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final exam Flashcards

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1
Q

reportable diseases

A
  • AIDS
  • chlamydia
  • gonorrhea
  • hepatitis A,B,C
  • syphilis
  • TB
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2
Q

2 months vaccines

A
  • DTaP - IPV - Hib
  • Pneu-C-13
  • Rot-1
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3
Q

4 months vaccines

A
  • DTaP - IPV - Hib
  • Pneu-C-13
  • Rot-1
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4
Q

6 month vaccines

A
  • DTaP - IPV - Hib
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5
Q

1 year vaccines

A
  • Pneu-C-13
  • Men-C-C
  • MMR
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6
Q

15 month vaccines

A
  • Varicella
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7
Q

18 month vaccines

A
  • DTaP - IPV - Hib
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8
Q

4 year vaccines

A
  • MMRV
  • Tdap - IPV
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9
Q

grade 7 vaccines

A
  • hepatitis B
  • HPV-9
  • Men-C-ACYW
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10
Q

14 year vaccine

A
  • Tdap
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11
Q

24 year vaccine

A
  • Tdap
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12
Q

65 year vaccine

A
  • HZ vaccine (herpes zoster)
  • Pneu-P-23
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13
Q

sex

A

chromosomal makeup determined by X or Y chromosomes

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14
Q

intersex

A

variety of conditions in which a person is born with reproductive or sexual anatomy that does not fit the typical definition of male or female

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15
Q

why sex differences matter

A
  • ensures interventions are relevant and effective
  • how we understand morbidity, morality and life expectancy
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16
Q

essentialist thinking (problematic theory)

A

women and men have a true essence related to sex organs, hormones and their role in reproduction

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17
Q

biology as destiny

A

part of essentialist thinking that suggests that women are naturally caring and emotional whereas men are assertive and emotionally distant

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18
Q

gender

A

the characteristics of women, men, girls, and boys that are socially constructed

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19
Q

masculinity and femininity

A

social constructs that have been created and reinforced by societies over time

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20
Q

gender identity

A
  • describes how we see ourselves as women, men, neither, or both
  • individual sense of self
  • may not confirm with assigned sex at birth
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21
Q

gender stereotype theory

A

suggests men are more masculine than women whereas women are more feminine

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22
Q

gender norms

A

ideas on how men and women should act that can restrict gender identity

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23
Q

gender roles

A

social and cultural expectations assigned to gender

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24
Q

binary

A

suggests people are either male or female and therefore are naturally masculine or feminine

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25
Q

cisgender

A

person whose internal gender matches their external gender identity

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26
Q

non binary

A

umbrella term used to include all gender identities that fall outside binary gender

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27
Q

agender

A

identifies as having no gender

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28
Q

bigender

A

person whose gender identity is a combination of 2 genders

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29
Q

gender fluid

A

person whose gender identity is not fixed. they may feel like a mix of 2 traditional genders but feel more like one at some point in time

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30
Q

two spirit

A
  • describes a person who embodies both masculine and feminine spirit
  • used in indigenous culture
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31
Q

gender non-conforming

A

person whose gender expression differs from societal norms for male and female

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32
Q

transfeminine

A

person who was assigned male sex at birth but who identifies with femininity

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33
Q

transmasculine

A

person who was assigned female sex at birth but who identifies with masculinity

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34
Q

pangender

A

person whose gender identity is comprised of many genders

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35
Q

genderqueer

A

person whose gender identity falls outside traditional binary gender structure

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36
Q

traditional gender roles in canada

A
  • patriarchal authority was the norm
  • strict roles in victorian era where men and women operated in operate spheres
  • during world wars roles were more elastic
  • gender role elasticity: returned to pre war norms
  • 1960s women returned and stayed in the workforce
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37
Q

indigenous gender roles

A
  • women responsible for household chores and gathering food
  • men responsible for hunting large game, gathering wood and figthing
  • led by Clan mothers who are responsible for ensure community welfare
  • gender is fluid
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38
Q

gender inequity

A

occurs when individuals are not provided with the same opportunities in society because of their gender

