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Mom and baby Exam 1 > Chapter 7: STI Infections > Flashcards

Chapter 7: STI Infections Flashcards

1
Q

Primary prevention of STI’s = ?

A

Preventing any infection! EDUCATION

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2
Q

Secondary prevention of STI’s = ?

A

Prompt Tx of the STI

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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)
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4
Q

Research now shows that N-9 lubricated condoms and spermicides are NOT recommended for what ?

A

The prevention of HIV & STI’s

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5
Q

What is the most common bacterial infection ?

A

Chlymidia

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6
Q

What is the oldest bacterial communicable disease in the US ?

A

Gonorrhea

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7
Q

What are Bacterial STI’s ?

A
  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Pelvic Inflammatory Disease
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8
Q

_______ (Bacterial STI), is transmitted by entry into subcutaneous tissue through microscopic abrasions that can occur during sexual intercourse ?

A

Syphilis

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9
Q

Syphilis can also be transmitted through what ?

A
  • Kissing
  • Biting
  • Oral - genital sex
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10
Q

True or False: With Syphilis, transplacental transmission may occur at any time during pregnancy ?

A

True

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11
Q

________ (Bacterial STI) can lead to serious systemic disease and even death ?

A

Syphilis

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12
Q

In terms of pregnancy, Syphilis can cause things such as ?

A
  • PTL (Pre-term Labor)
  • PTB (Pre-term Birth)
  • etc,.
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13
Q

Primary Syphilis (1 sore) typically starts to appear when ?

A

5 - 90 days

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14
Q

Secondary Syphilis (multiple sores) starts to appear when ?

A

6 weeks to 6 months

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15
Q

True or False: Pregnant women are screened for Syphilis ?

A

True

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16
Q

Serologic tests (can be false positives) & Microscopic exam of the lesions are screenings utilized for what Bacterial STI ?

A

Syphilis

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17
Q

What is the Drug of choice for the management of Syphilis ?

A

Penicillin

other drugs available, if allergic

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18
Q

True or False: When treating someone for Syphilis, their partners should also be treated ?

A

True

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19
Q

True or False: You should remain sexually abstinent during the treatment of Syphilis ?

A

True

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20
Q

What is the most common and fastest spreading STI ?

A

Chlamydia

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21
Q

_________ (Bacterial STI) infections are often silent and highly destructive ?

A

Chlamydia

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22
Q

What Bacterial STI is difficult to diagnose ?

A

Chlamydia

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23
Q

With Chlamydia, what type of people do we screen ?

A

Symptomatic & pregnant women

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24
Q

Why do we screen pregnant women for Chlamydia ?

A

Because we don’t want babies to get it

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25
Q

What WAS the Gold standard for diagnosing Chlamydia ?

A

Cultures

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26
Q

Now, what is the preferred method for the screening/diagnosis of Chlamydia ?

A

Nucleic acid test-urine and blood testing (NAAT)

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27
Q

What is the Management of Chlamydia focused on ?

A

Treatment & Rest

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28
Q

What drug is used to treat Chlamydia (if not pregnant) ?

A

Doxycycline

  • Azithromycin –> if pregnant
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29
Q

True or False: With Chlamydia, your partner should be treated ?

A

True

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30
Q

How is Gonorrhea transmitted ?

A
  • genital to genital
  • Oral to genital
  • Anal to genital
  • Mother to newborn
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31
Q

True or False: Men may have more symptoms than women ?

A

True

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32
Q

With gonorrhea, 80% of women are what ?

A

asymptomatic

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33
Q

Risk factors for Gonorrhea ?

A
  • Age
  • African American (most cases reported)
  • Early onset of sexual activity
  • Multiple partners
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34
Q

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
A

Gonorrhea

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35
Q

True or False: In pregnancy, Gonorrhea can affect the mother and fetus ?

A

True

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36
Q

Gonorrhea in pregnancy can cause things like what ?

A
  • PROM (premature rupture of membranes)
  • PTL (pre-term labor)
  • PTB (pre-term birth)
  • Uterine infection
  • IUGR (Intrauterine growth retardation)
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37
Q

Newborns, who’s mothers have Gonorrhea during pregnancy have the potential to develop what ?

A

Ophthalmic Neonatorum (eye infection)

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38
Q

What is Ophthalmic Neonatorum ?

And what can it lead to. ?

A

Eye infection

Can lead to blindness

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39
Q

What does the CDC recommend for screening for Gonorrhea ?

