sexual health

Question 1

Cullen’s Sign

Answer 1

indicative for ectopic pregnancy, ecchymosis around umbilicus

Question 1

Primary concern with ectopic pregnancy

Answer 1

Tubule rupture leading to hemorrhage

Question 2

Primary concern with ectopic pregnancy

Answer 2

Tubule rupture with hemorrhage

Question 3

Extreme tenderness with cervical motion on bimanual exam in PID

Answer 3

Chandelier sign

Question 4

Gonorrhea

Answer 4

A very common cause of infertility among women. Asymptomatic in women, copious penile discharge in men.

Can cause gonococcal arthritis - monoarticular septic infection.

Grow organisms on Thayer-Martin or Transgrow media.

All pts. should also be treated for Chlamydia

Question 5

Syphilis

Answer 5

Moves through several stages:
Primary: within 7-10 days with local s/s
Secondary: 6-8 wks. Macular rash on bilateral palms and soles or arms/legs
Latent: May never come back or will as
Tertiary: Can affect any system

Question 6

Screening for syphilis

Answer 6

VDRL, RPR, STS

These are non-treponemal antibody tests

Question 7

Confirmatory test for syphilis

Answer 7

FTA-ABS

Question 8

Chlamydia

Answer 8

Most common bacterial STI in US

Question 9

Genital Warts

Answer 9

Most common STD overall, viral

Increases risk of cervical cancer in women (subtype 16 & 18)

Question 10

AIDS diagnosis

Answer 10

Pt with HIV virus who meets CDC criteria

Question 11

Methods of HIV transmission

Answer 11

Sexual
Parenteral
Vertical- mother to fetus

Question 12

HIV lab studies

Answer 12

ELISA for screening
Western Blot for confirmation

-ELISA = -HIV
+ELISA & -WB = -HIV
+ELISA & +WB = +HIV
+ELISA & indeterminate WB = ?HIV (need more time to determine)

Question 13

CD4 counts

Answer 13

Normal is 800-1100

<350 prophylaxis for infections with Bactrim is indicated

Question 14

Viral load in HIV

Answer 14

Measures actual viral replication

Goal of therapy is undetectable viral load (<5000)

Question 15

Management of HIV/AIDS

Answer 15

Antiretroviral treatment for any pt with:
AIDS defining illness, HIV-associated nephropathy, co-infection with HBV when treatment is warranted, or pregnancy

Any pt. with CD4 count <350 regardless of s/s

Question 16

Triad for Pelvic Inflammatory disease

Answer 16

Lower abdominal pain
cervical wall motion tenderness
Adnexal tenderness (appendages or secondary structures of uterus)

Question 17

Prophylactic therapy for a pt. with CD4 count of < 350

Answer 17

Bactrim DS 1 tab 3x/week