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39
Q

leading health issues for transgender individuals

A

experience discrimination in
- employment
- health care
- overt and covert violence
- loss of social support networks

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40
Q

gender based lens

A

way to ensure policies, programs, services, and interventions are appropriate for everyone

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41
Q

misgendering

A

when non-binary people are addressed using gender specific language that does not match their gender identity

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42
Q

sexual orientation

A

the romantic and sexual attraction towards people of one or more genders

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43
Q

homosexuality

A

sexual attraction towards individuals of the same gender

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44
Q

heterosexuality

A

sexual attraction to another gender

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45
Q

bisexuality

A

sexual attraction to more than one gender

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46
Q

pansexual

A

sexual attraction to all genders

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47
Q

queer

A

another label for non-heterosexual individuals that some may prefer

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48
Q

socioecological examination

A

requires assessing the social determinants of health and reinforce the fact that some determinants are embedded in social structures that generate health inequality

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49
Q

violence

A

intentional use of physical force or power against yourself, another person, group or community

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50
Q

most at risk for violence

A
  • women
  • children
  • indigenous peoples
  • people with disabilities
  • people who identify as 2SLGBTQIA+
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51
Q

micro-aggression

A

associated with ageism, genderism, heterosexism, sexism, racism

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52
Q

violence and health

A

violence is a complex social and public health problem that is associated with the distribution of social and structural determinants of health

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53
Q

ACE (adverse childhood experiences) pyramid

A
  • early death
  • disease, disability, and social problems
  • adoption of health-risk behaviours
  • social, emotional and cognitive impairment
  • disrupted neurodevelopment
  • adverse childhood experiences
  • social conditions / local context
  • generational embodiment / historical trauma
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54
Q

ACE study

A
  • conducted 1955-1977 in 2 waves
  • categorized into abuse, neglect, household challenges
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55
Q

adverse childhood experiences

A
  • TBI, fractures, burns
  • depression, anxiety, suicide, PTSD
  • pregnancy, pregnancy complications, fetal death
  • HIV, STDs
  • cancer, diabetes
  • alcohol and drug abuse, unsafe sex
  • education, occupation, income
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56
Q

structural / systemic violence

A

privilege in tandem with power

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57
Q

white privilege

A
  • children’s books that overwhelmingly present caucasians
  • learning about caucasians in school curriculum
  • media is biased towards caucasians
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58
Q

heterosexual privilege

A
  • not being identified or labeled by your sexual orientation
  • no one questions “normality” of your sexuality
  • not having fear your peers will find out about your sexual orientation
  • can walk in public showing affection to your partner without negative consequences
  • can easily find welcoming religious communities
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59
Q

settler privilege

A
  • not being forcefully relocated
  • not being denied the right to vote
  • access to clean drinking water
  • having medical concerns listened to in hospital
  • knowing if a member of your family went missing, an effort would be made to find them
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60
Q

male privilege

A
  • less likely to be interrupted
  • people assume you know what you are talking about
  • social norms allow you to take up more physical space
  • buy clothes with functional pockets
  • less likely to experience IPV or stalked
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61
Q

class privilege

A
  • buying what you want without worry
  • being in control of how you spend your time
  • can live where you choose
  • believed to be innocent until proven guilty
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62
Q

systematic oppression

A

describes systematic injustice that intersect and impede peoples aspirations, progression and quality of life

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63
Q

role of CHN in violence

A
  • be aware of language used to describe violence
  • violence prevention
  • screening and early detection
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64
Q

people, poverty, power model (3P)

A
  • provides way for CHN to understand and intervene
  • demonstrates violence is more than individual behaviour
  • central to model is trauma, poverty, power, violence, and people
  • highlights importance of empathy to address and prevent violence
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65
Q

3P trauma

A
  • result from cumulative stressful experiences
  • long term
  • greater impact
  • makes people more sensitive to perceived risk
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66
Q

3P poverty

A
  • central to experiences of community violence
  • linked to structural oppression
  • power and poverty are supporting foundations of peoples trauma
  • social poverty = lack of social support, connection, community support
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67
Q

