NURS 5333 Family 1 Test3 Study guide STD's only LATEST EDITION 2024 UPDATE GUARANTEED GRADE A+

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STDs: Chancroid physical exam findings, -there will be unilateral abscess formation (or both) on genitals. -chancroids are caused by the organism Hemophilus ducreyi. gram (neg) bacillus -Women usu... ally are asymptomatic with this disease presentation -high rate of HIV identified among the individuals presenting with these red-rimmed ulcers -Men will present with single or multiple superficial painful ulcers that are surrounded by an erythematous halo. STDs: Trichomonas diagnostics NAAT PCR is the gold standard for diagnosis, and a rapid antigen or nucleic acid probe will affirm. -In men, the NAAT PCR of first fraction urine or urethral swab is recommended. -Saline microscopy has low sensitivity and is not required. STDs: Chancroid treatment, side effects of the medications, and prevention -Diagnosis of this skin ulcer is made by a matter of exclusion -Treatment is with azithromycin one gram po times one dose, -or ceftriaxone 250 milligrams IM times one dose, -or ciprofloxacin 500 milligrams by mouth twice daily. **IM or PO** STDs:Chlamydia physical exam findings, -is a parasitic STD "The Clam" -will have WBCs in the urine -serious reproductive tract complications in either sex. -the most common bacterial sexually transmitted disease in the United States. -Females present often asymptomatic. -dysuria and intermenstrual spotting, post-coital bleeding, dyspareunia or vaginal discharge. STDs: Genital Warts HPV physical exam findings, -the most common sexually transmitted infection in the United States. -viral infection -In the anogenital or genital area, or it can exist without producing any signs or symptoms. -Many strains of _ _ _are oncogenic -Oral HPV infection is the most common cause of oropharyngeal cancer as well. -signs and symptoms are single or multiple soft fleshy, papillary, or sessile painless keratinized growths around the anus, the vulvovaginal area, the penis, the urethra, or the perineum. STDs: Gonorrhea physical exam findings, -Neisseria gonorrhea is a gram-negative intracellular aerobic diplococcus -produces purulent inflammation of mucous membranes and is perinatally transmitted from an infected mother to her newborn during delivery. -Gonorrhea can be asymptomatic in early infection, especially among women. -STD.-manifest within 10 days of infection -urethritis and a purulent urethral discharge that can be blood-tinged. -Women will present within endocervical vaginal discharge that is thin, purulent, and mildly odorous, and this is usually minimal. -WOmen get dysuria, intra-menstrual abnormal bleeding, dyspareunia Bartholin's gland abscess. STDs: Genital Herpes physical exam findings, -a primary outbreak in image -incurable, cutaneous or mucous membrane ulcerations that are often recurrent. -vesicular in nature -causative agent is herpes simplex virus type 1 or 2. It is usually HSV-2 - STDs: Syphilis physical exam findings, -Primary is a chancre -secondary they get the petechial rash on their palms and their soles -Syphilis is an STD involving multiple organ systems -Primary, secondary, latent and tertiary. STDs: BV physical exam findings, Bacterial vaginosis -clinical syndrome resulting from loss of normal vaginal flora, decreased lactobacilli, and overgrowth of anaerobic organisms such as Gardernella, Prevotella, Mycoplasma hominis and the Mobiluncus species. Bacterial vaginosis occurs most often in women of childbearing age, but it may also occur in post-menopausal women and is rare in children. -may occur with douching, sexual intercourse and other factors that increase vaginal pH. -Most women with BV asymptomatic. -fishy or musty vaginal odor -more prominent after sexual intercourse and menses. It's profuse and watery, homogenous, off-white. -pruritus, dyspareunia, and burning or inflammation of the vulvovaginal area. -There won't be any redness or edema. STDs: Trichomonas physical exam findings, -Trichomonas vaginalis protozoan -early always sexually transmitted, but transmission via fomite is possible. -Women can acquire the disease from other women, but men rarely transmit the infection to other men. -Incubation period is about four to 28 days, -incidence is highest in non-Hispanic Black women, lowest in non-Hispanic white women. -women: asymptomatic up to 75% percent of the time. -vaginal discharge that is frothy, copious and pale yellow to gray-green in color may be present.The vaginal discharge will have a foul fishy odor. -vulvovaginal irritation -dysuria. -vaginal mucosa is