PrepU STI Flashcards
What is condylomata?
Genital warts, most commonly caused by human papillomavirus (HPV)
Which STI present a palmar rash, sore throat and nausea?
2nd stage syphilis
Symptoms of a female with white copious vaginal discharge, itch, swelling, dyspareunia, and dysuria indicates overgrowth of what organism?
candida albicans: discharge is usually thick, white, and odorless
symptoms of primary genital herpes infection:
tingling
itching
pain in genital area
followed by eruption of small pustules and vesicles
Which STI is associated with urethritis and lesions of the penis and scrotum?
HSV
What other body part can be infected by HSV?
mouth, rectum, and perianal
What is the full name for Pap test?
papanicolaou test
What is the only test for HPV
high-risk HPV DNA
Which STI may cause infertility, in men and women, and may lead to an ectopic pregnancy, and damage to the reproductive system in women if left untreated?
chlamydia
Why is is standard for a newly pregnant client at their first prenatal visit be tested for syphilis?
It can cause complications in pregnancy if left untreated- and increases the risk of HIV
What adverse pregnancy outcomes can occur of a pregnant female has untreated syphilis?
-still born
-neonatal death
-infant disorders (deafness and neurologic impairment
—– —— is a delayed response of the untreated disease (syphilis)
Tertiary syphilis
What physiological systems and organs does the symptomatic tertiary stage of syphilis affect?
-cardiovascular system
-CNS
-liver
-bones
-testes
Which STI in women causes unusual genital/urinary discharge, dysuria, dyspareunia, pelvic pain or tenderness, unusual vaginal bleeding (including after intercourse), and fever?
Gonorrhea
Which STI in women causes urinary frequency, cervicitis, dysuria, and vaginal discharge?
Chlamydia
Where might genital warts be seen?
penis
vulva
scrotum
perineum
perianal skin
How might external warts appear?
small bumps or flat, rough surfaced, or pedunculated
A pregnant client with a history of HSV ask me what she can do to prevent her baby from getting the virus? What can I advise her to do?
Take prescribed acyclovir from 36 weeks until delivery= suppresses outbreaks and viral shedding, reducing risk of perinatal transmission of the virus during L&D.
What are good educational methods for nurses to provide to the community to prevent STI spread?
-barrier contraceptives
-limiting amount of sexual partners
-being treated if infected
Within how many days should anyone who has had sex with someone positive for gonorrhea to be tested and treated?
Within 60 days
how can a pregnant mother pass on HIV to her newborn?
before or during birth
through breastfeeding
What is the percentage of perinatal transmission of HIV from an infected mother to her newborn?
25%
If a mother who has HIV is receiving antiretroviral therapy during pregnancy, what is the chance (%) that she will pass on the disease to her baby?
1%: breastmilk should still be avoided, with formula feeding being used instead
What symptom is the hallmark of primary syphilis?
-a painless chancre wherever the organism has entered the body (genitalia, anus or lips); may appear about 3 weeks after unprotected sex
Teaching points for condom use and storage:
-store in cool dry place away from direct sunlight.
-do not store in wallet
-put on before having any genital contact
-put on when condom is erect
-ensure adequate lubrication during intercourse
-use only water-based lubricants (oil-based or petroleum-based can weaken latex condoms)
-withdraw while penis is still erect and hold condom firmly against base of penis
-remove carefully to ensure no semen spills out
How many doses is required of the HPV vaccination?
2 doses given 6-12 months apart for individuals 9-15 prior to individual becoming sexually active.
Which STI may present no symptoms in females?
gonorrhea
What biological areas may an untreated gonorrhea infection affect in women, and what condition can it lead to?
genitals and reproductive organs, causing complications such as pelvic inflammatory disease (PID)
What other STI may lead to PID?
chlamydia
What is the mechanism of replication of the HIV retrovirus?
-entry into a host cell
-viral RNA genome is translated into DNA by a viral enzyme called reverse transcriptase.
-viral DNA copy is integrated into the host chromosome where it exists in a latent states (similar to herpes virus)
-reactivation and replication requires a reversal of the entire process
What does lysis of an HIV infected host cell lead to?
-permanent suppression of the immune response
What circumstances predispose a ct. with genital herpes to an outbreak?
-stress
-anxiety
-emotional upset
What should be advised to a ct. newly diagnosed with genital herpes?
-abstain from sex when having an active outbreak
-limit stress and emotional upset as much as possible
-use a condom in between outbreaks
-avoid creams and lubricants during an outbreak (may slow healing)
How often should a person with HSV get a Papanicolaou test done and why?
every year due to a link between genital herpes and cervical cancer
A yeast infection is commonly referred to as?
candidiasis vulvovaginitis
Discharge appearance when a female has candidiasis vulvovaginitis?
cottage cheese-like; adhere to walls of vagina.
