MCQ12A

12. Genital warts:

a.	are due to herpes virus infection	False
b.	may be treated with diflucan	False
c.	are grounds for Caesarean section to prevent neonatal infection	False
d.	podophyllin therapy should be avoided in pregnancy	True
e.	are grounds for more frequent than normal cervical smears	False

Genital warts are due to the human papilloma virus.

There are about 30 virus types known to cause warts, but most are due to types 6 & 11.

Diflucan is an oral treatment for infection with candida.

There is debate about the role of Caesarean section for patients with active herpes, but not for patients with warts.

Podophyllin in spirit is the standard treatment, but can be toxic in pregnancy.

Failing this, the warts can be frozen or treated with diathermy.

Cervical cancer is believed to be due to the wart virus, particularly types 16 & 18.

Though about 30 virus types have been implicated.

So patients with proven infection, be it clinical warts or evidence of wart infection on cytology, are at increased risk.

A vaccination programme for young girls was introduced in the UK in 2008.

The chosen vaccine is Cervarix.

It protects against types 16 & 18.

As noted above, these are the commonest causes of cervical cancer in the western world.

There is another vaccine, Gardasil, that protects against types 6, 11, 16, and 18.

6 and 11 are included as these cause about 90% of genital warts.

It seems a shame that the quadrivalent vaccine was not chosen.

I am not sure of the reasons, but would suspect that it was down to cost.

This programme should greatly reduce the incidence of the disease.