[GYNE] LE 4 STI/ INFERTILITY/VIOLENCE Flashcards

Question

Q: After determining the approximate ovulation day, what is the best timing advice for intercourse? A. On ovulation day only B. Starting the day before ovulation C. Three days before ovulation D. Day after menstruation ends

Answer 1

Starting the day before ovulation Rationale: Fertility is highest during the 1–2 days before ovulation, so timed intercourse should begin the day before ovulation.

Answer 2

TRUE Rationale: Female fertility declines with age, especially after age 35, due to decreased oocyte quality and quantity.

Answer 3

TRUE Rationale: Spermatogenesis takes around 74 days, and changes in sperm quality may reflect 3 months or more of production history.

Answer 4

FALSE Rationale: Endometrial biopsy is not routinely recommended in infertility workups unless there is a specific indication like suspected endometrial pathology.

Answer 5

FALSE Rationale: In up to 15–30% of cases, infertility remains unexplained, even after thorough evaluation of both partners.

Answer 6

Spirochete Rationale: Syphilis is caused by Treponema pallidum, a spirochete bacterium transmitted through sexual contact.

Answer 7

Syphilis Rationale: Primary syphilis presents with a painless chancre and regional lymphadenopathy, commonly on the vulva or labia.

Answer 8

Chlamydia trachomatis Rationale: This describes lymphogranuloma venereum (LGV), caused by Chlamydia trachomatis, presenting with painless vulvar lesions and suppurative lymph nodes.

Answer 9

Condyloma latum Rationale: Condyloma latum are broad-based, moist, painless, gray-white plaques, commonly seen in secondary syphilis.

Answer 10

Nucleic acid amplification test (NAAT) Rationale: NAAT is the most sensitive and specific test for detecting Chlamydia trachomatis, the causative agent of LGV.

Answer 11

Gardnerella vaginalis Rationale: Clue cells (squamous cells with adherent bacteria) are pathognomonic for bacterial vaginosis, most commonly caused by Gardnerella vaginalis.

Answer 12

Genital herpes Rationale: Herpes simplex virus (HSV) causes painful grouped vesicles that can ulcerate, often with flu-like symptoms during primary outbreaks.

Answer 13

Genital herpes Rationale: Dysuria along with vesicles and crusting strongly suggests HSV infection, especially during the primary episode.

Answer 14

Condyloma acuminata Rationale: Condyloma acuminata are cauliflower-like, flesh-colored warts caused by HPV, commonly seen on mucosal and cutaneous genital surfaces.

Answer 15

HIV Rationale: Human Immunodeficiency Virus (HIV) targets CD4+ T cells, leading to progressive immunodeficiency and ultimately AIDS.

Answer 16

Granuloma Inguinale Rationale: Klebsiella granulomatis is the causative agent of Granuloma Inguinale (Donovanosis), a chronic ulcerative STD.

Answer 17

Lymphogranuloma venereum Rationale: LGV, caused by Chlamydia trachomatis L1–L3, is characterized by painless genital ulcers followed by painful inguinal lymphadenopathy (buboes).

Answer 18

Syphilis Rationale: Secondary syphilis may present with generalized rashes, including on the palms and soles, along with constitutional symptoms.

Answer 19

Genital herpes Rationale: Genital herpes (caused by HSV) typically presents with painful grouped vesicles, systemic symptoms, and tender lymph nodes.

Answer 20

HPV Rationale: High-risk types of human papillomavirus (HPV), especially types 16 and 18, are strongly associated with cervical cancer.

Answer 21

Chancroid Rationale: Haemophilus ducreyi causes chancroid, characterized by a soft, painful ulcer and tender lymphadenopathy (bubo formation).

Answer 22

Lymphogranuloma venereum Rationale: LGV begins with a painless ulcer followed by painful inguinal adenopathy, common in high-risk sexual activity.

