Gynecology
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| What is the lifetime risk of contracting an STD | 1 in 4
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| STD: What age group is the highest at risk population | 15-24
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| What geographic regions are at highest risk for STD’s | southeast and urban
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| History of sexual intercourse with trauma increases the risk for what STD | Hep B , and Hep C
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| Why would you check the palms of a patient when concerned about STD’s | you are looking for secondary syphilis
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| 3 causes of genital ulcers in US | Herpes simplex virus, primary syphilis, chancroid
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| Herpes ulcers are __ | Painful, small, shallow, may have a clear exudate
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| Secondary herpes ulcers are __ | Smaller, and less dramatic looking than the primary lesions
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| Primary syphilis is a __ | Solitary, painless, indurated, large/deep ulcer
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| Agent responsible for chancroid | H. ducreyi
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| Clinical presentation of lymphogranuloma venereum (LGV) | Rectal ulceration or stricture, inguinal LAD
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| Etiology of LGV | Chlamydia trachomatis
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| Clinical presentation of granuloma inguinale | Chronic or recurrent ulcerative vulvitis. Donovan bodies on stained direct smear or biopsy of ulcer.
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| What is the etiologic agent of granuloma inguinale | Calymmatobacterium granulomatous
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| Etiologic agent of condyloma acuminata | HPV
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| What is the clinical appearance of condyloma acuminata | Flat, papillomatous, or pedunculated
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| Vaccine available for HPV | Gardasil
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| Who should Gardasil be offered to | Females 9-26 years old (full benefit if given prior to onset of sexual activity) even if history of hpv
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| What is the etiology of Chancroid | Haemophilus ducreyi
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| Chancroid is most often a co-infection with what | Herpes and or syphilis
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| Gram stain with a “school of fish” appearance is probably what | Chancroid (Haemophilus ducreyi)
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| Trichomonas is tested for by use of what | Wet prep
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| Type of cancer associated with HPV | Cervical cancer
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| Risk factors for cervical cancer | Smoker, hormones, multiple sexual partners, sex before 18, HIV, poor SES, age, multiple pregnancies, chlamydia infection, diet low in fruit and vegetables
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| Effective methods to prevent cervical cancer | Routine pap tests, condom use, limit partners, HPV vaccine, avoid smoking
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| Low risk HPV strains | HPV-6, and HPV-11 (cause genital warts)
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| High risk strains of HPV | HPV-16, 18, 31, 33, 35
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| What is the HPV vaccine | Gardasil (HPV 6,11,16,18)
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| Offer __ testing for all patients evaluated for STIs | HIV
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| Acute HIV symptoms | Fever, mono-like illness, diarrhea
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| Which hepatitides are commonly sexually transmitted | A, B, and C (especially B)
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| Vaccinations are available for which hepatitides | A and B (no hep C vaccine available yet)
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| Males voiding within __ before urethral culture washes secretions away | 1-2 hours
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| What are the 4 methods for diagnosis of HIV | Detect antibodies to the virus, detect viral p24 antigen, detect viral nucleic acid, culture HIV virus
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| What is the most widely used method to diagnose HIV | Detection of antibody to HIV
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| Most common cause of false positive tests for HIV in low risk pts | Recent immunization
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| What is the initial screening for HIV | EIA enzyme immunoassay (ELISA)
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| What is the confirmatory test for HIV (done after the screening test) | Western blot or IFA (Immunofluorescence Assay)
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| What is herpetic whitlow | Herpes on the fingers (especially around the nail bed)
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| Characteristic of primary HSV outbreak | 2-7 day course, systemic symptoms possible, local symptoms (painful), first outbreak is the worst
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| Precipitants of HSV recurrent outbreaks | Sun, wind, trauma, fever, menses, stress
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| __ may reduce transmission of HSV | Antivirals: acyclovir / pencyclovir topical; systemic acyclovir (eg, in PG) or valcyclovir. Foscarnet if need hosp
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| Best source of HSV for testing | Unroofing the vesicle
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| __% of US population have positive herpes antibodies on serological testing | 50
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| Multiple, vesicular, pruritic, painful, recurrent rash | Herpes simplex
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| Most appropriate way to test for herpes | Culture (not serological)
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| condyloma acuminata Tx | BCA/TCA; cryosurgery, electrosurgery, excision
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| USPSTF guidelines for STI screening | All sexually active women & men <26 yo. Patients w/increased risk: new/other STIs, new / multiple sex partners, erratic condom use, sex for money
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