Which test is done to determine presence of candidiasis vulvovaginitis?
hydroxide microscopy testing
What will the potassium hydroxide microscopy test reveal if candidiasis vulvovaginits is present?
pseudohyphae and sores
What is the most common treatment for candidiasis vulvovaginitis?
fluconazole (oral or vaginal) or miconazole
Why should reoccurrence of candidiasis vulvovaginitis be monitored for the course of over 1 year?
If ct. experiences condition more than 4 times in 1 year, it would be considered complicated and would require further follow-up such as testing for immunosuppression or diabetes.
What causes bacterial overgrowth leading to the condition of bacterial vaginosis?
high (alkaline) pH levels
Signs and symptoms of bacterial vaginosis:
-fishy vaginal odor
-thin white or gray vaginal discharge causing vulvar irritation
(no pruritus)
Trichomoniasis is a protozoan infection that has many similar symptoms as bacterial vaginosis. Which symptoms are dif. for trichomoniasis?
-abdominal pain
-dysuria
-urinary frequency
-between-cycle bleeding
-discharge may be greenish gray, watery, and frothy or purulent
Which medication is usually prescribed for bacterial vaginitis?
clindamycin
—– are circumscribed elevated, palpable masses containing serous fluid
vesicles
how big are vesicles?
less than 0.5 cm
examples of vesicles in 4 conditions
herpes simplex/zoster
varicella (chickenpox)
poison ivy
second-degree burn
—– is a pyogenic (i.e., pus-forming), Gram-negative diplococcus that evokes inflammatory reactions characterized by purulent exudates.
gonococcus
characteristics of condylomata acuminata warts caused by HPV and can affect which areas
cauliflower-shaped lesions that affect the mucous membranes of the vagina, urethra, anus, or mouth
Which medication is expected to be prescribed for syphilis in a ct. with no known drug allergies
benzathine penicillin G (injection) = long-acting penicillin = preferred treatment
If a client is allergic to penicillin, what other medications may be prescribed for syphilis?
doxycycline, tetracycline, or ceftriaxone
Medication to treat trichomoniasis
metronidazole
This type of lesion configuration forma a straight line, such as in a scratch or streak due to dermatographism
linear configuration
This type of configuration of lesions is circular in nature
annular EX: tinea corporis
This type of configuration of lesions are individual and distinct. -give example
discrete; multiple nevi
Important pt. education for medication use of metronidazole for treatment of trichomoniasis
avoid alcohol for 24 hours after taking the medication: may feel n/v; hot & flushed.
What side effect is common when taking metronidazole and does not need to be reported to the PCP?
metalic test
How long should sexual activity be abstained when being treated for trichomoniasis with metronidazole?
7-10 days after completing the course of medication
Secondary syphilis symptoms:
macules on palms and soles after fever
patchy hair loss
red-brown lesion on genital area
What are the 3 STIs that are required by the CDC to be reported?
-chlamydia
-syphilis
-gonorrhea
What is the cause of essentially all cases of cervical cancers (4th most common cancer among women)?
HPV
A ct. is dx with granuloma inginale. Which question should I ask the client?
“have you traveled outside of the country recently?”
-caused by a Gram-negative bacillus Klebsiella granulomatous (tiny encapsulated intracellular parasite), which is almost nonexistent in the United States.
-found in India, Brazil, the West Indies, and parts of China, Australia and Africa
What risk factors can increase the chances of candida albicans overgrowth?
-high hormone levels during pregnancy
-use of oral contraceptive pills (OCPs)
[both increase vaginal glycogen stores]
-recent antibiotic therapy
-poorly controlled diabetes
-HIV
[all compromise immune system]
Which STI exists in two morphologically distinct forms? elementary and reticulate bodies?
Chlamydia:
-small infectious elementary body
-large noninfectious reticulate body
Shape of trichomonas vaginalis
large anaerobic, pear-shaped, flagellated protozoan
——- is a disease of the external genitalia and lymph nodes caused by the gram-negative bacterium Haemophilus ducreyi
chancroid
What other organisms may be present in a vaginal candidiasis infections (besides candida albicans)?
Candida glabrata
Candida tropicalis
A young woman present with vaginal itching and irritation of recent onset. Her labia are swollen, and she has frothy yellowish discharge with an unpleasant smell and pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. What condition does she likely have, and what medication will likely clear up her symptoms?
-Trichomonas vaginalis
-metronidazole
(can exist asymptomatically and flare up if imbalance of normal vaginal flora from, for example, antibiotic treatment, which allows the protozoan to proliferate
