NUR 684- Test #1
Normal vaginal secretions- characteristics - answer-Clear/cloudy/white
-Thin/mucoid
-Nonirritating
Leukorrhea (define) - answerAn increase in the amount of vaginal secretions; can be
thin or thick, white discharge resulting from congestion of the vaginal mucosa and an
increase in polymorphonuclear leukocytes (WBCs)
^may be a normal finding!
Most common STI in the USA? – answer HPV
HPV- difference between types - answer Types 6 & 11- common with genital warts
Types 16, 18, 31, 33, 35- associated with cervical dysplasia/cancer
^16 & 18 cause 70% of cervical cancer
Condyloma acuminata- symptoms/exam findings - answer-Single or multiple soft,
fleshy, keratinized growths around vulvovaginal area, anus, or penis
-Painless
Condyloma acuminata- diagnostic tests - answerDiagnosis usually based on clinical
presentation!
-Consider VDRL/RPR to exclude syphilis
-Biopsy only if atypical characteristics or no response to standard therapy
Condyloma acuminata- complications - answer-Cervical dysplasia/cancer with certain
HPV serotypes
-Transmission to infant during vaginal delivery
Condyloma acuminata- treatment (clinician-administered) - answer-Cryotherapy with
liquid nitrogen or cryoprobe Q 1-2 weeks
-Trichloroacetic acid or bichloracetic acid
-Surgical removal
Condyloma acuminata- treatment (patient-administered) - answer-Podofilox 0.5%
solution/gel
-Imiquimod 3.75% or 5% cream
-Sinecatechins 15% ointment
,Molluscum contagiosum- symptoms/exam findings - answer-1-5 mm smooth, round,
firm, shiny, flesh colored to pearly white papules with central umbilication
-Usually on trunk or anogenital areas
-White cheesy material expressed from papule
-Painless
Molluscum contagiosum- diagnostic tests - answerDiagnosis based on clinical
presentation!
Molluscum contagiosum- complications - answer-Secondary infection
Genital herpes- symptoms (primary episode) - answer-Painful, pruritic multiple vesicles
-Dysuria, dyspareunia, watery vaginal discharge
-Systemic symptoms (fever, HA, chills, malaise)
^duration 2-3 weeks
Genital herpes- symptoms (recurrent episodes) - answer-Prodrome often precedes
eruption for 24 hours (itching, burning, tingling)
-Less severe symptoms of shorter duration
-No systemic symptoms
Genital herpes- diagnostic tests - answer-Clinical presentation with initial outbreak
-HSV tissue culture or PCR test of lesions for confirmation
-Serological type specific tests for HSV-1 and HSV-2 antibodies (several weeks after
exposure)
Genital herpes- complications - answer-Increased pregnancy loss & preterm labor of
initially infected during pregnancy
-Transmission to infant if active lesions at time of delivery
-Secondary infection of lesions, urethral strictures
Genital herpes- treatment - answer**Acyclovir 400 mg PO TID for 7-10 days**
-OR
-Famciclovir 250 mg PO TID for 7-10 days
-OR-
-Valacyclovir 1 gm PO BID for 7-10 days
Chlamydia- symptoms - answerFemales:
-dysuria
-vaginal discharge
-abnormal bleeding/postcoital spotting
-PID symptoms
Males:
, -dysuria
-urethral discharge
Chlamydia- exam findings - answerFemales:
-mucopurulent cervical discharge (yellow or green)
-endocervical friability
-cervical inflammation
Males:
-mucoid to purulent urethral discharge
Chlamydia- diagnostic tests - answer-Nucleic acid amplification test (NAAT)
Chlamydia- treatment - answer**Azithromycin 1 gm PO**
-OR-
-Doxycycline 100 mg PO BID for 7 days
Chlamydia- complications - answer-PID
-Infertility
-Ectopic pregnancy
Gonorrhea- symptoms - answerFemales:
-vaginal discharge
-dysuria
-PID symptoms
Males:
-urethral discharge
-dysuria
Gonorrhea- exam findings - answerFemales:
-mucopurulent cervical discharge
-endocervical friability
-urethral, Skene's gland, or Bartholin gland discharge
Males:
-purulent urethral discharge
Gonorrhea- diagnostic tests - answer-Nucleic acid amplification test (NAAT)
-Gram stain of discharge to look for gram negative diplococci
-Culture with antimicrobial sensitivity testing if suspect treatment failure (w/ male
urethral sample!)
