitis B and C
    5. Recognise the clinical presentations of primary HIV infection (seroconversion)\and describe the management of a suspected case (I&I 4)
    6. Describe the management of a person who has sustained a needlestick injury from a known HIV positive source (I&I 4)
    7. Describe the different groups of antiretroviral drugs and their mode of action (I&I 4)
    8. Explain the rationale for risk assessment and the use of antiretroviral agents for prophylaxis following sexual intercourse with a known or suspected HIV positive person (I&I 4)
    9. Describe examples of the most commonly prescribed antiretroviral drugs including major side-effects and interactions of therapy (I&I 4)
    10. Demonstrate the life cycle of HIV, with particular reference to the areas that have implications for therapeutic interventions (I&I 4)
    11. Describe why adherence to ARVs is important (I&I 4)
    12. Describe the principles of diagnosis, management and prevention of opportunistic fungi and protozoa (I&I 4)
    13. Review the specific details of development of ARV resistance (I&I 4)
    14. Describe the principles underpinning the diagnosis, management and prevention of opportunistic bacterial and viral infection in HIV infected patients (I&I 4)
    15. Formulate a plan for the treatment and prevention of opportunistic bacterial and viral pathogens (I&I 4)
    16. Consider specific difficulties associated with ARVs that have an impact on adherence and resistance including: bioavailability; side-effects (short and long-term); confidentiality; interactions (I&I 4)
    17. Describe how antiretroviral therapy may be used to prevent HIV transmission including: Mother to child transmission; Post-exposure prophylaxis (PEP / PEPSE); Pre-exposure prophylaxis (PrEP); Treatment as Prevention (TAsP) strategies including “test and treat” initiatives in high prevalence settings (I&I 4)
    18. Describe the potential uses of vaccination and immunotherapy in HIV (I&I 4)
  • Malignancies Associated with HIV Infection
    1. Understand the pathogenesis, diagnosis and management of the following in the context of HIV: Kaposi’s sarcoma, Non-Hodgkin’s B cell Lymphoma, Primary cerebral lymphoma, Burkitt’s lymphoma and squamous cell carcinoma
    2. To manage under supervision or refer as appropriate the presentations of HIV positive patients with Pneumocystis pneumonia, Candidiasis, Toxoplasmosis, Cryptococcosis, Tuberculosis, Cytomegalovirus, Kaposi’s Sarcoma, Lymphoma, Hepatitis B and C
    3. Explain why HIV infection predisposes to certain malignancies (I&I 4)
    4. Understand the relationship between HHV8, EBV and HPV in the etiology of malignancy (I&I 4)
    5. List the presenting clinical features of Kaposi’s sarcoma, non-Hodgkin’s B cell lymphoma and squamous cell carcinoma in HIV infection (I&I 4)
    6. Consider appropriate differential diagnoses for each condition (I&I 4)
    7. Discuss potential management strategies for each type of malignancy (I&I 4)
• Genital Discharge
  • General Outcomes for Genital Discharge
    1. Understand approach to diagnosing dysuria & discharge (history and examination) (I&I 4)
    2. Understand approach to diagnosing vaginal discharge (history and examination) (I&I 4)
    3. List a differential diagnosis for a male patient presenting with urethral and or rectal discharge
    4. List a differential diagnosis for a female patient presenting with vaginal and or rectal discharge
    5. List the diagnostic tests used (microscopy, culture, urinalysis) (I&I 4)
    6. List diagnostic tests used (eg microscopy, culture, NAATs) (I&I 4)
    7. List a differential diagnosis for a female patient presenting with vaginal and/or rectal discharge (I&I 4)
    8. List a differential diagnosis patient presenting with urethral or rectal discharge and/or dysuria (including NGU and LGV) (I&I 4)
    9. Offer STI and HIV testing if appropriate (I&I 4)
• Genital Ulcers and Lumps
  • General Outcomes for Genital Ulcers and Lumps
    1. Understand approach to diagnosis of genital lumps (history and examination) (I&I 4)
    2. List a differential diagnosis for a male and female patient presenting with genital lumps (including normal anatomical variance) (I&I 4)
• Pelvic Pain
  • General Outcomes for Pelvic Pain
    1. List a differential diagnosis for a female patient presenting with acute and or chronic pelvic pain
    2. Understand approach to diagnosing female pelvic pain (history, examination, pregnancy test) (I&I 4)
    3. List the diagnostic tests used (microscopy, culture, urinalysis, pregnancy test) (I&I 4)
    4. List differential diagnoses (eg ectopic pregnancy, PID, UTI) (I&I 4)
    5. Understand referral pathway for urgent management of ectopic pregnancy (I&I 4)
    6. Offer STI & HIV testing as part of management (I&I 4)
    7. Explain other aspects of management – eg Patient Information, Partner Notification issues, condom use (I&I 4)
  • Pelvic Inflammatory Disease (PID)
    1. Understand the pathogenesis, diagnosis and management of Pelvic Inflammatory Disease
• Testicular Pain
  • General Outcomes for Testicular Pain
    1. List a differential diagnosis for a patient presenting with acute or chronic testicular pain (I&I 4)
  • Epididymitis
    1. Understand the pathogenesis, diagnosis and management of epididymitis (I&I 4)
  • Testicular Torsion
    1. Describe the presenting features and referral pathway for testicular torsion (I&I 4)

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