Chapter 7: STI Infections Flashcards
(151 cards)
1
Q
Primary prevention of STI’s = ?
A
Preventing any infection! EDUCATION
2
Q
Secondary prevention of STI’s = ?
A
Prompt Tx of the STI
3
Q
Risk reduction measures for STI’s & STD’s
A
- knowledge of partner
- Reduction in the number of partners
- Condom use
- Negotiation of use
- Low-risk sex
- Avoiding exchange of body fluid
- Vaccination (HPV ages 8-9, guardacil-9, Hep B)
4
Q
Research now shows that N-9 lubricated condoms and spermicides are NOT recommended for what ?
A
The prevention of HIV & STI’s
5
Q
What is the most common bacterial infection ?
A
Chlymidia
6
Q
What is the oldest bacterial communicable disease in the US ?
A
Gonorrhea
7
Q
What are Bacterial STI’s ?
A
- Chlamydia
- Gonorrhea
- Syphilis
- Pelvic Inflammatory Disease
8
Q
_______ (Bacterial STI), is transmitted by entry into subcutaneous tissue through microscopic abrasions that can occur during sexual intercourse ?
A
Syphilis
9
Q
Syphilis can also be transmitted through what ?
A
- Kissing
- Biting
- Oral - genital sex
10
Q
True or False: With Syphilis, transplacental transmission may occur at any time during pregnancy ?
A
True
11
Q
________ (Bacterial STI) can lead to serious systemic disease and even death ?
A
Syphilis
12
Q
In terms of pregnancy, Syphilis can cause things such as ?
A
- PTL (Pre-term Labor)
- PTB (Pre-term Birth)
- etc,.
13
Q
Primary Syphilis (1 sore) typically starts to appear when ?
A
5 - 90 days
14
Q
Secondary Syphilis (multiple sores) starts to appear when ?
A
6 weeks to 6 months
15
Q
True or False: Pregnant women are screened for Syphilis ?
A
True
16
Q
Serologic tests (can be false positives) & Microscopic exam of the lesions are screenings utilized for what Bacterial STI ?
A
Syphilis
17
Q
What is the Drug of choice for the management of Syphilis ?
A
Penicillin
other drugs available, if allergic
18
Q
True or False: When treating someone for Syphilis, their partners should also be treated ?
A
True
19
Q
True or False: You should remain sexually abstinent during the treatment of Syphilis ?
A
True
20
Q
What is the most common and fastest spreading STI ?
A
Chlamydia
21
Q
_________ (Bacterial STI) infections are often silent and highly destructive ?
A
Chlamydia
22
Q
What Bacterial STI is difficult to diagnose ?
A
Chlamydia
23
Q
With Chlamydia, what type of people do we screen ?
A
Symptomatic & pregnant women
24
Q
Why do we screen pregnant women for Chlamydia ?
A
Because we don’t want babies to get it
25
What WAS the Gold standard for diagnosing Chlamydia ?
Cultures
26
Now, what is the preferred method for the screening/diagnosis of Chlamydia ?
Nucleic acid test-urine and blood testing (NAAT)
27
What is the Management of Chlamydia focused on ?
Treatment & Rest
28
What drug is used to treat Chlamydia (if not pregnant) ?
Doxycycline
- Azithromycin --> if pregnant
29
True or False: With Chlamydia, your partner should be treated ?
True
30
How is Gonorrhea transmitted ?
- genital to genital
- Oral to genital
- Anal to genital
- Mother to newborn
31
True or False: Men may have more symptoms than women ?
True
32
With gonorrhea, 80% of women are what ?
asymptomatic
33
Risk factors for Gonorrhea ?
- Age
- African American (most cases reported)
- Early onset of sexual activity
- Multiple partners
34
The symptoms listed below correlate with what Bacterial STI ?
- Women are often asymptomatic
- Purulent discharge (not seen often)
- Menstrual irregularities
- Pelvic or abdominal pain
- Rectal complications
Gonorrhea
35
True or False: In pregnancy, Gonorrhea can affect the mother and fetus ?
True
36
Gonorrhea in pregnancy can cause things like what ?
- PROM (premature rupture of membranes)
- PTL (pre-term labor)
- PTB (pre-term birth)
- Uterine infection
- IUGR (Intrauterine growth retardation)
37
Newborns, who's mothers have Gonorrhea during pregnancy have the potential to develop what ?
