OB Exam 3: STIs & Women’s Health Nursing (Wk 11)

What organisms cause STIs?

bacteria, viruses, parasites

Who can get an STI?

anyone sexually active

Are STIs symptomatic?

no, they are often asymptomatic

Are STIs treatable?

most are

Can asymptomatic STIs transmit?

yes

☆ What are common bacterial STIs?

chlamydia, gonorrhea, syphilis

☆ What are common viral STIs?

HSV, HPV, HIV

☆ Are chlamydia, gonorrhea, and syphilis curable?

yes

☆ What are chlamydia symptoms?

often asymptomatic, painful urination, discharge

☆ What are gonorrhea symptoms?

burning urination, discharge

☆ What are syphilis symptoms?

painless sores, rash, fever

☆ Are herpes (HSV), HPV, and HIV curable?

no

☆ What are herpes (HSV) symptoms?

painful blisters, flu like symptoms

☆ What are HPV symptoms?

often asymptomatic, warts, abnormal Pap tests

☆ What are HIV symptoms?

flu like symptoms, then often asymptomatic

☆ What is gonorrhea vaginal discharge like?

yellow-green, thick, foul odor

☆ What is gonorrhea penile discharge like?

yellow-white, thick pus like

☆ What is chlamydia vaginal discharge like?

yellow, cloudy, minimal

☆ What is chlamydia penile discharge like?

clear to white, watery to thick

☆ What is trichomoniasis vaginal discharge like?

yellow-green, frothy, strong odor

☆ What is trichomoniasis penile discharge like?

clear, white, or yellow

☆ What is a common symptom of trichomoniasis?

itching and burning

☆ What is bacterial vaginosis vaginal discharge like?

gray-white, thin, fishy odor

☆ What is bacterial vaginosis penile discharge like?

not typically transmitted to males

☆ Is a bacterial vaginosis an STI?

no

☆ Is a yeast infection an STI?

no

☆ What is yeast infection vaginal discharge like?

white, thick, cottage cheese like

☆ What is yeast infection penile discharge like?

rare, white, thick, cottage cheese like

When should someone seek immediate medical attention for a potential STI?

sudden unusual discharge, foul odor, green or yellow discharge, blood in discharge, itching and burning, pelvic or abdominal pain, fever with discharge changes

What are normal variations in discharge?

clear, white, menstrual cycle related changes, mild odor, increase during ovulation

What is the most common STI transmission route?

vaginal sex

Which sexual activity has higher STI risk due to tissue fragility?

anal sex

Which sexual activity can transmit STIs to the mouth, throat, and genitals?

oral sex

Which STIs transmit via skin-to-skin contact?

HSV, HPV, syphilis

Which STIs transmit via sharing needles?

HIV, hep B, hep C

How can mother-to-child STI transmission occur?

during pregnancy, birth, breastfeeding

Can STIs be spread via toilet seats, casual contact, drinks, hugging?

no LOLLLLL

Dyspareunia

painful intercourse

Is pain during intercourse a possible genital STI symptom?

yes

What are common general STI symptoms?

fever, flu like symptoms, swollen lymph nodes, rash, pelvic or abdominal pain, rectal pain, rectal discharge

What STI vaccinations are available?

HPV, hep B

When should STI testing occur?

before new sexual activity

if symptoms present

if partner diagnose

annual as routine

after unprotected sex

Which STI(s) does a urine sample test for?

chlamydia and gonorrhea

Which STI(s) does a blood sample test for?

HIV, syphilis, HSV

Which STI(s) does a Pap smear test for?

HPV

Are STI tests covered by insurance?

yes

What is used to cure chlamydia, gonorrhea, and syphilis?

antibiotics

What antibiotic is used to cure syphilis?

penicillin g

What is used to cure trichomoniasis?

antiparasitic

What is used to treat/manage HSV and Hep B?

antivirals

What is used to treat/manage HIV?

antiretroviral therapy

What are complications of untreated chlamydia/gonorrhea?

infertility, damages reproductive organs

What is a complication of untreated HPV?

cervical cancer

What are complications of untreated advanced syphilis?

neurological damage, cardiovascular damage

What are possible complications of untreated STIs?

PID

HIV risk

premature birth, low birth weight, infant death

infertility

cancer

heart problems, neurological damage

What type of prevention is this considered?:

prevent illness or injury, vaccinations, exercise, healthy diet

primary

What type of prevention is this considered?:

early detection or intervention to reduce disease impact, Pap test, cholesterol screening, STI screening

secondary

What type of prevention is this considered?:

manage disease progression and reduce complications, physical therapy, cardiac rehab, chemotherapy

tertiary

What does a Pap test screen for?

cervical cancer, HPV related changes, STIs, cytology

How often is HPV-only screening recommended?

every 5 years from ages 25-65

How many types of HPV are there that affect genitals?

40

Low-risk HPV can cause

genital warts

High-risk HPV can cause

cervical cancer

How long do most HPV infections take to resolve? Which types persist?

4 years; types 16 and 18

What is the risk of overscreening or overdiagnosing STIs?

unnecessary cervical tissue removal, potential pregnancy complications

Where are cell samples taken from for a Pap test?

transformation zone and squamocolumnar junction of cervix

Where do abnormal cervical cells develop?

transformation zone of cervix

What age should Pap screening start?

21

What is the pap screening timeline until age 29?

every 3 years

What is the pap screening timeline after age 30?

continue every 3 years or pap and HPV co-testing every 5 years

What age does pap screening end if there is no increased risk for cervical cancer?

65

What is the rate of low-grade lesions regressing in Pap tests? (in %)

90-95%

If ASCUS (atypical pap test result) between ages 21-29, what should be performed?

HPV test

What is performed if pap test cytology comes back abnormal?

colposcopy and histology

ASCUS

atypical cells of undetermined significance

What is the HPV vaccine?

gardasil

What age is gardisil most often given?

11-12

When is HPV vaccination most effective? What age is it most effective?

before sexual activity; under 26

Until what age can HPV vaccination be received?

45

What are barriers to HPV vaccination?

perceived lack of need, safety concerns, lack of provider recommendation

Are most breast cancer cases due to genetics?

no

What are breast cancer risk factors?

family history of cancer, BRCA mutation, radiation to chest ages 10-30, first birth after 30, nulliparity, dense breasts, prior breast biopsy, exogenous estrogen use

What is the BRCA mutation?

autosomal dominant gene, increases risk of breast, ovarian, prostate, and pancreatic cancer

When should breast self-exam start for BRCA carriers?

18

How often should clinical breast exam occur for BRCA carriers?

every 6-12 months starting at age 25

When should breast MRI start for BRCA carriers?

annually from age 25, earlier if family history

What are some preventive options for BRCA carriers?

mastectomy, medications, bilateral salpingo-oophorectomy

What is a bilateral salpingo-oophorectomy?

removal of fallopian tubes and ovaries

What is CBE?

clinical breast exam

What are trans fats?

bad fats, vegetable oil, fried food

What are saturated fats?

animal products, beef, butter, coconut oil

What are monounsaturated fats?

plant or animal fats, fish, olive oil, avocados

What does fiber reduce risk of?

CHD, type 2 diabetes, colon cancer

Who may need extra B vitamins?

vegans

Who may need vitamin D supplementation?

people with low sun exposure

Who needs extra folic acid, iron, DHEA?

pregnant women

Who may need thiamine?

heavy alcohol users

1 cup is equivalent to

a fist

½ cup is equivalent to

a rounded handful

¼ cup is equivalent to

golf ball