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STI 1
Gynecology
| Question | Answer |
|---|---|
| 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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