A
  • Screen all at risk women

- Screen All pregnant women

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40
Q

What is the Gold Standard for screening for Gonorrhea ?

A

Cultures

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41
Q

True or False: The management for Gonorrhea is straightforward and has a rapid cure ?

A

True

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42
Q

What is the Treatment for Gonorrhea ?

A

Ceftriaxone and Azithromycin

can get 1 Treatment or weekly

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43
Q

True or False: In people with Gonorrhea, their partners should also be cultured and treated ?

A

True

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44
Q

What type of bacterial STI, is an infectious process that involves the uterus, Fallopian tubes, possibly ovaries, and peritoneal surfaces ?

A

Pelvic Inflammatory Disease

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45
Q

_________________________ (Bacterial STI) results from ascending spread of microorganisms from the vagina and endocervix to the upper genital tract ?

A

Pelvic Inflammatory Disease

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46
Q

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)
A

Pelvic Inflammatory Disease

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47
Q

What Bacterial STI put’s you at increased for…

  • Ectopic pregnancy
  • Infertility
  • Chronic pelvic pain
  • Dysparunia, pelvic adhesions, pus in uterus (pyosalpinx)
A

Pelvic Inflammatory Disease (PID)

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48
Q

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
A

Pelvic Inflammatory Disease (PID)

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49
Q

True or False: PID is hard to treat ?

A

True

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50
Q

Why is PID hard to treat ?

A

Because there is no one test! Because it is a combination of diseases/infections

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51
Q

What is the management for PID ?

A
  • Prevention
  • Medication
  • Hospitalization
  • Education
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52
Q

HPV is what type of STI’s ?

A

Viral

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53
Q

What is the most prevalent viral STI seen in ambulatory health care settings (urgent cares) ?

A

HPV

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54
Q

True or False: HPV is a highly contagious viral STI ?

A

True

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55
Q

HPV is more frequent in who ?

A

pregnant women

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56
Q

True or False: HPV lesions enlarge during pregnancy ?

A

Ture

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57
Q

What is the primary cause of cervical cancer ?

A

HPV

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58
Q

What is the C/O of HPV ?

A

Profuse irritating vaginal discharge

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59
Q

What are others signs/symptoms of HPV ?

A
  • Itching
  • “bumps” on labia
  • Dysparunia (painful intercourse)
  • Vaginal bleeding
  • Lesions
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60
Q

True or False: Some Pap smears can detect BOTH abnormal cells AND HPV ?

A

True

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61
Q

How is screening done for HPV ?

A
  • Hx of known exposure
  • Physical inspection*** (looking for warts)
  • Pap smear (generally show abnormal cells)
62
Q

True or False: No cure has been shown to eradicate HPV ?

A

True

63
Q

What is the medication for HPV used for ?

A

For Discomfort

64
Q

True or False: If you have HPV, your partner should also be examined ?

A

True

65
Q

True or False: Sometimes HPV resolves on its own in young women ?

A

True

66
Q

True or False: There are vaccines for the management of HPV ?

A

True

67
Q

What is a medication that may be used in the management of HPV ?

A

Guardacil 9

68
Q

Genital herpes is what type of STI ?

A

Viral

69
Q

What is the abbreviation of Genital herpes simplex virus ?

A

HSV

70
Q

Herpes simplex virus 1 (HSV-1) is transmitted how ?

A

Non-sexually

71
Q

Herpes simplex virus 2 (HSV-2) is transmitted how ?

A

Sexually

72
Q

The initial infection of HSV is characterized by what ?

A
  • Multiple painful lesions
  • Fever
  • Chills
  • Malaise
  • severe dysuria
73
Q

Primary genital herpes lesions progress from _________ to _________ to __________ to_________ and _____ that _______ and ______ ?

A 
Macules -->
Papules -->
Vesicles-->
Pustules and Ulcers -->
            that
Crust and Heal
74
Q

True or False: The ulcers from HSV are…

  • tender
  • edematous
  • itchy
  • painful
A

True

75
Q

True or False: With HSV, maternal infection can have adverse effects on both the mother and baby ?

A

True

76
Q

True or False: With HSV, there are increased miscarriage rates in the first trimester ?

A

True

77
Q

True or False: With HSV, an association with cervical cancer has been observed ?

A

True

but primary way is HPV

78
Q

True or False: Pt’s who get HSV for the 2nd or 3rd time may feel tingling even in the perineal area ?