3P violence

A
  • violence manifests through person, poverty, power
  • poverty, privilege, oppression lead to violence
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68
Q

sexualized violence

A
  • disproportionately impacts women
  • rooted in gender inequality
  • rates highest among single women, FNIM individuals with poor mental health, students, gay, lesbian, bisexual, women ages 15-24
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69
Q

MeToo movement

A
  • coined 2006 by Tarana Burke
  • made to prevent other incidents against african american women
  • slogan for anti-sexual harassment movement
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70
Q

family violence

A

violence, abuse, unhealthy conflict, or neglect by family member towards another family member that has the potential to lead to ill health

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71
Q

most common to experience family violence

A
  • women, children, older adults, FNMI peoples, people with disabilities, 2SLGTBQIA+ members
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72
Q

social impacts of family violence

A
  • diminished capacity to heave healthy social relationships
  • poor academic performance
  • missing work
  • less productive
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73
Q

IPV

A
  • women are more likely to experience
  • strong association between SDoH
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74
Q

CHN role in IPV

A
  • universal screening recommended for all women ages 12 and older
  • identify men, boys, and trans men under threat of violence
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75
Q

mandatory reporting

A
  • no mandatory reporting obligations for IPV unless the person experiencing violence wants to
  • if IPV is in the home and children are exposed, CAS must be contacted
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76
Q

age of consent to sexual activity

A

16 years

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77
Q

close in age exceptions

A
  • people between 12-13 where the age difference is greater then 2 years, or the other person is in a position of authority must be reported
  • people between 14-15 where the age difference is greater then 5 years, or the other person is in a position of authority must be reported
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78
Q

power and control wheel

A
  • key tool for CHN to assess and intervene violence
  • describes how interpersonal power can operate
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79
Q

social-ecological model

A

individual, relationship, community, societal factors

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80
Q

individual

A

identifies biological and personal history that increase likelihood of becoming a victim or perpetrator

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81
Q

relationship

A

examines close relationships that influence behaviours and experiences that increase risk of becoming a victim or perpetrator

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82
Q

community

A

explores the settings in which social relationships occur and identifies the characteristics of these settings that are associated with becoming a victim or perpetrator

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83
Q

societal

A

looks at social factors that help create a climate in which violence is encouraged or inhibited

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84
Q

trauma and violence informed care

A
  • initiated by substance abuse and mental health services administration
  • establishes an environment of trust, safety and stabilization
  • thorough understanding of the development, symptoms, and impact of trauma through culturally sensitive lens
  • avoids re-traumatization
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85
Q

TIC principles

A
  • safety
  • trustworthiness and transparency
  • peer support
  • collaboration
  • empowerment, voice, choice
  • cultural, historical, gender issues
86
Q

technical approaches to defining rural

A
  • locators or geographic regions
  • stats canada by population size, density, labour market contexts
  • CIHI includes distance and relationship to urban areas
87
Q

census rural

A

individuals living in the countryside outside centres of 1000 or more population

88
Q

FNIHB non-isolated commuity

A

communities with road access of less than 90km to physician services

89
Q

FNIHB semi-isolated community

A

communities with road access of greater than 90km to physician services

90
Q

FNIHB isolated community

A

communities with good phone services, scheduled air transportation, but no road access

91
Q

FNIHB remote, isolated community

A

communities with no scheduled air flights, minimal telephone or radio access, no road access

92
Q

social approaches to defining rural

A
  • refers to specific services usually associated with a larger population (restaurants or stores)
  • includes healthcare delivery
  • stats canada; “individuals in towns outside the commuting zone of larger urban centres”
93
Q

resource base

A

influences health status of those who live in the community

94
Q

mining

A
  • 10 people have died, 50 injured
  • injuries due to water accumulation in mines, remote control equipment, explosives, mobile equipment
  • diesel emissions are carcinogenic
  • silica are airborne hazards
95
Q

forestry

A
  • injuries from noise, power tools, bodily motions, vehicles, trees, plants, overexertion, elevated fall
96
Q

oil and gas

A
  • 349 people died
  • transportation accidents (40%)
  • exposure to harmful substances (22%)
  • contact with objects/equipment (16%)
  • fire and explosions (4%)
  • diseases include asbestosis and mesothelioma
  • injuries include strains, sprains, tears
97
Q

