Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall 2020 Sexual and Reproductive Health > STIs/Vaginitis > Flashcards

STIs/Vaginitis Flashcards

1
Q

Objectives

A
  • Review components of a sexual history
  • Identify behavioral risk factors and high risk groups acquiring STIs
  • Discuss screening recommendations for STIs and related key points
  • Identify elements of history, phyiscal, and lab testing for common vaginal infections/vaginitis (bacterial vaginosis, candidiasis/yeast, and trichomoniasis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Talk, Test, Treat

Help Interrupt the Steady Climb in STDs with these Three Steps

  1. Talk _____ about STDs with your p____ and healthcare _____
  2. Get ____, its the only way to know if you have an STD
  3. If you have an STD, work with your provider to get the right ______
A
  1. openly, partner and provider
  2. tested
  3. medicine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Taking a Sexual History: CDC 5 P’s

  • P______: __, g_____
  • P______: sexual (3)
  • P______ from STIs: ___ about protection? Use? How often?
  • P_____ ___ of STIs
  • P______/P______ Preferences: _____ Questions
A
  • Partners: #, gender
  • Practices: oral, P in V, P in anus
  • Protection: Talk about it, use, how often?
  • Past Hx
  • Parenting/Pregnancy: PATH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

STIs: Risk Factors for Screening

High Risk Behaviors

  1. ​(1) in past 60 days
  2. (1) or (1)
  3. Sex with sex partners recently were?
  4. No or inconsistent use of?
  5. Trade sex for?
  6. Sex with _______ partners
A
  1. New partner
  2. Multiple partners or Sex partner has multiple concurrent sex partners
  3. Treated for STI
  4. Condom outside a mutually monogamous sexual partnership
  5. Money or Drugs or Sexual contact with those who do
  6. Anonymous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

STI’s Risk Factors for Screening

High Risk Groups

  1. ______ age (Females age ___ years old)
  2. Men who?
  3. _____ of a prior STI
  4. ____ positive status
  5. _____ women
  6. Admission to (2)
  7. Illicit ____ use
A
  1. Young (F <25)
  2. Men who have sex with men (MSM)
  3. Hx of prior STI
  4. HIV
  5. Pregnant
  6. Correctional facility, Juvie
  7. drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gonorrhea (GC), Chlamydia (CT)

  1. Timing to Detection via Test?
  2. Routine Screening Recs
    • ​​Females =
    • Males =
  3. Key Points
    • ​​__ > __, __-__yo
    • Can be ______
    • Can cause?
    • How to test?
    • When to re-test?
A
  1. 2 wks post exposure
  2. Routine Screening
    • Annual, <25 (includes pregnant women)
    • MSM (rectal, pharyngeal, urethral)
  3. Key Points
    • F>M, 18-24
    • Asymptomatic
    • PID, infertility, adverse pregnancy outcomes
    • F: Vaginal swabs preferred (clinician or pt collected)/ (Urine, Swab)
    • 3 months retest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Trichomoniasis

  1. Timing to Detection via test?
  2. Routine Screening Recs?
  3. Key Points
    • Type of tests (2)
    • _____ of care tests available
    • When to retest?
A
  1. Few days to a month
  2. none
  3. Key Points
    • Vaginal swab, urine
    • Point
    • 3m
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pelvic Inflammatory Disease

  1. Timing to Detection Via Test?
  2. Routine Screening Recs?
  3. Key Points​​
    • Caused by _____ of untreated STI
    • Criteria for dx: _____ active, pelvic/abdml ____ and one of
      • ______ motion tenderness
      • _____ tenderness
      • ________ tenderness
    • How to test?
    • Treatment?
    • Treatment response expected within?
A
  1. Weeks to months
  2. None
  3. Key Points
    • ascent
    • sexually active, pelvic/abd pain +
      • Cervical
      • Uterine
      • Adnexal
    • _​_Pelvic Exam
    • 3 antibiotics
    • 72 hrs