Gonorrhea- treatment - answer**Ceftriaxone 250 mg IM -OR- 400 mg PO**
-OR-
Normal vaginal secretions- characteristics - answer-Clear/cloudy/white
-Thin/mucoid
-Nonirritating
Leukorrhea (define) - answerAn increase in the amount of vaginal secretions; can be
thin or thick, white discharge resulting from congestion of the vaginal mucosa and an
increase in polymorphonuclear leukocytes (WBCs)
^may be a normal finding!
Most common STI in the USA? – answer HPV
HPV- difference between types - answer Types 6 & 11- common with genital warts
Types 16, 18, 31, 33, 35- associated with cervical dysplasia/cancer
^16 & 18 cause 70% of cervical cancer
Condyloma acuminata- symptoms/exam findings - answer-Single or multiple soft,
fleshy, keratinized growths around vulvovaginal area, anus, or penis
-Painless
Condyloma acuminata- diagnostic tests - answerDiagnosis usually based on clinical
presentation!
-Consider VDRL/RPR to exclude syphilis
-Biopsy only if atypical characteristics or no response to standard therapy
Condyloma acuminata- complications - answer-Cervical dysplasia/cancer with certain
HPV serotypes
-Transmission to infant during vaginal delivery
Condyloma acuminata- treatment (clinician-administered) - answer-Cryotherapy with
liquid nitrogen or cryoprobe Q 1-2 weeks
-Trichloroacetic acid or bichloracetic acid
-Surgical removal
Condyloma acuminata- treatment (patient-administered) - answer-Podofilox 0.5%
solution/gel
-Imiquimod 3.75% or 5% cream
-Sinecatechins 15% ointment
,Molluscum contagiosum- symptoms/exam findings - answer-1-5 mm smooth, round,
firm, shiny, flesh colored to pearly white papules with central umbilication
-Usually on trunk or anogenital areas
-White cheesy material expressed from papule
-Painless
Molluscum contagiosum- diagnostic tests - answerDiagnosis based on clinical
presentation!
Molluscum contagiosum- complications - answer-Secondary infection
Genital herpes- symptoms (primary episode) - answer-Painful, pruritic multiple vesicles
-Dysuria, dyspareunia, watery vaginal discharge
-Systemic symptoms (fever, HA, chills, malaise)
^duration 2-3 weeks
Genital herpes- symptoms (recurrent episodes) - answer-Prodrome often precedes
eruption for 24 hours (itching, burning, tingling)
-Less severe symptoms of shorter duration
-No systemic symptoms
Genital herpes- diagnostic tests - answer-Clinical presentation with initial outbreak
-HSV tissue culture or PCR test of lesions for confirmation
-Serological type specific tests for HSV-1 and HSV-2 antibodies (several weeks after
exposure)
Genital herpes- complications - answer-Increased pregnancy loss & preterm labor of
initially infected during pregnancy
-Transmission to infant if active lesions at time of delivery
-Secondary infection of lesions, urethral strictures
Genital herpes- treatment - answer**Acyclovir 400 mg PO TID for 7-10 days**
-OR
-Famciclovir 250 mg PO TID for 7-10 days
-OR-
-Valacyclovir 1 gm PO BID for 7-10 days
Chlamydia- symptoms - answerFemales:
-dysuria
-vaginal discharge
-abnormal bleeding/postcoital spotting
-PID symptoms
Males:
, -dysuria
-urethral discharge
Chlamydia- exam findings - answerFemales:
-mucopurulent cervical discharge (yellow or green)
-endocervical friability
-cervical inflammation
Males:
-mucoid to purulent urethral discharge
Chlamydia- diagnostic tests - answer-Nucleic acid amplification test (NAAT)
Chlamydia- treatment - answer**Azithromycin 1 gm PO**
-OR-
-Doxycycline 100 mg PO BID for 7 days
Chlamydia- complications - answer-PID
-Infertility
-Ectopic pregnancy
Gonorrhea- symptoms - answerFemales:
-vaginal discharge
-dysuria
-PID symptoms
Males:
-urethral discharge
-dysuria
Gonorrhea- exam findings - answerFemales:
-mucopurulent cervical discharge
-endocervical friability
-urethral, Skene's gland, or Bartholin gland discharge
Males:
-purulent urethral discharge
Gonorrhea- diagnostic tests - answer-Nucleic acid amplification test (NAAT)
-Gram stain of discharge to look for gram negative diplococci
-Culture with antimicrobial sensitivity testing if suspect treatment failure (w/ male
urethral sample!)
Gonorrhea- treatment - answer**Ceftriaxone 250 mg IM -OR- 400 mg PO**
-OR-