A

True

79
Q

Can a pregnant women with HSV, deliver her baby vaginally ?

A

NO !!!!!

80
Q

In pregnant women with HSV, why do they plan a C-section for the delivery method ?

A

Because you don’t want the baby coming into contact with the lesions !

81
Q

How do they screen/diagnose Herpes ?

A

Hx and physical exam

82
Q

Is there a cure for Herpes ?

A

No

83
Q

True or False: With Herpes, Antiviral meds are given to control symptoms ?

A

True

84
Q

What are examples of Antiviral meds used to control the symptoms of Herpes ?

A
  • Acyclovir

- Valtrex

85
Q

With Herpes, how many times a day should you clean the lesions ?

A

BID

86
Q

In what non pharmacological ways can Herpes be managed ?

A
  • Sitz baths
  • Oatmeal soaks
  • Tea bags
87
Q

True or False: Oral analgesics can be used in the management of Herpes ?

A

True

88
Q

True or False: The management of Herpes can be chronic or recurrent ?

A

True

89
Q

What is the most threatening Hepatitis to the fetus and neonate ?

A

Hepatitis B

90
Q

True or False: With Hepatitis B, disease of the liver is often a silent infection ?

A

True

91
Q

How is Hepatitis B transmitted ?

A
  • Parenterally
  • Perinatally
  • Orally (rarely)
  • intimate contact
92
Q

What populations are at risk for Hepatitis B ?

A
  • Asians
  • Pacific Island
  • Alaskan descent
  • Haitian
  • Sub-sahara African
93
Q

Other people at risk for Hepatitis B, include those with what medical ailments ?

A
  • Liver disease
  • Dialysis patients
  • Women in mentally challenged instituations
  • Multiple sex partners
  • IV drug users
  • Healthcare workers
94
Q

When are babies vaccinated against Hepatitis B ?

A

Immediately in the Hospital ! with the follow up injections taking place in the Dr. office on future visits

95
Q

Who is screened for Hepatitis B ?

A
  • Regular screenings for high risk individuals

- All pregnant women

96
Q

What is the management for Hepatitis B ?

A
  • Hep B vaccine

- Counciling and education

97
Q

True or False: their is no specific treatment for Hep B ?

A

True

98
Q

With HIV, what is now considered the most common means of transmission in women ?

A

Heterosexual transmission

99
Q

The transmission of HIV occurs primarily through ?

A

Exchange of Body Fluids

  • semen
  • blood
  • vaginal secretions
100
Q

Once HIV is in the bloodstream, Seroconversion occurs when ?

A

in 6 -12 weeks

101
Q

At risk behaviors of HIV include ?

A
  • Multiple partners
  • IV drug use
  • Hx of multiple STI’s
102
Q

What does the screening/diagnoses look like for HIV ?

A
  • Antibody testing

- CDC advocates for routine voluntary testing

103
Q

True or False: HIV testing is offered early sin pregnancy ?

A

True

104
Q

What is the preferred method for testing for HIV ?

A

Rapid testing

105
Q

True or False: Perinatal transmission has decreased with HIV due to antiretroviral prophylaxis ?

A

True

106
Q

With HIV antiretroviral prophylaxis is usually started when ? And continued through ?

A
  • Usually started after the first trimester

- Continued throughout pregnancy

107
Q

What is a major side effect with HIV in pregnancy ? (antiretroviral prophylaxis ?)

A

Bone marrow suppression

108
Q

In pregnant women with HIV, a cesarean birth should be scheduled for when ?

A

at 38 weeks

  • Because its an environment where the amount of blood can be controlled. (I.e. utilizing suction)
109
Q

Should pregnant women with HIV avoid breastfeeding ?

A

Yes !

110
Q

______ ________ is a syndrome in which normal H2O2-producing lactobacilli are replaced with high concentrations of aerobic bacteria ?

A

Bacterial vaginosis (BV)

111
Q

What vaginal infection is associated with preterm labor and birth ?

A

Bacterial vaginosis

112
Q

With what type of Vaginal infection, do women complain of a “fish odor” ?

A

Bacterial vaginosis

113
Q

What is the most common type of vaginitis ?

A

Bacterial vaginosis

114
Q

What type of vaginal infection has discharge that is profuse whiter, grey, or milky ?

A

Bacterial vaginosis

115
Q

How is bacterial vaginosis diagnosed ?

A

By clue cell findings in the vagina

116
Q

What is the Tx for Bacterial vaginosis ?