agriculture

A
  • biological hazards (moulds, zoonotic diseases, sharps injury)
  • chemical hazards (fertilizers, gases in manure, gases in silos)
  • ergonomic hazards (standing or sitting for long hours, repetitive tasks and lifting)
  • physical hazards (excessive noise, extreme conditions, UV radiation, safety hazards)
98
Q

employment opportunities in rural and remote communities

A
  • not all individuals have access to earn a reasonable living wage
  • reserve-based first nation women’s income is low
99
Q

education in rural and remote communities

A
  • 56% of women in remote communities have certificate, diploma, degree
  • 41% of rural indigenous women have no degree
  • stats show relationship between residing in urban areas and obtaining higher education
100
Q

diversity in rural and remote areas

A
  • CHN assess diversity, strengths, and needs of community
  • immigration adds challenges in the delivery of culturally sensitive care
  • CHN assess religious, socio-historical and policy contexts
101
Q

cultural safety principles

A
  • protocols; respect for cultural forms of engagement
  • personal knowledge; understanding one’s own cultural identity
  • process; engage in mutual learning
  • positive purpose; ensuring process yields right outcome
  • partnership
102
Q

inequity : health care access

A
  • fewer delivery options
  • travel longer distances for services
  • programs are not always culturally sensitive
103
Q

inequity : technology

A
  • unreliable internet access
  • health informatics
  • telehealth to increase access to healthcare
104
Q

telehealth

A
  • reduces spending
  • videoconferencing clinics
  • enables delivery of health services
  • pre and postoperative assessments
  • management of fractures
  • and more
105
Q

inequality : water quality

A
  • access to potable water is a fundamental right
  • to supply good drinking water, water infrastructures must be monitored, maintained and working properly
106
Q

walkerton tragedy

A
  • may 2000
  • 7 people died from e.coli from contaminated water
  • 2300 ill
107
Q

boil water advisories

A
  • BWA due to issues with equipment and processes used to treat, store, and distribute water
  • long term BWA continue to exist in first nation communities
  • 59 drinking water advisories in 41 first nations
108
Q

how water becomes contaminated

A
  • fertilizers, pesticides, chemicals
  • concentrated feeding operations
  • manufacturing operations
  • sewer overflows
  • wildlife
  • rocks and soil
  • cracks in water pipes
109
Q

disease and microbe transmissions related to contaminated water

A
  • cholera
  • hep A
  • typhoid
  • polio
  • e.coli
  • norovirus
  • rotavirus
  • salmonella
110
Q

chemicals in contaminated water

A
  • arsenic
  • copper
  • lead
  • nitrate (effects O2 carrying capacity)
  • radon (second leading cause of lung cancer)
111
Q

inequality : food insecurity

A
  • occurs when people lack secure access to sufficient amounts of safe and nutritious foods
  • rural communities have higher food costs
  • high transportation costs
  • many remote indigenous communities hunt and fish
  • due to poverty, unemployment, low income
112
Q

consequences of food insecurity

A
  • malnutrition
  • infections
  • chronic diseases
  • obesity
  • distress, social exclusion, depression
  • impacts child’s ability to learn
  • threat to social and culture stability
113
Q

initiatives for food insecurity

A
  • nutrition north canada program provides retail subsidies to target high costs of perishable and nutritious food in the north
  • food policy for canada states all people are able to access a sufficient amount of safe, nutritious and culturally diverse food
114
Q

CHN role in rural and remote communities

A
  • practice shaped by limited transportation. communication and other resources
  • focus on primary health care
115
Q

CHN role with substance use

A
  • develop and engage in health promoting practice
  • understand dynamics, social and health effects, and root cause of substance use
  • advocate for practices that embrace social justice
116
Q

praxis

A
  • process of using a theory or something you have learned in a practical way
  • used to eliminate injustice and discrimination in care
  • reflect on habits, ideas, values and actions
117
Q

substance use disorder

A
  • mild, moderate, severe
  • occurs when recurrent use of alcohol or drugs causes clinically and functionally significant impairment
118
Q

dependence

A
  • progressive in nature, affects the physiological, cognitive, behavioural and psychological dimensions of health
  • results in tolerance, withdrawal, compulsive substance taking behaviour
119
Q

physical dependence

A

occurs when individuals body reacts to the absence of a drug with withdrawal symptoms