Ophthalmic Neonatorum (eye infection)
38
What is Ophthalmic Neonatorum ?
| And what can it lead to. ?
Eye infection
| Can lead to blindness
39
What does the CDC recommend for screening for Gonorrhea ?
- Screen all at risk women
| - Screen All pregnant women
40
What is the Gold Standard for screening for Gonorrhea ?
Cultures
41
True or False: The management for Gonorrhea is straightforward and has a rapid cure ?
True
42
What is the Treatment for Gonorrhea ?
Ceftriaxone and Azithromycin
| can get 1 Treatment or weekly
43
True or False: In people with Gonorrhea, their partners should also be cultured and treated ?
True
44
What type of bacterial STI, is an infectious process that involves the uterus, Fallopian tubes, possibly ovaries, and peritoneal surfaces ?
Pelvic Inflammatory Disease
45
_________________________ (Bacterial STI) results from ascending spread of microorganisms from the vagina and endocervix to the upper genital tract ?
Pelvic Inflammatory Disease
46
Below, are Risk factors for what Bacterial STI ?
- Hx of STI's
- Multiple partners****
- High rates of new partners
- Untreated STI's****
- IUD's (increased risk for 3 weeks after insertion)
Pelvic Inflammatory Disease
47
What Bacterial STI put's you at increased for...
- Ectopic pregnancy
- Infertility
- Chronic pelvic pain
- Dysparunia, pelvic adhesions, pus in uterus (pyosalpinx)
Pelvic Inflammatory Disease (PID)
48
Below are symptoms of what Bacterial STI ?
- Bilateral sharp, cramping pain in the lower quadrants
- Fever greater than 100F
- Chills
- Cervical or vaginal discharge
- Irregular bleeding
- Cervical motion tenderness during intercourse
- Malaise
- N & V
Pelvic Inflammatory Disease (PID)
49
True or False: PID is hard to treat ?
True
50
Why is PID hard to treat ?
Because there is no one test! Because it is a combination of diseases/infections
51
What is the management for PID ?
- Prevention
- Medication
- Hospitalization
- Education
52
HPV is what type of STI's ?
Viral
53
What is the most prevalent viral STI seen in ambulatory health care settings (urgent cares) ?
HPV
54
True or False: HPV is a highly contagious viral STI ?
True
55
HPV is more frequent in who ?
pregnant women
56
True or False: HPV lesions enlarge during pregnancy ?
Ture
57
What is the primary cause of cervical cancer ?
HPV
58
What is the C/O of HPV ?
Profuse irritating vaginal discharge
59
What are others signs/symptoms of HPV ?
- Itching
- "bumps" on labia
- Dysparunia (painful intercourse)
- Vaginal bleeding
- Lesions
60
True or False: Some Pap smears can detect BOTH abnormal cells AND HPV ?
True
61
How is screening done for HPV ?
- Hx of known exposure
- Physical inspection*** (looking for warts)
- Pap smear (generally show abnormal cells)
62
True or False: No cure has been shown to eradicate HPV ?
True
63
What is the medication for HPV used for ?
For Discomfort
64
True or False: If you have HPV, your partner should also be examined ?
True
65
True or False: Sometimes HPV resolves on its own in young women ?
True
66
True or False: There are vaccines for the management of HPV ?
True
67
What is a medication that may be used in the management of HPV ?
Guardacil 9
68
Genital herpes is what type of STI ?
Viral
69
What is the abbreviation of Genital herpes simplex virus ?
HSV
70
Herpes simplex virus 1 (HSV-1) is transmitted how ?
Non-sexually
71
Herpes simplex virus 2 (HSV-2) is transmitted how ?
Sexually
72
The initial infection of HSV is characterized by what ?
- Multiple painful lesions
- Fever
- Chills
- Malaise
- severe dysuria
73
Primary genital herpes lesions progress from _________ to _________ to __________ to_________ and _____ that _______ and ______ ?
```
Macules -->
Papules -->
Vesicles-->
Pustules and Ulcers -->
that
Crust and Heal
```
74
True or False: The ulcers from HSV are...
