Sexually Transmitted Infection Flashcards by Angela Tiu

Causative organism for syphilis

Treponema pallidum

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Incubation period for syphilis

10 to 90 days, average of 21 days

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What is the diagnostic test of choice for STIs such as chlamydia, gonorrhoea and trichomoniasis?

Nucleic acid amplification test (NAAT)

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Antibiotic of choice for chlamydia if not contraindicated

Doxycycline twice a day for 7 days

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Considering its side effects, what is an important patient teaching to provide when patients are taking doxycycline?

Patient should avoid prolonged exposure to sunlight

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First line treatment for patients with diagnosed gonorrhoea

high dose IM ceftriaxone

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What are the characteristic symptoms of trichomoniasis in women?

Yellow-green, foul-smelling discharge
Cervix can have a “strawberry” appearance

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Drug of choice for trichomoniasis

metronidazole (Flagyl)

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What are the two strains of genital herpes and what is the difference between the two?

Herpes simplex virus type 1 is more common “above the waste” usually associated with oral lesions.

Herpes simplex virus type 2 is more associated with disease affecting the genital and anal area

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This is the spread of infection to areas outside of the genital when the active lesions are touched or scratched.

Autoinoculation

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What are some conditions that might trigger reactivation of genital herpes (and should be avoided by the patient)?

Stress
Fatigue
Sunburn
Illness
Trauma at the site of infection

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What would be the management for a pregnant woman who has an HSV infection and active genital lesion at the time of delivery?

Prepare for caesarean delivery

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What is the cure for herpes simplex virus infection?

There is no cure. Antiviral treatment are only used to reduce the duration of ulcers and reduce the risk of transmission.

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What medications can be given for patients with herpes simplex virus infection?

Anti-viral medications such as acyclovir, famciclovir, valaciclovir

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Causative agent for genital warts or condyloma acuminata

Human papilloma virus

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What is a recommended preventative measure for human papilloma virus?

HPV vaccine given in 2 or 3 IM doses over a 6-month period

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True or False: HPV vaccines should only be given to females

False. The CDC recommends that all children, male and female, be vaccinated at age 11 to 12or even as early as 9.

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What is the primary goal of treatment for HPV?

Removal of symptomatic warts

What is a common treatment for the removal of genital warts?

Use of trichloroacetic acid or bichloroacetic acid applied directly to the wart surface

This is a painless, indurated lesion that occurs 10-90 days after inoculation with syphilis, appearing in the primary stage

Chancre

These are chronic destructive lesions affecting any organ of the body, especially skin, bone, liver, and mucous membranes

Gummas, appearing during the late stage of syphilis

What are characteristic manifestations during the secondary stage of syphilis?

Flu-like symptoms such as malaise, fever, sore throat
Mucus patches in mouth, tongue or cervix

Symmetric, non-pruritic rash appear on bilaterally on trunk, palms, and or soles

Condyloma lata or moist weeping warts appear in the anogenital area

Progressive locomotor ataxia that occurs as a complication of syphilis

Tabes dorsalis

Between VDRL and FTA-Abs, which one is a better diagnostic test for syphilis?

Fluorescent treponemal antibody absorption test (FTA-Abs) test is a more specific test which detects antibodies for syphilis.

Venereal disease research laboratory (VDRL) test detect antibodies that are not specific for syphilis so it is possible to have false positive and false negative result.

If a patient has syphilis, the CDC also recommends screening diagnosed patients for which STI?

HIV

What is the drug of choice for syphilis?

Penicillin G benzathine is the recommended treatment for all stages, if not contraindicated

How can the nurse perform proper assessment to gather the history of a patient with STI? Remember, mind your P’s and Q’s:

Privacy: interview patients alone, without parents or partners Place: provide a safe, quiet space to encourage honest discussion Queer: Be sensitive to gender identity and sexual preferences; start by asking patients how they identify etiQuette: Conduct the interview with respect, compassion, and a non-judgmental attitude

Name some health teaching that can be provided for patients with STI. Remember to be in love!

Inspection: teach patient signs and symptoms and to take notice of partner’s genitalia before sex Mechanical barriers: Proper condom use Identify and Interview: finding and examining all sexual contacts of patients with reportable STI so that they receive treatment No drugs and alcohol Limits: be comfortable saying no; limit number of sexual partners One and only: have sex in an established monogamous relationship Vaccination against HPV Examine: regular testing for self and partners if sexually active and at risk

Name common modes of transmission of HIV:

Unprotected sexual contact – most common Exposure to blood when sharing drug-using paraphernalia Work-related HIV transmission from needle-stick injury Perinatal transmission

HIV targets which part of the body?

Immune system, specifically CD4 T-cell

An enzyme that allows HIV DNA to enter the genetic structure of the host

Integrase

At what level of CD4 T-cells do immune problems begin to occur in patients with HIV?

Below 500 CD4 cells/microlitre

What is the main cause of disease, disability, and death in patients with HIV infection?

Opportunistic disease/infection

What is the length of the window period where a person infected with HIV may have a negative result in a diagnostic test?

3 weeks

What is the normal value of the CD4 T-cell count

500 to 1600 cells/L

Normal CD4 to CD8 ratio?

2:1

True or False: When the patient’s viral load is so low and cannot be traced, they are not able to transmit the disease?

True: Remember U=U, untraceable = untransmissible

This is a widely used laboratory test for detecting antibodies in HIV. It is often the first test ordered to screen for HIV detection

ELISA (Enzyme-linked Immunosorbent Assay)

This is a confirmatory test used to verify the results of an ELISA test

Western Blot test

What is the classification and mechanism of action of the HIV drug fostemsavir?

Attachment inhibitor, blocks the initial step of viral entry when it prevents the HIV virus from attaching to the CD4 receptor on the surface of the host cell

Which of the following drugs prevents the fusion of the viral envelop with the host cell membrane thus blocking the virus from entering the cell? Enfuvirtide Bictegravir Atazanavir Efavirenz

Enfuvirtide, which is an entry or fusion inhibitor

Which drug prevents HIV from incorporating its genetic material into the host cell? Enfuvirtide Bictegravir Atazanavir Efavirenz

Bictegravir

This is a prevention method where people who no not have HIV take HIV medicine to reduce their risk for acquiring HIV.

Pre-exposure prophylaxis (PrEP)

This is a prevention method where combination HIV ART is given to someone within 2 hours after a potential exposure to HIV to reduce risk of infection.

Nonoccupational post-exposure prophylaxis (nPEP)