SCREENING DIAGNOSIS & TREATMENT STI'S

Question 1

Bacterial Vaginosis
- gray with fishy or musty odor
- pruritus

Answer 1

a. normal saline smear (10% KOH)
b. metronidazole (flagyl)
- 0.75% vaginal gel
c. clindamycin
- 2% vaginal cream

d. metronidazole
- 500 mg orally twice daily x 5 days
e. Clindamycin
- 300 mg orally twice daily

Question 2

Candidiasis
- thick cream cheese (normal odor)
- white patches on vaginal wall

Answer 2

a. KOH wet smear (20% KOH; fungal hyphae)

b. Vaginal suppositories or creams for 7 days
a. Miconazole
b. Clotrimazole

c. Oral fluconazole (diflucan)
- single dose

Question 3

Chlamydia
- grayish white (no musty)

Answer 3

a. cervical culture during 1st prenatal visit; if positive repeat at 36 weeks
b. non pregnant
- teratogenic effects
a. tetracycline
b. doxycyline

c. pregnant
a. amoxicillin or erythromycin : 3-4 months
b. azithromycin : 1 g orally

Question 4

Gonorrhea
- yellowish discharge
- inflamed glands

Answer 4

3rd gen cephalosporin
a. oral cefixime (suprax)
- 400 mg PO once
b. ceftriaxone (rocephin)
- 125-250 mg IM once

NOTE: after 24 hours treatment, gonorrhea is no longer infectious

Question 5

Herpes Genitals
- pin point vesicles
- flu - like symptoms
- 3-14 days incubation period

Answer 5

a. ELISA
b. Pap smear

c. acyclovir: inhibits replication
d. imiquimod

e. foscarnet (foscavir): resistant lesions

f. valacyclovir (valtrex): limit disease spread

g. sitz bath
h. condoms
i. Pap test

note: associated with cervical cancer

Question 6

Papilloma Infection
- warts
- bumps on vulva

Answer 6

a. Histological evaluation biopsy of specimen (most definite)

removal of warts
a. podophyllin (podofin)
- small lesions
b. laser therapy, cryocautery, knife excision
- large lesions

administer vaccine
a. Gardasil
- teenage girls (3 doses)

Question 7

Trichomoniasis
- frosty white or grayish - green vaginal discharge
- reddened upper vagina

Answer 7

a. metronidazole (anti-fungal)

Question 8

Syphillis
- primary: chancre
- secondary: rashes, malaise, fever
- latent: asymptomatic
- tertiary: gamma form.

Answer 8

a. VDRL
- done in 1st prenatal visit
- repeated at 8th month of pregnancy if exposure is concern

b. pregnant
a. benzathine penicillin G
b. procaine penicillin
- 750 mg daily x 10 days

if allergic to penG
a. erythromycin
- 500 mg, 4x a day x 14 days
b. azithromycin
- 500 mg, daily x 10 days

Question 9

HIV / AIDS
- initial: mononucleosis
- seroconversion: hiv antibodies, 6 weeks - 1 yr
- asymptomatic: weight loss & fatigue (3-11 years)
- symptomatic: opportunistic infections

Answer 9

a. ELISA
b. Western blot analysis
- confirmation
c. acyclovir: antiretroviral therapy

Question 10

Nursing Management STI’s

Answer 10

a. Primary
- education and identification

b. Secondary
- directed towards prevention and complications of disease or infection

c. Tertiary
- supporting and counseling infected persons to receive treatment to prevent complications