Answer 23

CD4+ T cells Rationale: HIV targets CD4+ T lymphocytes, weakening the immune response and progressing to AIDS as the CD4 count drops.

Answer 24

Gonorrhea Rationale: Caused by Neisseria gonorrhoeae, gonorrhea presents with purulent discharge, abdominal pain, and systemic symptoms, especially around menses.

Answer 25

ELISA and Western blot Rationale: ELISA is the screening test for HIV; a positive result is confirmed by Western blot, making this the standard protocol for AIDS diagnosis.

Answer 26

FTA-ABS Rationale: Fluorescent treponemal antibody absorption (FTA-ABS) test is a confirmatory test for syphilis that detects antibodies against Treponema pallidum.

Answer 27

Endocervix Rationale: The primary site of gonorrheal infection in women is the endocervix, although other sites like the Bartholin glands may also be affected.

Answer 28

Vulva Rationale: LGV commonly affects the vulva, presenting initially with a painless ulcer followed by inguinal adenopathy.

Answer 29

Sexual transmission Rationale: Sexual transmission is the most common route of HIV spread worldwide, through unprotected sex.

Answer 30

Donovanosis Rationale: Donovanosis (Granuloma Inguinale) presents with beefy red, painless ulcers and is caused by Klebsiella granulomatis.

Answer 31

Condyloma acuminata Rationale: Condyloma acuminata (genital warts) are HPV-related growths that turn white with acetic acid during colposcopic exam.

Answer 32

ELISA Rationale: ELISA is the standard screening test for detecting HIV antibodies, especially in symptomatic individuals.

Answer 33

6–12 weeks Rationale: HIV antibodies can typically be detected in 6–12 weeks post-exposure; this period is referred to as the window period.

Answer 34

Chancroid Rationale: Chancroid is caused by Haemophilus ducreyi, characterized by painful ulcers and inguinal lymphadenopathy (buboes).

Answer 35

Remove the IUD Rationale: Presence of an IUD with signs of infection (purulent discharge, tenderness) requires immediate removal.

Answer 36

Ectopic pregnancy Rationale: Scarring of the fallopian tubes post-PID increases the risk of ectopic pregnancy significantly.

Answer 37

Tubo-ovarian abscess Rationale: Tubo-ovarian abscess is a severe complication of PID, typically caused by gonorrhea or mixed anaerobes, and requires hospitalization.

Answer 38

AFB culture Rationale: AFB culture from biopsy remains the gold standard for diagnosing abdominal or genital TB.

Answer 39

Cervical cancer Rationale: In cases of cervical TB, cancer should always be the top differential diagnosis due to overlapping presentations.

Answer 40

Salpingitis Rationale: The “tobacco pouch” appearance is a classic sign of tubal pathology such as salpingitis, commonly seen in genital TB.

Answer 41

Power and control Rationale: The Power and Control Wheel explains how abusers maintain dominance in abusive relationships, using physical, emotional, and psychological tactics.

Answer 42

Cycle of violence Rationale: The Cycle of Violence consists of three phases: tension-building, acute battering, and honeymoon phase, and often repeats in abusive relationships.

Answer 43

Incest Rationale: Incest is sexual intimacy between close blood relatives and is a criminal form of abuse, regardless of consent or penetration.

Answer 44

False Rationale: There is no excuse for domestic violence. Blaming the victim is a manipulation tactic to justify abuse and shift responsibility.

Answer 45

Sexual abuse Rationale: Sexual abuse refers to any sexual act without consent, including unwanted touching, assault, or forced intercourse.

Answer 46

Physical violence Rationale: The tire of the Power and Control Wheel represents physical and sexual violence, which enforces the tactics used inside the wheel.

Answer 47

Often wears dark glasses, long sleeves, and slacks Rationale: Victims often conceal physical signs of abuse with clothing and makeup due to shame, fear, or coercion by their abuser.

