Women's Health- STI's

Question 1

Estradiol

• Estrone
• Estriol

Answer 1

Estradiol Predominent estrogen during reproductive years – Most potent 80x that of estriol
• Estrone Predominant during menopause
• Estriol Predominant during pregnancy

Question 2

• Hypoactive sexual desire disorder

Answer 2

Deficient (or absent) sexual fantasies and desire for sexual activity

Question 3

• Female sexual arousal disorder

Answer 3

Inability to attain or maintain until completion adequate lubrication-swelling response of sexual excitment

Question 4

Female organismic disorder

Answer 4

Delay in or absence of orgasm following a normal sexual excitment

Question 5

Vaginismus:

Answer 5

involuntary contraction of the penile muscle due to something going in

Question 6

Untreated G and C lead to

Answer 6

Infertility.

Question 7

Untreated Syphilis leads to

what if + during preg?

Answer 7

brain CV and organ damage

if + during perg baby will be + too

Question 8

what are the 5 Ps of protection

Answer 8

Partmeners, Prevention of pregnancy, protection from STDs, Practices, Past hx of STDs

Question 9

what STIs are infected from the urethra or vaginal sections

Answer 9

G, C, trich

Question 10

what STIs are infected from the surface/ skin?

Answer 10

Herpes, Syphilis, chancroid, HPV

Question 11

what is one of the most affective methods for preventing the transmission of STDs

Answer 11

pre exposure vaccinations.
HPV
HEP B- everyone
Hep A and B ( recommended for MSM and Injecion drug users)

Question 12

There are 2 HPV vaccinations what are they and who are they recommended for?

Answer 12

Gardasil and cerviarix
Girls 13-26
Boys: 13-21

Question 13

Male Condoms
Helpful in the privation of:
-
May be helpful in the prevention of:

Heterosexual

Answer 13

• Helpful in prevention
– Pregnancy, GC, HIV, hepatits, chlamydia and
trichomonas
• May be helpful in prevention of (data is limited)
– HSV, HPV and syphilis
• Heterosexual relationships
– HIV negative partners likely to become HIV infected compared to similar rela+onships without condom use

Question 14

what type of lubricant can you use with condoms?>

Answer 14

only water based, not oil based.

Question 15

Female Condoms

Answer 15

Effective : Viruses, HIV, Semen

may be better at preventing HPV skin transmission

Question 16

Male circumcision reduces the risk of what?

Answer 16

HIV and STDs in heterosexulal men

Question 17

is there a post exposure prophylaxis for HIV and STD?

Answer 17

Antivital therapy (ART)

Question 18

what STIs are reportable to the state?

Answer 18

C&G, Syphilis, chancroid, HIV and AIDs

Question 19

rates of what STDs are highest in adolescents?

Answer 19

Chlamydia, HPV and hERPES

Question 20

What STI is common in WSW?

Answer 20

BV

Question 21

what is pelvic inflammatory disease?

Answer 21

Ascending genital infection of the fallopian tubes.

C&C aerobic and anaerobic

Question 22

what are some PE findings for PID?

Answer 22

Cervical Motion Tenderness (Chandelier sign)
Mucopurulent cercitis
Adenexal tenderness

Question 23

what is the treatment for PID?

Answer 23

Out pt: Rocephin Ceftriazone and Doxycycline

In:
Clindamycin and gentamicin IV

CAUSES INFERTILITY!

Question 24

All patients who have genital, anal or perianal ulcers should be evaluated with a serologic test for:

in the US what are the most common causes for genital ulcers?

Answer 24

Syphilis and Genital Herpes

Chancroid, herpes and syphilis

Question 25

in the setting where chancroid is + a test for _________ should also be performed

Answer 25

Haemophilius ducreyi

Question 26

For genital, anal and perianal warts when do you start treatment?

Answer 26

RIGHT away!

Question 27

Chancroid what does it look like?

Answer 27

Painful genital ulcer and tender suppurative ingulinal adenopathy Vesiculo pustule that breaks down to form a painful, soft ulcer with necrotic base

Question 28

how do you dx charncroid? Tx:

Answer 28

Identification of H. Ducreyi Azithromycin, F/U in 3-7d should see improvement in 3 days

Question 29

Herpes Simplex II ( Genital herps) cause: presentation transmission dx: Tx:

Answer 29

Herpes simplex virus Multiple vesicular lesions in anogenital region, wil assoicated puritis, dysuria, vulvitis sexual contact clinical findings, confirm via viral culture of unroofed vesicle, tzank smear Blood: HSV II antibody Tx: Acyclovir

Question 30

HSV-II highest rates in: More common among:

Answer 30

Young white teenager females than males

Question 31

Syphilis Causative agent Presentation Primary Secondary Tertiary dx

Answer 31

- Treonema pallidum - Papular lessons that ulcerate to painless genital oral or anal lesions. Primary: Chancre (PAINLESS) Secondary: Rash (Copper Pennies) malase, mucocutaneous lessions and lympadenopathy tertiary: Neurologic, cardiac, opthalmic and auditory Neurosyphilis Dx: VDRL, if + then confirm with FTA-ABS of lesion

Question 32

If you suspect neurosyphilis you must perform what?

Answer 32

a LP with VDRL

Question 33

Gonorrhea: Highest among who causative agent: presentaion: F: M Dx tX: Complications M F

Answer 33

MSM Neisseria gonorrhoeae F: Vaginal D/c lower ab pain, cervical motion tenderness and fever Males: Experience dysuria and yellowish white penile D/C DX: swab Tx: Rocephin PID Epidiymitis

Question 34

Chlamydia: Most common dx tx - -Preg:

Answer 34

Reported Infectious disaese in the US ( 9th -12 th grade most common) NAAT Tx: Azithtomycin Preg: Amox or azithro

Question 35

Asherman syndrom: define: symptoms: Tx:

Answer 35

Scaring of the uterus, most after D &C Symptoms: Amenorhhea, repeated miscarriage Tx: Sxr

Question 36

HPV | most of the time

Answer 36

The system fights off HVP within 2 years- if not treated causes most cancers of the anus vagina and penis and about 1/3 of ca in the oral pharynx

Question 37

Genital warts Causative agent: Clinical presentation Visible: Strong link to cervical ca: 1

Answer 37

HPV Soft fleshy growths on genital area Visible: types 6 and 11 Strong link to cervical ca: 16, 18, 31, 33, 35

Question 38

Genital warts Dx: Tx Provider applied: Patient applied:

Answer 38

Stain with Acetic acid and PAP smear Provider applies: Trichloroacetic acid or Podophylline resin or Cryo Patient applied: Condylox or aldara

Question 39

what is Sub clinical gentital HPV without exophytic warts?

Answer 39

+ for HPV with no warts

Question 40

``` Trichamonas: causative agent: Presentation Dx T ```

Answer 40

Tichomonas Vagnialis Frothy yellow/ green malodorous discharge with strawberry cervix Microscopic exam and wet mount Metronidalzole

Question 41

``` BV Causative agent: presentation dx Tx ```

Answer 41

Gardnerella vainalis Fishy odor grey dc DX: Clue cells and wiff test tx: Metronidazole

Question 42

Molluscum Contagiosum

Answer 42

Cantharidlin solution .