Sexually Transmitted Diseases Flashcards

1
Q

What is the purpose of screening for BV?

A

Over growth of bacteria however should not be screening routinely

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2
Q

Why and how would you screen for BV?

A

May notice discharge, an odour or fishy smell.
With Vaginal swab

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3
Q

What are the implications of untreated BV?

A

Preterm and low birth weight baby

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4
Q

What is the treatment for BV?

A

Metronidazole 400mg BD for 7 days.
It can be given as STAT dose (2g) if pregnancy at TERM, refrain from breast feeding if 2g prescribed for 12 - 24hours. Express but discard EBM as it has a bitter/metallic taste and high transfer rate to baby.

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5
Q

Is prescribing for BV in a midwifes scope?

A

No - treatment must be prescribed by obstetric team in pregnancy

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6
Q

What advice would you give to prevent thrush?

A

Hygiene, wipe from front to back, cotton underwear, showers, no douching

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7
Q

As a midwife, what is the management for symptoms of thrush?

A

Take a swab or if discharge suggest thrush can start treatment.

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8
Q

What is the recommended treatment for thrush in pregnant woman?

A

Clotrimazole 1% Cream for 6 days or Miconazole 2% cream (Micreme) for 7 days

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9
Q

Do you refer for thrush in pregnancy?

A

No - only if not responding to treatment that refer to GP/Obstetric team

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10
Q

What is the recommended treatment option for a positive swab result for gonorrhoea and who decides the treatment plan?

A
  • Recommended injection of ceftriaxone 500mg and state dose of azithromycin 1g
  • Decision is made by specalist/obstetric team
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11
Q

Do you need to refer for positive result of gonorrhoea?

A

Yes to specialist / obstetric team

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12
Q

How can gonorrhoea harm the baby?

A

Untreated gonorrhoea can cause preterm birth and low birth weight
Gonorrhoea can also be passed onto the neonate and presents as conjunctivitis

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13
Q

What are some symptoms of gonorrhoea

A

Often asymptomatic
Vaginal discharge
Bleeding between periods
Lower abdominal pain
Pain during sex
Pain when weeing (urinating)
Discharge from the penis or rectum

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14
Q

What is the most commonly reported STI in NZ?

A

Chlamydia

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15
Q

What are the signs and symptoms of chlamydia?

A

Painful urination, vaginal discharge in women,
pain during sex.

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16
Q

What do you advise to your client around risk factor of chlamydia to pregnancy and her baby?

A

Chlamydia can be passed from mother to baby during birth, the baby may subsequently develop eye and or ear infections or pneumonia
Untreated chlamydia can also cause infertility

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17
Q

When should you screen for chlamydia?

A

If they have a previous history of chlamydia
If they have symptoms of chlamydia

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18
Q

What is the test for chlamydia and how is it taken?

A

Self collect Chlamydia NAAT swab - NAAT detects the genetic material (DNA or RNA) of Chlamydia trachomatis

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19
Q

What is the treatment for chlamydia in pregnancy?

A

Azithromycin 1g STAT can be used in pregnancy
No harm to baby
Use condoms for 7 days

20
Q

Is treating chlamydia within the midwifery scope?

A

Yes

21
Q

What is the management for a baby that presents with red and weepy eyes

A

Swab. If swab result not available, clean with saline, refer to neonatal team as requires antibiotics

22
Q

What swab would you use to test a baby for chlamydia

A

NAAT swab for Chlamydia

23
Q

What is the recommended treatment for a neonate with a positive swab for chlamydia

A

Erythromycin or Azithromycin syrup – decided by neonatal team.

24
Q

Do you refer for positive chlamydia in the neonate?

A

Yes to the neonatal team as it can lead to pneumonia

25
Q

If a pregnant woman says her partner has been diagnosed with syphilis what management will you take

A

Ask when was he diagnosed
Has she had a test, if so what were the results
If not had a test offer one as a part of routine antenatal screening
Ask about symptoms

26
Q

What are the symptoms of syphilis?

A

Chancre on genitals. mouth or anus, rash, swollen lymph glands, headaches, muscle aches.

27
Q

What is the screening for syphilis?

A

A part of routine antenatal blood test screening - EIA (enzyme immunoassay)

28
Q

What is the management for a “reactive” syphilis screening result?

A

All reactive EIA tests will be reflex-tested with a second treponemal test (TPPA - Treponema pallidum particle agglutination) and a non-treponemal test (RPR - Rapid Plasma Reagin). If the TPPA is also reactive then current or past syphilis infection is confirmed.

29
Q

What is the management and treatment of syphilis infection?

A

Referral guidelines 1047 for urgent consultation with obstetric team/specialist.
Treatment started asap as decided by team referred to
Retest offered at 28 - 32 weeks or anytime woman request

30
Q

What are the treatment options for genital warts / HPV

A

creams, laser, cryotherapy (may not always be treated in pregnancy) – Generally may get better on their own so may not be treated

31
Q

Will HPV harm the baby?

A

Generally no but can have warts on vocal cords/mouth several weeks after birth

32
Q

What advice do you give to a woman with HPV around risk factor to pregnancy and her?

A

Genital warts do not affect pregnancy - some cases complications can arise – large warts may affect urination or cause bleeding, warts on vaginal wall can affect stretching

33
Q

What is the recommended treatment option for HPV?

A

No cure but treatment to make them less visible with creams, solutions and sometimes cryotherapy

34
Q

Do you need to refer for HPV and if so who do you refer to?

A

Yes - to a specialist

35
Q

How is diagnosis made of HPV?

A

Via speculum, genital, and perineal examination looking for warts

36
Q

What are the symptoms of trichomonas

A

Greeny, frothy, watery discharge – fishy odour.

37
Q

What advice do you give a woman around risk factor to pregnancy and her?

A

Can be recurrent
Can be mother to child transmission no significant effect, Can also have Chlamydia infection
Can lead to pre-term birth and Premature rupture of membranes
Untreated increases risk of infertility and and getting infected with HIV easier

38
Q

What is the recommended treatment for trichomonad?

A

Metronidazole 400mg BD for 7 days.
Can be given as STAT dose (2g) if pregnancy at TERM. Refrain from breast feeding if 2g prescribed for 12-24hours, express but discard EBM as bitter/metallic taste and higher transfer rate to baby

39
Q

Do you need to refer for trichomonas?

A

Yes - to a specalist

40
Q

What STI can midwives prescribe for?

A

Chlamydia

41
Q

What STIs are treated with Azithromycin 1g Stat

A

Chlamydia and gonorrhea

42
Q

What STIs are treated with metronidazole 2g PO stat or 400mg PO BD 7/7 days

A

Bacterial vaginosis and trichomonas

43
Q

The USUAL cause of genital herpes is:

A

Herpes simplex virus 2.

44
Q

Trichomonas vaginalis is what type of infection:

A

Protozoan

45
Q

Which is the most common STI caused by a bacteria?

A

Chlamydia

46
Q

On day 2 postnatal visit you notice baby Tara has pussy eyes. You:

A

Offer Tara’s mum a consultation with a neonatologist.

47
Q

Chancre due to syphilis is found in the:

A

anus, mouth and cervix