- tender
- edematous
- itchy
- painful
True
75
True or False: With HSV, maternal infection can have adverse effects on both the mother and baby ?
True
76
True or False: With HSV, there are increased miscarriage rates in the first trimester ?
True
77
True or False: With HSV, an association with cervical cancer has been observed ?
True
| but primary way is HPV
78
True or False: Pt's who get HSV for the 2nd or 3rd time may feel tingling even in the perineal area ?
True
79
Can a pregnant women with HSV, deliver her baby vaginally ?
NO !!!!!
80
In pregnant women with HSV, why do they plan a C-section for the delivery method ?
Because you don't want the baby coming into contact with the lesions !
81
How do they screen/diagnose Herpes ?
Hx and physical exam
82
Is there a cure for Herpes ?
No
83
True or False: With Herpes, Antiviral meds are given to control symptoms ?
True
84
What are examples of Antiviral meds used to control the symptoms of Herpes ?
- Acyclovir
| - Valtrex
85
With Herpes, how many times a day should you clean the lesions ?
BID
86
In what non pharmacological ways can Herpes be managed ?
- Sitz baths
- Oatmeal soaks
- Tea bags
87
True or False: Oral analgesics can be used in the management of Herpes ?
True
88
True or False: The management of Herpes can be chronic or recurrent ?
True
89
What is the most threatening Hepatitis to the fetus and neonate ?
Hepatitis B
90
True or False: With Hepatitis B, disease of the liver is often a silent infection ?
True
91
How is Hepatitis B transmitted ?
- Parenterally
- Perinatally
- Orally (rarely)
- intimate contact
92
What populations are at risk for Hepatitis B ?
- Asians
- Pacific Island
- Alaskan descent
- Haitian
- Sub-sahara African
93
Other people at risk for Hepatitis B, include those with what medical ailments ?
- Liver disease
- Dialysis patients
- Women in mentally challenged instituations
- Multiple sex partners
- IV drug users
- Healthcare workers
94
When are babies vaccinated against Hepatitis B ?
Immediately in the Hospital ! with the follow up injections taking place in the Dr. office on future visits
95
Who is screened for Hepatitis B ?
- Regular screenings for high risk individuals
| - All pregnant women
96
What is the management for Hepatitis B ?
- Hep B vaccine
| - Counciling and education
97
True or False: their is no specific treatment for Hep B ?
True
98
With HIV, what is now considered the most common means of transmission in women ?
Heterosexual transmission
99
The transmission of HIV occurs primarily through ?
Exchange of Body Fluids
- semen
- blood
- vaginal secretions
100
Once HIV is in the bloodstream, Seroconversion occurs when ?
in 6 -12 weeks
101
At risk behaviors of HIV include ?
- Multiple partners
- IV drug use
- Hx of multiple STI's
102
What does the screening/diagnoses look like for HIV ?
- Antibody testing
| - CDC advocates for routine voluntary testing
103
True or False: HIV testing is offered early sin pregnancy ?
True
104
What is the preferred method for testing for HIV ?
Rapid testing
105
True or False: Perinatal transmission has decreased with HIV due to antiretroviral prophylaxis ?
True
106
With HIV antiretroviral prophylaxis is usually started when ? And continued through ?
- Usually started after the first trimester
| - Continued throughout pregnancy
107
What is a major side effect with HIV in pregnancy ? (antiretroviral prophylaxis ?)
Bone marrow suppression
108
In pregnant women with HIV, a cesarean birth should be scheduled for when ?
at 38 weeks
* Because its an environment where the amount of blood can be controlled. (I.e. utilizing suction)
109
Should pregnant women with HIV avoid breastfeeding ?
Yes !
110
______ ________ is a syndrome in which normal H2O2-producing lactobacilli are replaced with high concentrations of aerobic bacteria ?
Bacterial vaginosis (BV)
111
What vaginal infection is associated with preterm labor and birth ?
Bacterial vaginosis
112
With what type of Vaginal infection, do women complain of a "fish odor" ?
Bacterial vaginosis
113
What is the most common type of vaginitis ?
Bacterial vaginosis
114
What type of vaginal infection has discharge that is profuse whiter, grey, or milky ?
Bacterial vaginosis
115
How is bacterial vaginosis diagnosed ?