120
Q

problematic substance use

A
  • spans life cycle
  • severe and permanent consequences
  • adverse physical, psychological, legal, social, interpersonal issues
  • multifactorial (use socio-ecological model)
121
Q

psychological dependence

A

occurs when drug use becomes central to a persons thoughts and emotions

122
Q

violence, trauma, mental health related to substance use

A

abuse and sexual assault have been associated with substance use

123
Q

concurrent disorder

A

1+ co-occuring mental health challenges simultaneously with problematic substance use

124
Q

chronic pain

A
  • those who experience problematic substance use encounter resistance in health acre when requesting pain management
  • opioids should not be first line treatment
125
Q

CHN role in pain management

A
  • respect underlying beliefs
  • evidence-based
  • in line with cultural safety
126
Q

socio-ecological model and opioid use

A
  • individual: age, race, gender, stress and trauma exposure, mental health, pain
  • relationships: influence of family, friends, coworkers, opioid access via relationships
  • community: treatment availability and access, norms, access to opioids, over-perscription
  • society: law enforcement, educational campaigns, insurance coverage
127
Q

tobacco use

A
  • higher rates in men
  • youth smoking decreased
    -17% aged 15+ have vaped
128
Q

tobacco health effects

A
  • cancer (mouth, throat, lungs, liver, kidney…)
  • heart disease (CAD, increased triglycerides)
  • COPD
  • fertility (effects men’s sperm)
  • bone health
  • cataracts
  • type 2 DM
129
Q

alcohol use

A
  • 64% 15+ report using
  • heavy use is 4+ drinks per occasion
  • higher heavy use in men
130
Q

short term alcohol health effects

A
  • injuries (MVC, falls, burns)
  • violence (homicide, sexual assault)
  • alcohol poisoning
  • risky sexual behaviours
  • miscarriages, still birth, fetal alcohol disorders
131
Q

long term alcohol health effects

A
  • hypertension, heart disease, stroke
  • liver disease, pancreatitis
  • cancer of breast, mouth, liver, rectum
  • weakened immune system
  • learning and memory issues
132
Q

low risk drinking guidelines

A
  • 10 drinks/week for women, no more then 2 a day
  • 15 drinks/week for men, no more then 3 a day
  • plan non-drinking days every week
  • no more then 3 drinks (w) and 4 men (m)
133
Q

cannabis use

A

40% 15+ report using

134
Q

short term cannabis health effects

A
  • hypotension
  • tachycardia
  • psychotic episodes
  • confusion
  • impaired ability to remember, concentrate, pay attention
135
Q

long term cannabis health effects

A
  • dependency risk
  • lung health (bronchitis, lung infections, chronic cough)
  • effects on brain (memory, concentration)
  • increased risk of developing schizophrenia, depression, anxiety
136
Q

cannabis hyperemesis syndrome (CHS)

A

reoccurring nausea, vomiting, dehydration, abdominal pain

137
Q

opioid crisis factors

A
  • misunderstanding of the additive risk of prescription opioids
  • psychological, social, and biological risk factors
  • stigma
  • frequent opioid prescribing
  • illegal drugs that are laced with fentanyl
138
Q

opioid overdose

A
  • 21 deaths a day (most by accident)
  • mostly males between 20-59
  • majority of deaths in BC, alberta, ontario
139
Q

opioid overdose - construction workers

A
  • 1/3 of overdoses
  • reasons: physical demands of job increase chronic pain, mental health challenges associated with long hours
140
Q

opioid overdose and fentanyl

A
  • street drugs tainted with fentanyl
  • approximately 100 times stronger than morphine
  • most pills contain 2mg
141
Q

harm reduction

A

represents a continuum of services that provide care while minimizing the negative harms associated with substance use

