Genital herpes — RACGP Fellowship MCQ

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ModerateWomen's health and O&GGenital herpesRACGP Fellowship

A 19-year-old university student presents with painful grouped vesicles on the vulva, dysuria and tender inguinal nodes. This is her first episode of genital herpes. She is systemically well and pregnancy test is negative. What is the most appropriate management?

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Correct answer: B — Start oral antiviral therapy and arrange STI testing with counselling

The correct answer is B. First-episode genital herpes requires immediate oral antiviral therapy (acyclovir 200 mg five times daily for 5 days or valacyclovir 1 g twice daily for 10 days) to reduce symptom duration and viral shedding. Topical agents are ineffective for systemic symptoms (eliminating A and C delays treatment). Penicillin treats syphilis, not herpes (eliminating D). Sexual health follow-up with STI screening and counselling is essential to identify comorbid infections, provide transmission prevention advice, and facilitate partner notification (eliminating E). This integrated approach reflects evidence-based STI management in Australian general practice.

Reference: Cochrane Review 'Interventions for men and women with their first episode of genital herpes' (2016); WHO Guidelines for the Treatment of Genital Herpes Simplex Virus (2016); RACGP Australian Family Physician 'Genital herpes' (2002), https://pubmed.ncbi.nlm.nih.gov/27575957/