By clue cell findings in the vagina
116
What is the Tx for Bacterial vaginosis ?
Often Flagyl (metronidazole)
117
What is the common medication ending that is used for a lot of vaginal infections ?
"azole"
Ex: metronid"azole" (flatly)
118
What is the second most common type of vaginal infection ?
Vulvovaginal Candidiasis, or yeast infection
119
Vulvovaginal Candidiasis (VVC) can be what type of infection ?
Fungal or Yeast infection
120
When does Vulvovaginal Candidiasis occur ?
When new yeast is introduced or more yeast is present in the vagina
121
What type of vaginal infection has discharge that is Thick and white, and looks like cottage cheese ?
Vulvovaginal Candidiasis (VVC)
122
What are manifestations of Vulvovaginal Candidiasis (VVC) ?
- Severe itching
- Dysuria
- Dyspareunia
- Edema
123
How Is Vulvovaginal Candidiasis Diagnosed ?
- Exam
- Wet smear
(Will see bud like branches)
124
How is Vulvovaginal Candidiasis Treated ?
- Fluconazole (Diflucan)
| - Miconazole cream (Monistat)
125
With what type of type of vaginal infection should you think of "bud like branching" ?
Yeast
126
What are factors affecting predisposal to Candidiasis ?
- Antibiotic therapy
- Diabetes
- Pregnancy
- Obesity
- Diets high in refined sugars
- Use of corticosteroids
- Immunosuppressed states
** A common factor in all of these except the first one = Environments with high amounts of sugar **
127
___________ is a vaginal infection and STI and is a common cause of vaginal infections ?
Trichomoniasis
128
What are the manifestations of Trichomoniasis ?
- Inflammation of the vulva and vagina
- Puritis
- Copius frothy yellow-green discharge
129
What is the recommended test to diagnose Trichomoniasis ?
NAAT (is the most sensitive)
130
What other ways is Trichomoniasis screened ?
- Speculum examination
(very uncomfortable b/c of swelling, itching, etc.)
- Pap smear
131
How is Trichomoniasis Managed/Treated ?
Metronidazole (2g orally in a single dose)
132
True or False: The partners of someone with Trichomoniasis should also be treated ?
True
133
Why should the partner of someone diagnosed with Trichmoniasis be treated ?
B/c the Trichomoniasis infection can harbor in the urethra of males, so they have the potential to keep spreading it
134
______ ___ ___________ is considered normal flora in the non-pregnant women ?
Group B Streptococci
135
True or False: Group B Strepococci is a concern in pregnancy ?
True
136
Why is Group B Streptococci a concern in pregnancy ?
B/c there is an increased risk for preterm labor and transmission to the newborn
137
True or False: With Group B Streptococci, there is screening in pregnancy ?
True
138
When is Group B Streptococci treated in pregnancy ?
Treated in labor and delivery
* treated with IV penicillin before you deliver the baby*
( treating mom in L&D, but not the baby)
139
Is a pregnant women with Group B Streptococci, required to have a C-section ?
No !
140
With Group B Streptococci, There is a risk of _____ for the neonate ?
GBS
141
What are key STI-prevention strategies ?
Risk-reduction
142
Prevention of mother-to-newborn HIV transmission is most effective when ?
When the women receives antiretroviral drugs during pregnancy, labor and birth, and when the infant receives the drugs after birth.
143
_________ has reemerged as a common STI, affecting African American women more than any other racial or ethnic group ?
Syphilis
144
Effective screening by health care providers requires what ?
An open discussion about sexual orientation in an accepting manner
145
Women who have sex with women are at risk for what type of infections ?
Bacterial, viral, and protozoal infections
146
Person's in what community are at risk for STI'S ?
LGBT community
147
_________ is the most common STI in women in the United States and is the most common cause of PID ?
Chalmydia
148
Viral Hepatitis has several forms of transmission, but _____ infections carry the greatest risk ?
HBV
149
What type of individuals are at the greatest risk for STI's and HIV ?
Young, sexually active women who do not practice risk reducing sexual behaviors and who have multiple partners
150
______ are responsible for substantial mortality and morbidity, great personal suffering, and heavy economic burden in the Unites States ?
STI's
151
True or False: Both mother and baby should be considered when the pregnant women contract an infection ?
True