142
Q

basics of harm reduction

A
  • goal-oriented
  • humanistic
  • nonjudgemental
  • person-centred approach
  • healthcare providers “meet people where they’re at”
143
Q

housing first

A
  • mental health strategy that focuses on housing people regardless of substance use
  • not conditional on sobriety or abstinence
144
Q

5 principles of Housing First

A
  • immediate access to housing with no readiness requirement
  • consumer choice and self-determination
  • recovery orientation
  • individualized supports
  • social and community integration
145
Q

supervised consumption sites

A
  • provide safe, clean space for people to bring their own drugs to use in the presence of trained staff
  • prevent overdose
  • reduce spread of infectious diseases
146
Q

needle exchange programs

A
  • reduce exchange of blood borne pathogens
  • reduce needles discarded in community
  • needle distribution and disposal
  • condom distribution
  • education
  • referrals and counselling
  • HIV, STD, hep B/C, pregnancy testing
  • offer supplies for safe drug administration
147
Q

safer supply programs

A
  • provide prescribed medications as a safer alternative to toxic illegal drugs
  • prevent overdose
  • medications: opioids, stimulants, benzos
148
Q

safe injection nursing education

A
  • IV injections
  • how to choose a safe site (arms, back of hand)
  • veins vs arteries
  • exercises to improve vein visibility
  • cleaning the site
  • inserting needles
  • missed shots and aftercare
149
Q

injecting cocaine

A
  • has numbing effect and causes constriction so ensure you are in the right spot before injecting
  • injecting multiple times can be traumatic for the tissues
150
Q

injecting crack

A
  • dissolve using powdered citric or ascorbic acid (avoid lemon juice and vinegar as they can lead to infection)
  • do dissolve put crack and acid into cooker, add water and mix well
151
Q

naloxone programs

A
  • ontario naloxone program
  • ontario naloxone program for pharmacies
  • ministry of community safety and correction services
152
Q

substance use : CHN primary prevention

A
  • preventing problematic substance use before it occurs with focus on individual or community
  • preventing regular substance use from becoming problematic
153
Q

substance use : CHN secondary prevention

A
  • early identification of when substance use becomes problematic and rapid support
  • screening, tools, or conversations that allow for detection of signs and symptoms
154
Q

substance use : CHN tertiary prevention

A
  • reducing harms of problematic use
  • clean needs, supervised consumption sites, managed alcohol programs, naloxone distribution
155
Q

substance use : CHN quaternary prevention

A
  • addressing stigma
  • education on appropriate language
156
Q

sexually transmitted and blood borne infections (STBBIs)

A
  • infections that spread through insertive and receptive sexual practices with someone who is carrying the infection
  • genital herpes and HPV can be transmitted by intimate skin-to-skin contact
  • HIV and Hep B are transmitted through blood
  • bacterial, viral, ectoparasitic
157
Q

venereal disease

A
  • defined a disease that was only transmitted by sexual intercourse
    in 1970 was replaced with STD
158
Q

STD

A
  • disease that could be transmitted from person to person through sex or intimate contact with genitals, mouth or rectum
  • STI became preferred term in 2006
159
Q

BBI

A
  • infections that could be carried and transmitted through the blood
  • HIV, hep B and C
160
Q

past health public policy

A
  • prior to antibiotics, bacterial STBBIs weren’t treatable
  • stigma influenced to the extent that infections were rarely reported
  • anti-VD campaign in 1920 targeted education and tx
161
Q

current health public policy

A
  • screening for HIV, syphilis, chlamydia, gonorrhoea, and hep B at first prenatal visit
  • BBI screening with blood products
  • immunization partnership fund
  • public health surveillance
162
Q

chlamydia

A
  • symptoms in 1-3 weeks
  • through vaginal, anal, oral sex
  • from mother to newborn
  • increased rates
  • mostly women aged 15-24
163
Q

chlamydia and women

A
  • contract in cervix, rectum, throat
  • lead to PID, infertility, pelvic pain
  • in pregnancy: ectopic, premature birth, eye infection and pneumonia for baby
  • symptoms: mucopurulent discharge, endocervical bleeding, urinary frequency
164
Q

