womens health & STD's

Question 1

trichomoniasis

Answer 1

STI vaginal infection
s/s: 
yellow/green, frothy discharge 
vaginal/cervix inflammation 
dysuria - difficult/painful urination
dyspareunia - pain/difficult sex

Question 2

tx trichomoniasis

Answer 2

flagyl

partner treatment important

Question 3

chlamydia

Answer 3

bacterial infection - most common STI in US
80% asymptomatic but thin purulent (pus containing) vaginal discharge, pelvic cramping, reddening eyes
- can result in pelvic inflammatory disease (PID) and infertility

Question 4

tx chlamydia

Answer 4

azithromycin, doxycycline, floxin

partner tx important

Question 5

gonorrhea

Answer 5

bacterial STI
usually asymptomatic but purulent discharge, dysuria, dyspareunia, white dry toungue
increase risk PID, infertility

Question 6

tx gonorrhea

Answer 6

a more resistant organism now
Ceftriaxone IM once = 1st line tx
partner tx
- reculture women to verify cured

Question 7

syphilis

Answer 7

bacterial STI - bacterium introduced genitally but carried through bloodstream to all parts of the body
- has early and late stages
s/s: initial chancre (primary lesion), splenomegaly (enlargement spleen), hepatomegaly, headache, skin rash on palms and soles, sores on tongue, penis, vag

3rd stage - multi-system complication

Question 8

tx syphilis

Answer 8

penicillin

Question 9

genital herpes: virus

Answer 9

HSV 1 = oral lesions, transmitted non-sexually
HSV 2 = genital lesions, transmitted sexually. can cause viremia (virus in the blood) during pregnancy and can pass to baby

• blisters at site of infection
  flu-like symptoms

Question 10

tx herpes

Answer 10

no cure
antiviral drugs suppress symptoms
- Zovirax, Famvir, Valtrex

Question 11

human papillomavirus

Answer 11

virus - spread through oral, anal, and genital sex
low, moderate, and high risk “types”
high risk - associated with cervical cancer
low risk - visible warts
- profuse, irritating vaginal discharge and itching, bleeding after sex, “bumps” = common complaint
highest risk age group: 15-24

Question 12

tx human papillomavirus

Answer 12

no cure

immune system may repress the virus

Question 13

HPV vaccine

Answer 13

Gardasil: quadrivalent vaccine
- blocks 4 types of HPV, helps decrease deaths of cervical cancer

Cervarix: bivalent vaccine

• best if administered prior to first intercourse
• blocks 2 types of HPV
• vaccine is a series of 3 injections
• use in people 9-26 years of age

Question 14

human immunodeficiency virus (HIV)

Answer 14

• once HIV enters bloodstream it takes 6-12 wks to seroconvert (neg. to pos. test in blood)
• presents like viremic, flu-like symptoms, fever, headache, night sweats, fatigue, nausea, diarrhea, weight loss
• higher risk: IV drug use, multiple partners, hx of STI

Question 15

tx HIV

Answer 15

antiretroviral therapy

- sooner the mom begins treatment then less likely to spread to newborn

Question 16

Pelvic inflammatory disease (PID)

Answer 16

• bacterial infection of upper genital tract (uterus, fallopian tubes, adnexal)
• fever, pelvic pain, cervical motion tenderness (CMT)
• usually caused by chlamydia or gonorrhea
• causes infertility, abnormal (ectopic) pregnant
• infection can spread by leaving fallopian tubes

Question 17

tx PID

Answer 17

broad spectrum antibiotics

Question 18

PID complications

Answer 18

I FACE PID
I - infertiility
F - fitz-huhg-curtis syndrome (perihepatic adhesions)
A - abscesses (swollen area body tissue)
C - chronic pelvic pain
E - ectopic pregnancy - fetus attaches outside the uterus
P - peritonitis (inflammation of abdomen cavity)
I - intestinal obstruction
D - disseminated: sepsis, endocarditis, arthritis, meningitis

Question 19

bacterial vaginosis

Answer 19

• not considered STI
• most prevalent in sexually active women
• overgrowth normal vaginal flora
• excessive, thin, water, white or gray discharge with foul “fishy” odor
• can lead to preterm labor and delivery

Question 20

tx bacterial vaginosis

Answer 20

Flagyl

Question 21

vulvovaginal candidiasis (yeast)

Answer 21

• most common form vaginitis
• not considered STI, but can be irritated by sex
• thick, curdish, vaginal discharge, severe itching, dysuria (pain/difficult urination)
• common during pregnancy
• can see it on tongue

Question 22

tx yeast infection

Answer 22

Miconazole

Question 23

STI Considerations

Answer 23

risk factors:
- younger than 25
- multiple sex partners
- prior history sti
- women twice likely as men to get sti
preventative steps:
- abstinence until active lesions have heals
- spermicide (substance killing spermatozoa) is NOT helpful
- late 3rd trimester testing for high risk pts
- c/s may be needed for prevention to newborn
- barrier methoss helpful