Yet another new Q

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

Yet another new Q

Login or Register to post messages

Rated:

(0 votes)

Author

16 Posts

SA
Forum Elite

Topics: 21
Posts: 193

01/29/05 - 01:59 AM

A 39 year male come to your office with his ELIZA report which is showing positive for HIV. On history he told you that he use to take iv drugs but now stop it for last one years. He is living with her girl friend for last 5 year and she is the only sexual partner. He has broken with one before and that is all the sexual contact he had. On examination you did not find any abnormality. Western blot was advised confirme HIV positive on further investigation CD4 300 viral load is 55000. You started him on HAART. The patient brings his gf to your office as she had some queries about his disease. She asked you one question and what will be your answer out of the following choices.
Her question was that if we don’t use condom what sexual behavior is safest for her
1. Oral sex
2. Anal sex
3. Vaginal sex
4. All or equally safe
5. Get divorce

___________________
Wish best of luck to all users

mikyro
Forum Junior

Topics: 0
Posts: 81

01/29/05 - 04:53 AM

1. oral sex

___________________
the same miky - always ready to help my patients and friends as well

mash
Forum Fanatic

Topics: 147
Posts: 1,326

01/29/05 - 06:35 AM

5) none is safe w/o protection

___________________
I hear and I forget. I see and I remember. I do and I understand.
--Confucius

sanz
Forum Elite

Topics: 14
Posts: 154

01/29/05 - 06:49 AM

Abstinence is the safest option... so 5.

SA
Forum Elite

Topics: 21
Posts: 193

01/29/05 - 07:43 AM

As a Physician can you ask some one to Get divorce? is it ethical?
sanz it is not Abstinence it is divorce :shock:

___________________
Wish best of luck to all users

sanz
Forum Elite

Topics: 14
Posts: 154

01/29/05 - 08:37 AM

SA, we can only advise/recommend pts and explain to them the risks involved. They have to decide in the end.

I wouldnt tell her to divorce him but in yr question, there isnt an option as such... and divorce, among all other options in the q, would be the safest in her case... That's what i feel anyway. Wuz the ans?

lucky
Forum Guru

Topics: 23
Posts: 505

01/29/05 - 08:46 AM

5......

SA
Forum Elite

Topics: 21
Posts: 193

01/29/05 - 10:22 AM

I think we can't go for option 5 for ethical reason and my answer is vaginal sex but let me clear one thing here it the “most safe” option but nothing is safe in this situation in absolute term sad

.
Any comment

___________________
Wish best of luck to all users

ELM
Forum Guru

Topics: 28
Posts: 936

01/29/05 - 10:41 AM

No contact is safe.
Options for this q are fraud, we need better options.
I think USMLE is pretty fair game.

___________________
ELM

mikyro
Forum Junior

Topics: 0
Posts: 81

01/29/05 - 11:23 AM

#10

Come on, guys. You will never find such weird qs in the real exam grin

.

I remember a test like this one, but the husband informs you that he does not want to tell his pregnant wife (6th week) about his being infected (they have unprotected sex) and USMLE asked you what you should do next. I think the answer is more logical now :wink: .

The USMLE qs are fair - you can give a correct answer if you read carefully the item and the options they give you :idea: . The secret is that 2-3 out of 5-6 answers they give you can be easily ruled out as being correct grin

.

The only serious problem is time sad

. You barely have time to complete the blocks. Some tests can be 2 displays in length. Lot of info there but it's actually to clarify the diagnosis or the next investigation.

___________________
the same miky - always ready to help my patients and friends as well

SA
Forum Elite

Topics: 21
Posts: 193

01/29/05 - 12:14 PM

#11

Thanks you for your participation.
I am glad to hear from both of you that USMLE is pretty fair game but I don’t agree with the idea that “The only serious problem is time”. I think there must be some tricky question like this in actual exam as well.
About whole of this scenario let me tell you it is a real case and I had to face this in my practice. After testing the gf (which in that case was wife but that hardly make any difference) negative, I give her the option of divorce but she refused, condom but both of them did not like that idea and ask me the same question and I give them same answer that is vaginal sex. I still like to hear more form all of you. Did I do right thing with them? :?

___________________
Wish best of luck to all users

ELM
Forum Guru

Topics: 28
Posts: 936

01/29/05 - 01:04 PM

#12

Holly smoke! I can't believe, ...i don't know what to tell her either. I can't tell her to leave him. Noone could...... :lol: love is the most amazing thing, if someone is really in love, nothing matters.....not even AIDS :lol: .
So i guess, what i would do is, educate them the nature and the prognosis of the disease which includes safety of the healthy partner and leave the rest up to them. What esle can you do?
I would answer her q by telling the thruth that there is no safe sex contact, ALL are unsafe. So she is the one has to decide.
SA, sorry i don't think vaginal sex is no safer than any other sex practices. Do you have any reason that you think this way? :|

___________________
ELM

SA
Forum Elite

Topics: 21
Posts: 193

01/29/05 - 02:16 PM

#13

Yes vaginal sex is definitely safe then anal sex (not in absolute term) (AIDS is most common in anal receptive homosexual that is now a very well know fact) but between oral and vaginal a big question mark

___________________
Wish best of luck to all users

mikyro
Forum Junior

Topics: 0
Posts: 81

01/30/05 - 10:04 AM

#14

I believe that oral sex is the safest under the mentioned circumstances :roll: . Acquiring HIV infection is less probable with oral sex. As far as I know the HIV is present in almost any secretion of the body at certain time during the disease evolution :wink: . But is it present in saliva too :? ? Is HIV resistant to saliva or gastric secretions :? ? If not, than oral sex is safest unless mucosal lesions present in the oral cavity (portal of entrance for the virus).
Please offer me an answer grin

.

___________________
the same miky - always ready to help my patients and friends as well

noelle
Forum Elite

Topics: 59
Posts: 226

02/09/05 - 01:25 AM

#15

divorce doesnt mean the pt wont have sex....

___________________
only strong survive......

SA
Forum Elite

Topics: 21
Posts: 193

02/09/05 - 01:46 AM

#16

"noelle" wrote:
divorce doesnt mean the pt wont have sex....

for me "Get divorce" means getting separated and not having any more sex between those two I hope you understand what I mean and now give me answer what you think?

___________________
Wish best of luck to all users

Similar forum topics

Related resources