Most STIs take some time to show up on screening tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Herpes Simplex Virus

  1. Timing to Detection via Test?
    • ​Vesicles (blisters) =
    • Antibodies =
  2. Routine Screening Recs?
  3. Key Points
    • ​​HSV Types __ and __ can infect genitals
    • Acute or Chronic? Can be ____ without symptoms
    • Treatment?
    • Rx of _____ reduce transmission by 50%
A
  1. Time to Detection
    • 2d - 2wks
    • up to 12 wks post exposure
  2. If ptnr +
  3. Key Points
    • 1 and 2
    • Chronic, shed w/o sx
    • Antivirals (regimens differ for initial episode, recurrent/episodic, suppressive (daily, rec 1st year)
    • condoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Human Papilloma Virus

  1. Timing to Detection Via Test
  2. How to Test?
  3. Routine Screening Recs
  4. Key Points
    • ​​____ risk HPV types only
    • Majority of infections _____ within 2yrs
    • ______ available: ages __-__ (rec __-__)
    • Tx (3)
A
  1. 2wks - 8 months
  2. Visual exam, biopsy
  3. None
    1. Low risk HPV types only
    2. clear
    3. Vaccine, 9-45 (11-12)
    4. Cryotherapy, chemical acids, immunomodulators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Syphilis

  1. Time to Detection via Test?
  2. How to test?
  3. Routine Screening Recs?
  4. Key Points
    1. Occurs in _____ (3)
    2. ____ tests required to confirm is active; one _____ (reactive/non-reactive), one _____ (titer); either a nontreponemal or treponemal tet
    3. Tx (1)
A
  1. 2-12 wks post exposure
  2. Serum
  3. MSM, all pregnant women
  4. Key Points
    1. Phases: primary (chancre), secondary, latent, late/tertiary
    2. Two tests, qualitative, quantitative
    3. Benzathine Penicillin G
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differential Dx of Genital Lesions: Visual Exam

  1. Condyloma Acuminata Genital Warts =
  2. Herpes =
  3. Syphilis =
A
  1. “Cauliflower-like” lesions, Pruritic
  2. Small clustered blisters, then ulcerations, painful
  3. Larger, single, painless ulceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

HIV

  1. Timing to Detection Via Test?
  2. How to Test?
  3. Routine Screening Recs (4)
  4. Key Points: ___ tests required, what is it? ​
A
  1. 10-33d post exposure
  2. serum-blood draw or rapid POC fingerstick
  3. Universal, age 13-64 at least once, all pregnant women, MSM
  4. 2 tests** - antigen/antibody combination HIV 1/2 + confirmatory HIV1/2 antibody differentiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hep B Virus

  1. Timing to Detection of Test?
  2. How to test?
  3. Routine Screening Tests (2)
  4. Key Points
    1. Test for HBV _____ antigen and HBV _____ antibody
A
  1. 1-10 wks post exposure
  2. Serum
  3. All pregnant women, MSM one time screen for immunity
  4. Key Points
    1. surface antigen (HBsAg) + core antibody (HBcAb)

one time screen for MSM bc most of us are vaccinated as babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hepatitis C Virus

  1. Time to Detection via Test?
  2. How to test?
  3. Routine Screening Recs (3)
  4. Key Points
    1. Test for HCV _____: standard, rapid and FDA approved at _____ test available
A
  1. 8-11 wks
  2. Serum
  3. Univeral, Age 18-79 at least once, IV drug use
  4. Key Points
    1. antibody, at home test available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

STI’s Transmitted through Sexual Fluids

(3)

A

characterized by: urethritis/cervictitis, discharge

Gonorrhea, Chlamydia

Trichomoniasis

Pelvic Inflammatory Disease

17
Q

STI’s Transmitted through Skin to Skin contact

(3)

A

Ulcerations or Lesions

HSV

HPV

Syphilis

18
Q

STI’s Transmitted through Blood, Sexual Fluids, Pregnancy

(3)