chlamydia and men

A
  • contract in urethra, rectum, throat
  • lead to lymphogranuloma venereum, proctitis
  • symptoms: mucoid discharge, burning sensation when urinating, itching, epididymitis
165
Q

rectal chlamydia

A
  • symptoms: rectal pain, bleeding, discharge, mucous with stools, painful BM
166
Q

ocular chlamydia

A
  • through contact with genital secretions
  • symptoms: conjunctivitis, mucous discharge, tearing, photophobia, decreased vision
167
Q

chlamydia tx

A
  • non-LGV strains: 1g PO azithromycin once OR 100mg doxycycline PO BID x 7 days
  • LGV strains: 100mg doxycycline PO BID x 21 days
168
Q

gonorrhoea

A
  • infection in penis, vagina, cervix, anus, urethra, throat, eyes
  • bacteria in semen and vaginal fluids
  • symptoms within 2 weeks
  • 2nd most common
169
Q

gonorrhoea and women

A
  • thin, watery, green or yellow discharge
  • dysuria
  • pain in lower abdomen
  • bleeding between periods or after sex
170
Q

gonorrhoea and men

A
  • white, yellow, green discharge
  • dysuria
  • foreskin inflammation
  • pain in testicles
171
Q

gonorrhoea in rectum

A
  • discomfort, pain, itching, discharge, bright red blood
172
Q

gonorrhoea in throat

A
  • sore throat, swollen lymph nodes
173
Q

gonorrhoea in eyes

A
  • conjunctivitis, photophobia, purulent drainage
174
Q

gonorrhoea tx

A
  • 250mg ceftriaxone IM + 1g azithromycin PO
    OR
  • 100mg doxycycline PO BID x 7 days
175
Q

syphilis

A
  • first symptoms in 21 days
  • progresses if left untreated
  • highest amongst 25-29 and 30-39
176
Q

primary syphilis stage

A
  • pt most infectious
  • cancre sore or proctitis
  • sores are firm, round, small and painless
  • last 3-6 weeks and will health without treatment
177
Q

secondary syphilis stage

A
  • pt infectious
  • starts with skin rash and mucous membrane lesions
  • rash is rough, reddish brown on palms of hands, soles of feet, torso extremities
  • not itchy
  • fever
  • swollen lymph glands
  • sore throat
  • patchy hair loss
  • fatigue
178
Q

early non-primary, non-secondary syphilis stage

A
  • pt infectious
  • no primary or secondary symptoms identified at time of medical visit
  • infection is identified to have occurred within the last 12 months
179
Q

late syphilis stage

A
  • pt not infectious
  • tumors
  • blindness
  • paralysis
  • brain and nervous system damage
  • possible death
180
Q

syphilis tx

A
  • primary or secondary: 2.4 million units penicillin G benzathine IM
  • neurosyphilis: 2.4 million units IM qWeek x 3
  • pregnant women should only be treated with penicillin
  • if allergic to penicillin: doxycycline or tetracycline
181
Q

bacterial STIs

A
  • chlamydia
  • gonorrhoea
  • syphilis
182
Q

viral STIs

A
  • genital herpes simples virus (HSV)
  • human papilloma virus (HPV)
  • transmitted through intimate skin-skin sexual contact and from mother to fetus
  • non reportable
183
Q

HSV

A
  • type 2 most common
  • both types can cause genital infections
  • type 2 rarely causes oral
  • 1+ painful, itchy, fluid filled blisters
  • burning while voiding
  • fever / flu symptoms
  • transmission when symptomatic and asymptomatic
184
Q

HSV dx

A
  • nucleic acid amplification test (NAAT)
  • viral culture
185
Q

HSV tx

A
  • oral acyclovir, famciclovir, valacyclovir within first 3-4 days of symptom onset
  • caesarean delivery if first episode is in 3rd trimester
  • suppressive therapy
186
Q

HPV

A
  • estimated 75% of people will have at least one HPV infection
  • most peoples immune system will clear infection
  • no cure but symptoms are treatable
  • causes cancer in the cervix, throat, oral cavity, penis, anus, vagina
187
Q

HPV symptoms

A
  • many asymptomatic
  • anogenital warts (small cauliflower or flat)
  • active infection will show change in cervical cells
188
Q

