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STI 1

Gynecology

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

 



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