A

Viral transmission

HIV

Hep B

Hep C

19
Q

TEST: Gonorrhea and Chlamydia (GC/CT)

Test (1)

  • Clinician-collected endo____, v____, or male _____ _____
  • Patient-collected _____ swab specimens
  • Male and female _____ specimens
  • F/U testing ___ mos post tx
  • Non genital sites (3)
A

NAATS (Nucleic acid amplification tests) for GC/CT

  • endocervical, vaginal, urethral swabs
  • pt collected vaginal swab
  • urine
  • 3 mo
  • oral, rectal, esophageal
20
Q

Common Outpatient Treatments for Gonorrhea and Chlamydia

Chlamydia

Gonorrhea

A

Azithromycin 1g PO once OR Doxycycline 100mg PO BID x 7 days

Ceftriaxone 250mg IM PLUS Azithromycin 1 g PO once

21
Q

Expedited Partner Therapy (EPT)

For which STI only?

A

Chlamydia Only

You can provide extra prescription for the partner

22
Q

Requests for STI Testing: Standard Panel

  • ______ (at genital, and if exposed, rectal and pharygneal sites)
  • ______ (at genital and, if exposed, rectal and pharyngeal sites)
  • ______
  • ______
  • ___
  • ___ (serology)
A
  • Gonorrhea
  • Chlamydia
  • Trichomonas
  • Syphilis
  • HIV
  • HSV-2
23
Q

Management of Positive Test

  • T______
  • Notify ____ _____ (chlamydia, gonorrhea, acute HBV, acute HCV, HIV, syphilis)
  • Notfiy and Treat ______
  • Re-testing when post tx for (3)?
A
  • Treatment
  • Health Dept
  • Partner
  • 3 mos for GC, CT, Trich (bc extremely high rates of reinfection-we want to check again)
24
Q

How to Put On and Off a Male Condom

  • _____ open and remove condom from wrapper
  • Place condom on the head of the erect, hard penis. If uncircumcised pull back the _____ first
  • Pinch ___ out of the tip of the condom
  • Unroll all the way down penis
  • After sex but before pulling out, hold condom at the ____ then pull out, while holding condom in place
  • Carefully remove and throw in the _____
A
  • Carefully
  • foreskin
  • air
  • base
  • trash
25
Q

Vaginal Microbiome

  • Lactobacillus produce ____ ____: pH ___-___
    • ​“anything new or different in or near the vainga” can change __
  • Secretions: cervical mucosa and glands
    • ​L______
    • Respond to _____ mileu
    • Normal: cl___ or cl____
      • ​Midcycle: st____, non_____, mild ____, wh___-y____
    • Leukorrhea =
    • Vaginosis =
  • Different Diagnosis of Abnormal Vaginal Discharge (3) vs. other STIs
A
  • Lactic Acid: pH 3.5-4.5
    • ​pH
  • Secretions
    • ​Lubrication
    • hormonal
    • clear or cloudy
      • sticky, nonirritating, mild odor, white-yellow
    • increased WBCs
    • Microorganisms or proliferation of normal vaginal pathogens
  • Bacterial Vaginosis vs. Candidiasis vs. Trichomoniasis - 3 most common causes of abnormal vaginal discharge
26
Q

Wet Prep: Normal Discharge

Under microscope

A
27
Q

Vaginitis

History

  • Characteristics of vaginal ______
  • S_____ history
  • Vaginal ______ practices (e.g douching)
  • Prior history of vaginal in_____ and S__
  • ______ or other products to treat current symptoms and outcome
  • M_____ history
  • M_____ and all_____
A
  • discharge
  • Sexual
  • hygiene
  • infections, STIs
  • Medications
  • Menstrual
  • Meds and Allergies
28
Q