HPV vaccines

A
  • gardasil & gardasil 9 for males and females
  • cervarix for females
  • no live biologicals or DNA
  • no impact on existing infection
189
Q

gardasil and gardasil 9

A
  • protect against 2 high risk types (16 and 18)
  • protect against 2 low risk types (6 and 11)
  • approved for females 9-45 and males 9-26
  • 1st dose, 2nd two months later, 3rd six months after 1st
190
Q

when to screen for STIs

A
  • those who have been previously diagnosed
  • new sexual partner
  • multiple sexual partners
  • sexual partner having a STI
  • unprotected sex
  • sex while under the influence of alcohol or drugs
191
Q

prenatal STI screening

A
  • at first prenatal visit
  • repeat based on risk factors
192
Q

HIV

A
  • attacks immune system
  • manageable
  • left untreated can cause AIDS
  • NOT transmitted through kissing, hugging, toilet seats, sharing foods, mosquito bites
193
Q

HIV symptoms

A
  • 50% develop within 2-4 weeks for few days-weeks
  • chills
  • fever
  • fatigue
  • joint pain
  • headache
  • sore throat
  • swollen lymph nodes
194
Q

HIV testing

A
  • blood serum tests
  • rapid HIV tests
  • some cannot detect virus within first 2-4 weeks of infection
195
Q

HIV treatment

A

antiretroviral medications …
- suppresses viral load
- slows spread within body
- helps immune system fight other infections

196
Q

PrEP medication

A
  • prevention strategy
  • involves antiretroviral drugs, regular medical appointments, monitoring and supporting
197
Q

PEP medication

A
  • taken after HIV exposure to help prevent infection
  • started ASAP up to 72 hours after
  • no further exposure when taking PEP
  • combination of three medications
198
Q

reducing stigma

A
  • being respectful
  • compassionate
  • non-judgemental
199
Q

hepatitis B

A
  • liver disease spread by contact with infected bodily fluids
  • 50% will develop symptoms of fatigue, nausea, vomiting, jaundice, decreased appetite
  • 95% will clear virus
  • dx confirmed with blood tests
  • tx with antivirals
  • most common males 40-59
200
Q

hepatitis B vaccine

A
  • engerix B
  • Infanrix hexa
  • Recombivax
  • Twinrix : 3 doses over 6 months, not covered under OHIP
201
Q

hepatitis C

A
  • spread by percutaneous exposure with infected blood
  • most people are asymptomatic
  • symptoms; jaundice, fatigue, arthralgia
  • 45% will clear infection
  • highest in males ages 25-29
  • dx through blood testing
  • tx with antivirals to block replication ability
202
Q

sex workers

A
  • increased risk for STBBIs
  • CHN promote risk-reduction strategies: use of protection, education, vaccine clinics, access to testing and treatment
203
Q

street involved youth

A
  • addressing basic necessities is greater priority then addressing potential health risks
  • use of alcohol or drugs impact ability to make decisions
  • do not always take effective action to prevent STBBIs
204
Q

people in correctional facilities

A
  • high rates due to injection drug use, substance use, unprotected sex, sharing tattoo or piercing equipment
  • barriers to accessing health care
  • upon admission, voluntary infectious disease testing is offered
205
Q

STBBIs implications

A
  • underreported
  • many don’t know they are infected
  • can negatively impact a person
  • economic implications of medical costs
206
Q

primordial prevention of STBBIs

A
  • preventing STBBIs and risk factors
  • creation of programs that keep youth off the streets or advocating for sex education
207
Q

primary prevention of STBBIs

A
  • preventing start of disease with goal of decreasing incidence
  • activities prior to sign of disease, injury, transmission
  • use of protection
  • vaccination
208
Q

secondary prevention of STBBIs

A
  • early detection
  • regular testing and screening
209
Q

tertiary prevention of STBBIs

A
  • decrease progress of disease and controlling long term effects
  • medication for tx
  • manage symptoms
210
Q

quaternary prevention of STBBIs

A

avoid unnecessary or excessive intervention

community health nursing (2 decks)

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