Vaginitis Differentiation

Question 1

What is the symptom presentation in Trichomoniasis? (3 items)

Answer 1

discharge, itch, 50% asymptomatic

Question 2

What is the description of the vaginal discharge in Trichomoniasis? (3 items)

Answer 2

Frothy, gray or yellow-green; malodorous

Question 3

What are the clinical findings in Trichomoniasis? (2 items)

Answer 3

Cervical petechiae “strawberry cervix” and “whiff” test is often positive

Question 4

What is the pH that is often found in Trichomoniasis?

Answer 4

> 4.5

Question 5

What is found on a Trichomoniasis positive NaCl Wet Mount? (2 items)

Answer 5

Motile flagellated protozoa and many WBCs

Question 6

What is the typical symptom presentation in Candidiasis? (4 items)

Answer 6

Itch, discomfort, dysuria and thick discharge

Question 7

What are the clinical findings in Candidiasis? (2 items)

Answer 7

Inflammation and erythema

Question 8

What is the typical pH seen in Candidiasis?

Answer 8

usually < 4.5

Question 9

What is seen on a NaCl Wet Mount in Candidiasis?

Answer 9

Few WBCs

Question 10

What is seen on a KOH Wet Mount in Candidiasis?

Answer 10

Pseudohyphae

Question 11

What is the symptom presentation in Bacterial Vaginosis? (3 items)

Answer 11

Odor, discharge, itch

Question 12

How is the discharge described in Bacterial Vaginosis?

Answer 12

Homogenous adherent, thin, milky white; malodorous “foul fishy”

Question 13

What is the typical pH found in Bacterial Vaginosis?

Answer 13

> 4.5

Question 14

What is the results to the KOH “whiff” test in Bacterial Vaginosis?

Answer 14

positive

Question 15

What is seen on a NaCl Wet Mount when the patient has Bacterial Vaginosis? (2 items)

Answer 15

Clue cells (>20%) and no or few WBCs

Question 16

What are the initial treatment options for Herpes Simplex Virus? (4 options)

Answer 16

1- acyclovir 400mg TID x 7-10 days
2- acyclovir 200mg 5x daily for 7-10 days
3- Famciclovir 250mg TID x 7-10 days
4- Valacyclovir 1g BID x 7-10 days

Question 17

What is the episodic therapy for recurrent HSV? (4 items)

Answer 17

1- Acyclovir 400mg TID for 5 days
2- Acyclovir 800mg BID for 5 days
3- Valacyclovir 500mg BID x 3 days
4- Valacyclovir 1 g daily for 5 days

Question 18

What is the treatment of choice for clients with syphilis, syphilis in pregnancy and congenital syphilis?

Answer 18

2.4 million units of Benzathine PCN G

Question 19

If there is a suspected or culture proven chancroid what is the treatment of choice? (3 options)

Answer 19

1- 1 g of azithromycin x 1
2- Ceftriaxone 250mg IM x 1
3- Ciprofloxacin 500mg BID x 3 days
4- Erythromycin 500mg po TID x 7 days

Question 20

What are the high risk types of HPV because of their cause of cervical cancer.

Answer 20

16 and 18

Question 21

What type of cells are found in patient who has HPV

Answer 21

squamous intraepithelial lesions

Question 22

What does a colposcopy with directed biopsy for HPV evaluation involve? (4 steps)

Answer 22

1- application of a 3-5% solution of acetic acid to the tissue of the vulva or cervix
2- after several seconds the affected tissue will turn white
3- the white tissue is then examined under magnification
4 directed biopsy is done on the most abnormal tissue

Question 23

What is the diagnostic test that is used to differentiate between low-risk and high-risk HPV types?

Answer 23

DNA: Nucleic Acid Hybridization

Question 24

Is BV considered a STI

Answer 24

no

Question 25

WHAT IS THE MOST PREVALENT FORM OF VAGINITIS AMONG WOMEN OF CHILDBEARING AGE?

Answer 25

Bacterial Vaginosis

Question 26

What is the treatment for bacterial vaginosis? (2 methods)

Answer 26

1- ORAL METRONIDAZOLE 500 MG BID FOR 7 DAYS OR GEL (0.75%) INTRAVAGINALLY ONCE FOR 5 DAYS 2- CLINDAMYCIN 300 MG BID X 7 DAYS OR 2% CREAM PER VAGINA HS X 7 NIGHTS

Question 27

What is the most common Candida species?

Answer 27

ALBICANS

Question 28

What is the treatment of trichomoniasis?