Bacterial Vaginosis

  • Clinical Symptoms: _____ discharge, th__, white “____” odor increases postcoital or near menses, “_____”, new partner, female partner w sx, prior BV, _____menstrual bleeding/spotting
  • Exam: ____, ____/grey discharge
  • pH =
  • Microscopy =
  • Point of care test =
  • Whiff Test =
A
  • increased, thin, “fishy”, “burning”, intermenstrual
  • thing, white
  • >4.5
  • Clue cells and/or mobiluncus, decreased lactobacilli
  • +sialidase
  • Positive - mix vaginal discharge with KOH -> wil get amine odor (fishy)

More burning than itchy

29
Q

Bacterial Vaginosis Treatment

(2)

  • Recurrence rates are?
  • Persistent > 4 infx in 1 yr requires what?
  • Co-Rx ______ 150mg po x 1 dose (take last day of tx)
A

**Metronidazole, 500mg po twice/day x 7 days**

**Metrogel, 1 applicator per vagina at night for 5 nights**

  • High
  • alternative tx
  • Fluconazole (often prescribed as well for candidiasis bc if we’re giving metronidazole can cause candidiasis)
30
Q

Candidiasis

Telltale Sign =

  • pH =
  • Microscopy =
  • Whiff test =
A

ITCHY, WHITE COTTAGE CHEESE DISCHARGE

  • <4.5
  • Branching Hyphae, round buds/spores, few WBCs
  • Negative (helps diff from BV)
31
Q

Candidiasis Treatment

(1) or (1)

  • Severe VVC (extensive vulvar erythema, edema, excoriation, and fissure formation)
    • ​7-14 days of topical _____ or
    • 150 mg of ______ in ___ sequential oral doses (second dose __ hrs after initial dose)
  • Recurrent/persistent: _____ regimen, ____ regimen, ____ duration therapy: test for or optimize mngmt for ____ mellitus and ____ infection
A

Fluconazole po x 1 OR Terazol 3 or 7d vaginal cream/ovules

  • Severe
    • topical azole
    • fluconazole 2 doses (72 hrs after)
  • Recurrent: repeat, change, longer, diabetes, HIV
32
Q

Trichomoniasis

  • Presentation/Clinical Symptoms =
  • pH =
  • Microscopy =
  • Whiff Test =
  • Point oc care tests have ____ sensitivity and specificity
A
  • Copious yellow-green, Frothy, bubbly discharge, Strawberry Cervix, post coital spotting*
  • >4.5
  • Single cell protozoan w motile flagellae, WBCs, decreased lactobacilli
  • Pos or neg
  • higher
33
Q

Trichomoniasis Treatment/Follow Up

(1) or (1)

  • Tx failure: either Rx 2g po qd x __ wk
  • _____ Tx*
  • Increased risk for other STIs so what do you do?
  • Re-test when?
A

Metronidazole 2g po x1 OR Tinidazole 2g po x1

SINGLE DOSE vs. multiple doses in BV

  • 1 wk
  • Partner
  • test for all
  • 3 mos (not test for cure, test for rpt infection)
34
Q

Vaginitis Patient Education

  • No sex until how long after tx?
  • Creams and suppositories are oil based, can _____ condoms
  • Complete tx, no _____ with metronidazole
  • Use creams/supps at ____
  • ____ use
  • No D______
  • _-F transmission (yeast, BV, trich)
  • _-F transmission (trich, yeast/BV possible)
A
  • 1 wk afer tx
  • weaken
  • alcohol x metronidazole
  • night
  • condom
  • douching
  • F–F
  • M-F
35
Q

Prevention: General Care of Vulva and Vagina

  • Hygiene: wipe ___ to ____, with ____ water
  • Anything used in vagina: cl____ and do not ____
  • Avoid ALL _____: unscented everything
  • Avoid tr____
  • Clothing =
  • Consider not sh____, w____, using depilatories
  • No ______
  • C_____
A
  • front to back, plain water
  • cleaned, NOT shared
  • irritants
  • trauma
  • loose, breathable
  • shaving, waxing
  • douching
  • Condoms

Fall 2020 Sexual and Reproductive Health (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions