STDs & Vagina Infections

Question 1

Most Common STD in the U.S; most prevalent in adolescents

Answer 1

Chlamydia

Question 2

Chlamydia CM’s

Answer 2

Inflammation of cervix with mucopurlent discharge
Maybe asymptomatic
Untreated may lead to urethritis, tubal occlusion, PID, and infertility

Question 3

Chlamydia Screening

Answer 3

Scree 1st Trimester
Test for gonorrhea
By culture or DNA probe, or enzyme immunoassay. CDC recommends, nuclelcacid amplification test (NAAT) or urinary, vagina, or endocervical areas.
Retest 3rd trimester if multiple sex partners or younger than 25 years old

Question 4

Neisseria Gonorrhea: an aerobic gram-negative diplococcus

Answer 4

Gonorrhea

Question 5

Gonorrhea CM’s

Answer 5

Often asymptomatic
Complaint of mucoid or mucopurulent bag/endocervical discharge
Dysuria and swollen, reddened labia
Pelvic lower or rectal pain
Vulvovaginal inflammation progresses to yellow-green vagina discharge
May ascend to involve pelvic structures… PID.

Question 6

Gonorrhea Screening

Answer 6

Gram stain culture of endocervical, vagina, rectum, and possibly pharynx. Chlamydia culture and serologic test for syphilis. Screened @ 1st prenatal visit, at risk clients screened again @ 3rd trimester (36 weeks)

Question 7

Treponema Pallidum (Spirochele)

Answer 7

Syphilis

Question 8

Syphilis CM’s

Answer 8

Primary stage: ulcer (chancre) Condyloma - warts maybe present on vulva, perineum or anus. (Flatter than HPV genital warts)

Secondary stage: Maculopapular rash can be on hands and soles of. feet can go from secondary –> tertiary with varying characteristics

Question 9

Syphilis Screening

Answer 9

Screened @ 1st prenatal visit VDRI or RPR serology and again in 3rd trimester and at the time of birth if they are high risk

Question 10

Herpes Simplex Virus Type 2 (HSV) CM

Answer 10

lesions: pain, red papules: pustular vesicles that break and form wet ulcers that later crust
low grade fever, chills, malaise, and severe dysuria
Dyspaleunia (pain during intercourse)

Question 11

HSV Screening

Answer 11

History and exam for lesions
new cases by culture for active lesions
Multinucleate giant cells in microscopic exam of lesions exudates

Question 12

Human Papilloma Virus (HPV) CMs

Answer 12

Condyloma acuminate (genital warts) that spread, enlarged during pregnancy (small soft papallicolaou) in genital and anorectal region.

Question 13

HPV Screening

Answer 13

Speculum exam
Pap test (papallicolaou)
History and SNS

Question 14

Bacterial Vaginosis CMs

Answer 14

Vagina discharge: thin grayish with fish-like odor

Question 15

Bacterial Vaginosis Screening

Answer 15

Wet-mount slide positive for clue cells

Question 16

Gardnerella CM

Answer 16

Intense Pruritus

Question 17

Candida Albican (Yeast Infection)

Answer 17

Candidiasis

Question 18

Candidiasis CM

Answer 18

Thick, white, pruritic vagina discharge common in pregnant r/t changes in vagina with antibiotic tx and with DM or HIV infection.

Question 19

Candidiasis Screening

Answer 19

Wet-mount slide

Question 20

Protoxoan =

Answer 20

Trichomoniasis

Question 21

Trichomoniasis CM

Answer 21

Frothy, odorous vaginal discharge

Question 22

Trichomoniasis Screening

Answer 22

Flagellated trichomonads
Visible on microscopic exam of wet-mount slide

Question 23

Group B Streptococcus CM

Answer 23

Asymptomatic
UTI

Question 24

Group B Strep Screening

Answer 24

@ 35-58 weeks gestation is recommended for all pregnant women

Question 25

Virus transmitted through blood, saliva, vagina secretions, semen, and breast milk

Answer 25

Hepatitis B

Question 26

Hep B CM

Answer 26

Jaundice
Fever
Painful Joints

Question 27

Hep B Screening

Answer 27

HBsAG test detects acute and chronic infection
IgM antibodies to Hep B detects acute and chronic infection
Identify @ prenatal screening
Screened again 3rd trimester to all TX during delivery and of neonate at birth

Question 28

Screenings for STDs:

Answer 28

1. All women should be screened HIV, Hep B, Syphilis, Chlamydia and Gonorrhea 1st trimester ( and how: ACoG recommends Hep C.)
2. women at risk (multiple sex partners; drug abuse) prescreened 3rd trimester
3. Hep c included for patients at risk