A

Often Flagyl (metronidazole)

117
Q

What is the common medication ending that is used for a lot of vaginal infections ?

A

“azole”

Ex: metronid”azole” (flatly)

118
Q

What is the second most common type of vaginal infection ?

A

Vulvovaginal Candidiasis, or yeast infection

119
Q

Vulvovaginal Candidiasis (VVC) can be what type of infection ?

A

Fungal or Yeast infection

120
Q

When does Vulvovaginal Candidiasis occur ?

A

When new yeast is introduced or more yeast is present in the vagina

121
Q

What type of vaginal infection has discharge that is Thick and white, and looks like cottage cheese ?

A

Vulvovaginal Candidiasis (VVC)

122
Q

What are manifestations of Vulvovaginal Candidiasis (VVC) ?

A
  • Severe itching
  • Dysuria
  • Dyspareunia
  • Edema
123
Q

How Is Vulvovaginal Candidiasis Diagnosed ?

A
  • Exam
  • Wet smear

(Will see bud like branches)

124
Q

How is Vulvovaginal Candidiasis Treated ?

A
  • Fluconazole (Diflucan)

- Miconazole cream (Monistat)

125
Q

With what type of type of vaginal infection should you think of “bud like branching” ?

A

Yeast

126
Q

What are factors affecting predisposal to Candidiasis ?

A
  • 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
Q

___________ is a vaginal infection and STI and is a common cause of vaginal infections ?

A

Trichomoniasis

128
Q

What are the manifestations of Trichomoniasis ?

A
  • Inflammation of the vulva and vagina
  • Puritis
  • Copius frothy yellow-green discharge
129
Q

What is the recommended test to diagnose Trichomoniasis ?

A

NAAT (is the most sensitive)

130
Q

What other ways is Trichomoniasis screened ?

A
  • Speculum examination
    (very uncomfortable b/c of swelling, itching, etc.)
  • Pap smear
131
Q

How is Trichomoniasis Managed/Treated ?

A

Metronidazole (2g orally in a single dose)

132
Q

True or False: The partners of someone with Trichomoniasis should also be treated ?

A

True

133
Q

Why should the partner of someone diagnosed with Trichmoniasis be treated ?

A

B/c the Trichomoniasis infection can harbor in the urethra of males, so they have the potential to keep spreading it

134
Q

______ ___ ___________ is considered normal flora in the non-pregnant women ?

A

Group B Streptococci

135
Q

True or False: Group B Strepococci is a concern in pregnancy ?

A

True

136
Q

Why is Group B Streptococci a concern in pregnancy ?

A

B/c there is an increased risk for preterm labor and transmission to the newborn

137
Q

True or False: With Group B Streptococci, there is screening in pregnancy ?

A

True

138
Q

When is Group B Streptococci treated in pregnancy ?

A

Treated in labor and delivery

  • treated with IV penicillin before you deliver the baby*

( treating mom in L&D, but not the baby)

139
Q

Is a pregnant women with Group B Streptococci, required to have a C-section ?

A

No !

140
Q

With Group B Streptococci, There is a risk of _____ for the neonate ?

A

GBS

141
Q

What are key STI-prevention strategies ?

A

Risk-reduction

142
Q

Prevention of mother-to-newborn HIV transmission is most effective when ?

A

When the women receives antiretroviral drugs during pregnancy, labor and birth, and when the infant receives the drugs after birth.

143
Q

_________ has reemerged as a common STI, affecting African American women more than any other racial or ethnic group ?

A

Syphilis

144
Q

Effective screening by health care providers requires what ?

A

An open discussion about sexual orientation in an accepting manner

145
Q

Women who have sex with women are at risk for what type of infections ?

A

Bacterial, viral, and protozoal infections

146
Q

Person’s in what community are at risk for STI’S ?

A

LGBT community

147
Q

_________ is the most common STI in women in the United States and is the most common cause of PID ?

A

Chalmydia

148
Q

Viral Hepatitis has several forms of transmission, but _____ infections carry the greatest risk ?

A

HBV

149
Q

What type of individuals are at the greatest risk for STI’s and HIV ?

A

Young, sexually active women who do not practice risk reducing sexual behaviors and who have multiple partners

150
Q

______ are responsible for substantial mortality and morbidity, great personal suffering, and heavy economic burden in the Unites States ?

A

STI’s

151
Q

True or False: Both mother and baby should be considered when the pregnant women contract an infection ?

A

True

Mom and baby Exam 1 (14 decks)

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