Answer 28

1- METRONIDAZOLE 2 GMS PO X1 FOR ALL PARTNERS | IF NEED TO RETREAT 500 MG BID X 7 DAYS

Question 29

What is chlamydial infections associated with? (6 items)

Answer 29

``` 1- URETHRITIS 2- ACUTE URETHRAL SYNDROME 3- SALPINGITIS 4- PID 5- INFERTILITY 6- PERIHEPATITIS ```

Question 30

WHAT IS THE TREATMENT MANAGEMENT FOR CHLAMYDIAL INFECTIONS WITH UNCOMPLICATED URETHRAL, ENDOCERVICALN AND RECTAL INFECTIONS? (2 METHODS)

Answer 30

AZITHROMYCIN 1 G X 1 OR | DOXYCYLCINE 100 MG BID X 7 D

Question 31

WHAT IS THE TREATMENT MANAGEMENT FOR CHLAMYDIAL INFECTIONS DURING PREGNANCY?

Answer 31

ERTHROMYCIN 500 MG PO QID X 7 D

Question 32

WHAT IS THE TREATMENT OR UNCOMPLICATED URETHRAL, ENDOCERVICAL, PHARYNGEAL OR RECTAL INFECTION OF GONORRHEA? (3 METHODS)

Answer 32

1- CEFTRIAXONE 250MG IM X1 2- CEFIXIME 400 MG PO X 1 3- AZITHROMYCIN 2 GM PO X1

Question 33

WHAT ARE THE SYMPTOMS OF HERPES?

Answer 33

``` 1- MULTIPLE PAINFUL VESICULAR LESIONS 2- FEVER 3- CHILLS 4- MALAISE AND SEVERE DYSURIA 5- LYMPHADENOPATHY ```

Question 34

SYMPTOMS OF HERPES PEAK IN ___ DAYS AND MAY LAST ___-___ WEEKS

Answer 34

5; 2-3

Question 35

WHAT IS THE DIAGNOSTIC TEST FOR HERPES AND WHEN IS THE BEST TIME TO OBTAIN THE SAMPLE?

Answer 35

CELL CULTURE AND PCR; DURING THE VESICULAR PHASE

Question 36

WHAT IS THE DIAGNOSTIC TEST FOR SYPHILIS (2 items)

Answer 36

VDRL OR RPR

Question 37

WHAT IS THE TERTIARY/LATENT TREATMENT FOR SYPHILIS?

Answer 37

2.4 M UNITS IM WEELY X3 WEEKS

Question 38

WHAT IS FOUND ON THE PHYSICAL EXAM OF SOMEONE WITH SYPHILIS?

Answer 38

ULCERATIVE LESION WITH NECROTIC BASE (MAY BE MULTIPLE)

Question 39

WHAT IS THE TREATMENT PLAN FOR PATIENTS WITH LOW RISK HPV VS THE TREATMENT PLAN FOR PATIENTS WITH HIGH RISK HPV?

Answer 39

LOW RISK: REPEAT IN 1 YR | HIGH RISK: REFER FOR COLPO

Question 40

WHAT ARE THE TREATMENT OPTIONS FOR EXTERNAL HPV? (5 OPTIONS)

Answer 40

``` 1- TRICHLORACETIC ACID 80-90% 2- LIQUID NITROGRN CRYOTHERAPY: 3- IMIQUIMOD 5% CREAM 4- PODOFILOX 0.5% 5- PODOPHYLLIN 10-25% ```

Question 41

Presentation of this disease: primary starts with chancre at site of bacterial entry, secondary is flu-like symptoms with a maculopapular rash on the palms and soles, and tertiary presents with cardiovascular, neurologic, dermatologic or bone disease.

Answer 41

sypilis

Question 42

_____ is characterized by a painful vesiopapule lesion

Answer 42

chancre

Question 43

Normally HPV lesions are painless but they can cause: (4 items)

Answer 43

1- malodorous vaginal discharge 2- pain and burning with urination 3- pruritis 4- bleeding during/after coitus

Question 44

Many person with hepatitis B may have no symptoms during infection and develop lifelong immunity, but if symptoms do present that can include: (8 items)

Answer 44

``` 1- fatigue 2- loss of appetite 3- dark urine 4- light-colored bowel movements 5- nausea/vomiting 6- diarrhea 7- malaise 8- myalgia ```

Question 45

SOMEONE WHO IS EXPOSED TO HIV THROUGH SEX OR INJECTION DRUG USE, CAN USE THESE MEDICATIONS TO KEEP THE VIRUS FROM ESTABLISHING A PERMANENT INFECTION: (2 FORMS)

Answer 45

``` 1- TRUVADA 2- PEP MUST BE STARTED AS SOON AS POSSIBLE TO BE EFFECTIVE—AND ALWAYS WITHIN 72 HOURS OF A POSSIBLE EXPOSURE ```