Answer 48

Has your partner ever hit or physically hurt you? Rationale: Direct screening involves asking explicit questions about violence or injury, which helps identify abuse more effectively.

Answer 49

Every couple fights; what are fights like in your house? Rationale: Indirect screening uses general or normalized statements to create a safe space for victims to disclose abuse without feeling targeted.

Answer 50

Failure to ask the right questions Rationale: Many healthcare providers miss the diagnosis of abuse because they don’t screen or ask questions proactively and consistently.

Answer 51

4 years Rationale: On average, it takes a battered woman 4 years before seeking help due to fear, financial dependency, or psychological manipulation.

Answer 52

Emotional control to total loss of control Rationale: Victims in the acute phase of rape trauma may show a range of emotions, from well-controlled behavior to emotional breakdown.

Answer 53

Flashbacks and nightmares Rationale: The reorganization phase involves nightmares, flashbacks, and lifestyle adjustments as the victim processes trauma.

Answer 54

Prevention of pregnancy Rationale: Physicians should offer emergency contraception after ruling out pregnancy when managing sexual assault survivors.

Answer 55

Pregnancy test Rationale: In sexual assault victims, pregnancy must be ruled out first, especially when uterine enlargement is present.

Answer 56

Proper collection of forensic specimens Rationale: Proper forensic evidence collection ensures validity in legal proceedings and supports justice for the victim.

Answer 57

Chain of evidence Rationale: The chain of evidence ensures that forensic specimens remain untainted and admissible in court.

Answer 58

Provide a safe, non-threatening environment Rationale: First and foremost, create a secure space for the victim to disclose abuse and receive care.

Answer 59

Physical abuse Rationale: Wearing clothes to cover injuries indicates physical violence, which is the most visible form of abuse in the wheel.

Answer 60

Using male privilege Rationale: Male privilege as a tactic includes acting as the "master of the castle" and making unilateral decisions.

Answer 61

Emotional abuse Rationale: Emotional abuse includes verbal humiliation, insults, or put-downs meant to control, manipulate, or belittle the victim.

Answer 62

Intimidation Rationale: Intimidation includes non-verbal behaviors used to instill fear in the victim, such as aggressive gestures or destruction of property.

Answer 63

Physical abuse Rationale: Physical abuse involves the use of physical force that causes harm or injury to the victim.

Answer 64

Stand-over Phase Rationale: The stand-over phase is marked by emotional abuse and control, where tension escalates before the actual violence.

Answer 65

Honeymoon Phase Rationale: The honeymoon phase follows abuse and is characterized by remorse, affection, and gifts, reinforcing the cycle.

Answer 66

Violent Outburst Rationale: The violent outburst phase is where physical violence occurs, releasing the tension built up in earlier phases.

Answer 67

Shared responsibility Rationale: Shared responsibility emphasizes fairness in duties and decisions, promoting equality in the relationship.

Answer 68

Trust and support Rationale: Trust and support includes helping each partner achieve their goals and honoring their emotions and autonomy.

Answer 69

Economic partnership Rationale: Economic partnership means both parties share control over finances, promoting transparency and balance.

Answer 70

Respect Rationale: Respect means acknowledging the other’s voice, feelings, and individuality in a non-judgmental and affirming way.

Answer 71

True Rationale: Victims often report chronic physical complaints like headaches, fatigue, and pelvic pain, linked to emotional trauma.

Answer 72

True Rationale: Abusers may demonstrate aggression toward others, though intimate partners often bear the brunt due to proximity and control dynamics.

Answer 73

True Rationale: Abuse is often associated with physical manifestations of stress, including headaches, GI disturbances, and fatigue.

Answer 74

True Rationale: Many women stay due to misplaced hope or belief that staying helps preserve the family, often due to cultural or societal pressure.

Answer 75

True Rationale: Domestic violence is a crime with legal consequences under national and international laws protecting victims.

[GYNE] LE 4 STI/ INFERTILITY/VIOLENCE Flashcards

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