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NURS 501 > Exam 2 - Genital warts > Flashcards

Exam 2 - Genital warts Flashcards

1
Q

Common clinical manifestations of warts (aka condyloma acuminata)

A
  • Single/multiple, soft, flesy, papillary or flat, keratinized growths on genital mucosa
  • Usually asymptomatic and painless
    • May be painful and pruritic
  • Can occur at multiple sites
    • Commonly vaginal introitus, shaft of penis, vaginal wall, cervix
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2
Q

How would a provider diagnose genital warts?

A
  • Visual inspection
  • Biopsy NOT necessary, but can indicate if warts are atypical or used when warts don’t respond to treatment
  • HPV testing not recommened
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3
Q

What differential diagnosis should the provider consider and rule out?

A

Condyloma lata

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4
Q

What is the mode of transmission for genital warts?

A

Sexual contact

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5
Q

Is it okay for the provider to choose not to treat?

A

Yes, can choose to monitor

  • May spontaneously resolve within 1 year or get worse
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6
Q

Does treatment eradicate HPV infection?

A

No, genital warts can reoccur after treatment (especially in first 3 months)

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7
Q

What three patient applied treatment therapies could the provider use to treat genital warts?

A
  • Imiquimod (Aldara) or Zyclara cream
  • Podofilox (Condylox)
  • Sinecatechins (Veregen)
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8
Q

What is the MOA of imiquimod (Aldara) or zyclara cream?

A

Active immune enhancer

  • Stimulates production of interferon and other cytokines
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9
Q

How are imiquimod (Aldara) or zyclara cream applied?

A

Imiquimod (Aldara) - apply 3x weekly at bedtime, leave on for 6-10 hours, wash off with soap and water, continue for max of 16 weeks

Zyclara - apply daily at bedtime, leave on for 8 hours, wash off with soap and water, continue for max of 8 weeks

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10
Q

What is the MOA of podofilox (Condylox)?

A

Antimitotic that results in wart necrosis

  • Should not prescribe more than 10 mg/day because can be cytotoxic
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11
Q

How would you advise patients to apply podofilox (Condylox)?

A

Apply daily for 3 days, stop for 4 days

  • Repeat cycle four times then d/c
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12
Q

What is the MOA of sinecatechins (Veregen)?

A

Green tea extra with active catechins

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13
Q

How would you advise patients to apply sinecatechins (Veregen)?

A

Apply 3 times/day until warts are cleared (max of 16 weeks)

  • Requires the most patient compliance
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14
Q

Can you prescribe topicals for genital warts for patients that are pregnant?

A

No

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15
Q

What are the main two provider applied treatment therapies could the provider prescribe for genital warts?

A
  • Trichloroacetic acid (TCA)
  • Bichloroacetic acid (BCA)
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16
Q

What is the MOA of TCA and BCA?

A

Destroys warts by chemical coagulation of proteins

  • Patients need to come back weekly for treatment until warts resolve
17
Q

Other than TCA and BCA, what other provider applied treatment therapies are available for patients with genital warts?

A
  • Surgical removal for large warts
  • Cryotherapy
18
Q

Genital wart treatment side effects

A
  • Local irritation
  • Redness
  • Itching
  • Mild to moderate pain
  • Ulcerations
  • Persistent hyper or hypopigmentation
19
Q

How often should patients come in for follow up for genital warts?

A

Return for regular treatment until lesions are resolved

  • Most respond within 3 months of treatment
20
Q

What are complications that are associated with anogenital warts?

A
  • Large lesions may stimulate carcinoma and require biopsy
  • In pregnancy, warts can enlarge (d/t immunocompromised state) and obstruct birth canal leading to c section
  • People with HIV can have large warts
21
Q

Genital warts prevention

A
  • Abstain from sex
  • HPV vaccination
  • Condom use (but not fully protected)
22
Q

Genital warts patient education

A
  • Treatment DOES NOT kill the virus (only treats warts)
    • Common for warts to reoccur in first 3 months
  • Women with genital warts DO NOT need pap tests more often
  • Sex parters can share HPV
    • Can still be transmitted after warts are gone/removed
  • Smoking cessation

NURS 501 (66 decks)

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