STIs

Question 1

Most Common STIs in women

Answer 1

Chlamydia
Gonorrhea
Human papillomarvirus
Herpes Simplex Virus type 2
Syphilis
HIV infection

Question 2

Primary Prevention

Answer 2

Primary prevention the most effective way of reducing STIs in women

Question 3

Secondary Prevention

Answer 3

Prompt diagnosis and treatment can prevent personal complications and transmission to others

Question 4

Primary Prevention

Risk Reductions

Answer 4

Measures
Physical barriers
* Condoms

Communication
* Expressing feelings and fears
* Attention to partner’s response

Vaccination
PrEP

Question 5

Prevention

Answer 5

Risk reduction measures
Knowledge of partner
Reduction of the # of partners
Low Risk sex
Avoiding exchange in body fluids
Immune

Question 6

Care Management

Answer 6

Expected outcomes of care
* focus on physical and psychological needs with emphasis on avoidance of reinfection and harmful sequelae

Plan of care and interventions
* Management during pregnancy
* Infection control
* Health Promotion: Lifestyle management

Question 7

HPV Vaccine

Answer 7

Dose schedule: Gardasil-9
* Two dose series: all boys/girls ages 11 and 12
* Three dose series: all boys/girls ages 15 and over
* CDC rec vaccine for boys and girls age 11-12 (9-45yrs)

Facts:
The younger the vaccine is given, the better the immunity

Side effect: Fainting: pts sits for 15 mintues after (major); pain at injection site

How to improve rates: Provider recc, bundle w/ all school vaccine

Question 8

PrEP

Answer 8

Pre-Exposure Prophylaxis: taken to prevent acquiring HIV
Highly effective: Reduces 99% from sex and 74% from injections
Prescribed
HIV and Kidney test prior to taking
Safer than condoms but does not prevent other STIs

Question 9

Health Promotion: Prevention

Answer 9

Mutual monogamy (one sex partner)
Reduced number of sex partner
Condoms
Get tested !!!

Question 10

Bacterial Sexually Transimitted Infections

Chlamydia

Chlamydia trachomatis

Answer 10

Women: Cerivcal os
Men: urethal os
Most common and fastest STI
* Infection often silent and high destructive
* Diff to diagnosis

Screening and diagnosis
* Asymptomatic and pregnant women
* Comparsion of diagnostic procedures

Age 15-21 at highest risk
Incubation id 10-30 dys (may grow b/4 having s/s)
S/S
* Mucopurulent Discharged
* BTB or post coital bleeding
* Friable cervis (thin tissue)
* Suprapubic tenderness
* S/S UTI
* S/S PID

Question 11

Chalmydia + Gonorrhea

Answer 11

Left untreated can turn into PID

Question 12

Bacterial Sexually Transimitted Infection

Gonorrhea

Answer 12

Aerobic gram-neg diplococus
Oldest communicable disease
Second to chlamydia
Women often asymptomatic

Screening and diagnosis
* CDC recommended screening all women at risk
* Testing during 1st trimester and at 36 wk of preg
* Reportable disease

Managment
* Antibiotic therapy (shot)
* Concomitant treatment for chlamydia

Question 13

Bacterial

Syphilis

Answer 13

“SNAKE”
Earliest described STI
Transmission by entry in sub tissue through micro abrasions that occurs during intercourse
Also transmitted through kissing, bitting, or oral
Transplacental transmitted may occur
Can lead to serious systemic disease and even death
* Primary: 5-90 dys after exposure (pt have crackers- large lesions in reproductive tract, flu like symptoms)
* Secondary: 6 wks-6 mos (Rash palm/sole of feet( also disappears)
* Tertiary: Develops in 1/3 of the women infected ( not curable after this )

Screening and Diagnosis
* Preg women: twice in preg screen first and third trimester
* Serologic tests ( RPR/VDRL - correlates with disease activity, usually decreases with treatment; may be reactive life)
* False postive

Managment
* Penicillin (IM 1/2) (IV 3)
* Sexual abstinence during treatment

Question 14

Bacterial

Pelvis Inflammatory Disease

Answer 14

An infectious process that most commonly involves the fallopian tubes, uterus, and occasionally the ovaries and peritoneal surfaces

Increases risk of
* Ectopic preg
* Infertility
* Chronic Pelvic Pain

Screening and diagnosis
CDC, History

S/S
1. Fever (onset) abx
2. Generalized pelvic pain
3. On exam: jump of the table pain, cervical motion tenderness

Question 15

Viral Sex Trans Infections

Human Papilomavirus (HPV)

Answer 15

“Gential or Venereal Warts”
More freq in women
Symptoms
Painless, wart-like bumps in gential regions
* Flat, inverted, soft, pale, pink or flesh colored

Some types subclinical
May be small or large
Singular or coalesced (grouped)

Screening/Dx
* History
* Physcial inspection
* Pap smear

Managment
* Removal
* Meds
* Vaccinate before sex !!!!

Question 16

Herpes Simplex Virus (HSV)

Answer 16

Herpes simplex virus (HSV-1)
* Transmitted nonsexually

Herpes simplex virus (HSV-2)
* Transmitted sexually

intitial infection characterized by multi painful lesions, fever, chills, malaise, and severe dysuria

Maternal infections with HSV-2 can have adverse effects on bby
Neonatal Herpes must have C/S

For LIFFFEEEE !!!

Question 17

Viral Hep B Virus

Answer 17

Most threatening to the fetus and neoante
Disease of the liver and often a silent infection
Transmitted parentally, perinataly, and orally (rare)
Vaccine

Question 18

Human Immunodeficiency Virus (HIV)

Answer 18

Heterosexual transmission most common
Transmission of HIV occurs primarily through body fluids

Screening/Dx
* Antibody testing
* Detection

Counseling for HIV testing
* HIV testing offered early in preg
* Perinatal transmission decrease if treated

HIV and preg: transimission rates depends on viral load
Perinatal trans has decreased due to antiretroviral therapy
(ART (triple drug antiretroviral therapy or HAART (highly active antiretroviral therapy (decreases mother-to-child transmission))

Pregnancy: crosses the placenta and breast milk (no breastfeeding)

Cesarean section recommended for high viral load (>1000 copies/mL); vaginal delivery for low viral load

Infants of HIV mothers receive oral zidovudine for 6 weeks after birth

Question 19

PrEP Meds

Answer 19

Truvada and Descovy
Reduces the risk of contracting HIV from sex 99%
And by injection 74%
**Side effects: **
Diarrhea, N/V, Ha, Fatigue