Med Surg I: Sexuality, Fertility, and Sexually Transmitted Diseases Exam #2 Study Guide (Part 2)

What is tertiary (late) syphilis?

Could be 10-20 years later causing damage to heart, eyes, brain, nervous system, bone and joints

What are signs of neurosyphilis?

Dementia, headaches, seizures; May occur during tertiary syphilis

How is syphilis screened?

Two types of serologic (blood) studies are done; Both done using sample of blood and reported as nonreactive (-) or reactive (+); False positives can occur secondary to infection, pregnancy, malignancies, and autoimmune disorders

What is often detected with syphilis?

HIV

How is syphilis usually treated?

Penicillin G benzathiine; Doxycycline, erythromycin or tetracycline can be used if allergic to PCN; Treatment can destroy the syphilis organism at any stage but damage cannot be reversed

What is genital herpes?

Caused by herpes simplex virus; HSV-1 Cold sores of the mouth; HSV-2 Genital sores; Recurrences are common

What can occur with either type of herpes simplex virus?

Either type can affect the other via oral genital sex. Lesions can spread to other areas of the body; Can be contagious without symptoms; Dysuria is common

What occurs during the 1st episode of genital herpes?

2-10 days after exposure x 2-3 weeks, itching, burning pain and paresthesia in genitalia, legs, and buttocks then redness/swelling and small vesicles, and then weeping blisters then open sores that crust over after a few days

When do genital herpes outbreaks usually happen?

Spontaneously or during times of stress or illness; Virus is small enough to penetrate a condom! But condoms are helpful in preventing STI's

Which sexually transmitted diseases have no cure and the client is infected for life?

Genital herpes and cytomegalovirus (CMV); Treatment is geared toward alleviating symptoms of the disease and the prevention of spread

What can be used to alleviate genital herpes symptoms?

Antivirals (acyclovir, famvir, valtrex); Cleanliness and dryness are essential to promote healing. Avoid sexual contact when an outbreak is present; Don't touch lesions; Use meticulous handwashing

What is a genital herpes diagnosis based on?

History and physical

How is a herpes viral culture taken?

Fluid from a lesion is obtained using a swab and placed in a cup for culture

What is a polymerase chain reaction (PRC) test?

Identifies the type of virus present

What is an antibody test?

Blood is tested for antibodies to the virus

What is an immunoblot and ELISA test used for?

Differentiates between HSV 1 and HSV 2

What is cytomegalovirus (CMV)?

Virus primarily transmitted via contact with body fluids such as saliva, urine and respiratory secretions; By adulthood, most people have acquired CMV

If symptoms are present for cytomegalovirus, what would they look like?

It would mimic mononucleosis; Fever, weakness, fatigue

What is the most common STD?

Genital warts

What is genital warts caused by?

Human papillomavirus

How many strains of HPV are there?

100; Several cause cancer (greatest risk)

What are risks of genital warts?

Latex, multiple sex partners, sexually active people in teens and 20s

How do genital warts usually look?

Painless, soft, fleshy growths appearing in the genital area

What can genital warts usually cause?

Closely associated with the development of cervical cancer, especially in smokers; It can cause cancer of the vulva, anus and head/neck in females; Can cause cancer to the penis, anus, head/neck in males;

What should be taught to the client that has or may have genital warts?

Educate women about frequent pap smears, they detect cervical cancer; HPV has high risk for cervical cancer; Allow patient to empty bladder before pelvic or pap smear

How are genital warts usually treated?

Removing the warts, but they may recur at any time or may clear without treatment; Vaccine can help to protect against HPV

What is HIV/AIDS?

Severe disorder of the immune system; Virus that is transmitted sexually, blood-borne from mother to infant (childbirth, prenatally, breastfeeding; Not curable; Can be fatal

How are at least 1/2 of HIV/AIDS cases usually spread?

Through heterosexual contact

What may be one of the 1st symptoms of HIV/AIDS?

Vaginal candidiasis

How is trichomoniasis transmitted?

Sexual, although the parasite can survive in water for a period of time so other modes are possible

What is the incubation time for trichomoniasis?

4-20 days

What are classic symptoms of trichomoniasis?

Sever itching of vulva, redness, swelling of vulva, pain on intercourse and urination, and clear, white, yellowish or greenish vaginal malodorous discharge with distinct odor; Many cases are asymptomatic

What should be done with clients that have HIV/AIDS?

Treat both partners with metronidazole (Flagyl); Pregnant women not treated until after the 1st trimester

What type of affect does metronidazole (flagyl) have when taken with alcohol?

Antabuse (severe vomiting) like effect

What is a trichomoniasis client more at risk for?

Increased risk of prematurity, cervical cancer and much greater risk of contracting HIV

What is hepatitis B?

Blood borne DNA virus present in serum, saliva, semen and vaginal secretions

How is hepatitis B spread?

Through sexual contact, blood-borne, perinatal

What are symptoms of hepatitis B?

Anorexia, vague abdominal discomfort, nausea, vomiting, fatigue, jaundice

How is hepatitis B treated?

No specific therapy; Treatment is based on relieving symptoms; Vaccine, 3 series is usually started shortly after birth

What is bacterial vaginosis/vaginitis?

Inflammation and possible bacterial infection of the vagina

What are contributing factors to bacterial vaginosis/vaginitis?

Poor personal hygiene, soaps, condoms, sexual activity, frequent douching

What are s/s of bacterial vaginosis/vaginitis?

"Stale fish" vaginal odor with vaginal discharge

What can bacterial vaginosis/vaginitis lead to if left untreated?

PID and sterility

How is bacterial vaginosis/vaginitis usually treated?

Topical creams, antibiotics (Flagyl or clindamycin)

What is the main symptom of vaginal yeast infections?

Itching

What does a vaginal yeast infection usually cause?

Thick, white, cottage cheese-like discharge

What increases the risk of a vaginal yeast infection?

Use of oral contraceptives alter the pH of the vagina

Who is more likely to get testicular cancer?

Clients with a family history of testicular cancer; Typically between ages 15-40;

When does testicular cancer usually occur?

In the productive years and has significant economic, social, and psychological impact on the client and his family; Rarely bilateral

What are early signs of testicular cancer?

Painless scrotal swelling, backache, and weight loss

What are s/s of endometrial cancer?

Abnormal vaginal bleeding, including postmenopausal bleeding and bleeding between normal periods

What is the most common finding in endometrial cancer in premenopausal women?

Abnormal vaginal bleeding