intensely erythematous. The women will complain of dyspareunia. -Symptoms may worsen during menstruation, and there will also be post-coital bleeding and pruritus. chancroid (bacterial infection) -Painful genital ulcers will be present in the absence of treponema pallidum and HSV by inspection or culture with, co-existing tender inguinal lymphadenopathy. -0% of patients are also infected with syphilis and the herpes simplex virus. Chlamydia treatment, side effects of the medications, and prevention -"Dox(100) or ziti(1) clam" -azithromycin one gram in a single dose or -doxycycline, 100 milligrams twice daily for seven days, or -doxycycline for 10 to 14 days if epididymis is involved, or if pelvic inflammatory disease is present. -Second-line would be levofloxacin for seven days or ofloxacin for seven days. Erythromycin 500 four times daily for seven days if the patient is unable to take doxycycline -with pregnancy, you would give amoxicillin 500 milligrams three times a day for seven days. -In children that are less than 45 kilograms, you would use erythromycin base, greater than 45 kilograms azithromycin, and then greater than eight years old, azithromycin or doxycycline Genital warts treatment, side effects of the medications, and prevention -infection is transmitted through direct contact with infected people -Condoms provide limited protection when it comes to preventing genital warts. -The best prevention is with the HPV vaccination. -Gardasil 9 is being used -circumcision of men and may prevent the transmission and acquisition of HPV -encourage these patients to use condoms and abstinence from sexual activity until their therapy is completed. -You can use a CO2 laser for external genital warts. -pharmacologic treatment for warts by the provider can be done with podophyllin resin, which is applied topically every one to two weeks. Gonorrhea treatment, side effects of the medications, and prevention -high rate of anti-microbial resistance -all cases of gonorrhea need to be treated with two anti-microbials with different mechanisms of action. - third-generation cephalosporin plus azithromycin on the same day simultaneously and directly observed is preferred. Fix your mouth gonorrhea: Oral cefixime is not sufficient for pharyngeal infections, but can be used if ceftriaxone is not available, Genital Herpes treatment, side effects of the medications, and prevention -transmitted by direct contact with active lesions or with virus-containing fluid. -patient may be asymptomatic but can still be shedding the virus and infecting others, and the usual incubation period is two to 12 days. -educated about sexual transmission and should be encouraged to use condoms. -can pass this on to their newborn child, so they need to know the implications of pregnancy, - need to be counseled if they're a discordant couple where one person has it and the other one does not. Syphilis treatment, side effects of the medications, and prevention -benzathine penicillin G intramuscularly -adults 2.4 million units for primary and secondary stage -Alternate therapies are doxycycline, tetracycline, ceftriaxone or azithromycin. -Follow up is mandatory. -Children get five 50,000 units of the benzathine penicillin G. Alternate regimens: procaine penicillin, ceftriaxone. -latent without evidence of neurosyphilis: they get the benzathine penicillin 2.4 million units IM weekly for three doses. -Late latent without evidence of neurosyphilis, they still get the benzathine penicillin IM weekly for three doses -Neurosyphilis, they would get the aqueous crystalline penicillin G intravenous every four hours for 10 to 14 days. BV treatment, side effects of the medications, and prevention -Metronidazole 500 milligrams twice a day for seven days, or you can use the metronidazole gel or clindamycin vaginal cream - STDs: BV diagnostics diagnosed by Amsel's criteria, and it's based on three or more clinical signs and symptoms: homogenous, thin gray-white discharge coating the vaginal wall, a vaginal pH of greater than 4.5, a positive whiff-amine test, which it gives off the fishy odor when using 10% of KOH, presence of more than 20% epithelial or clue cells on a wet mount microscopy. -The presence of clue cells diagnosed by an experienced microscopist is the single most reliable predictor of bacterial vaginosis. -Presence of sialidase enzyme produced by anaerobes that are associated with BV. STDs: Syphilis diagnostics -diagnostic testing (NTT) nontreponemal tests: VDRL or RPR -treponemal testing( antibody test): particle agglutination assay(PA) -fluorescent treponemal antibody absorption confirms positive in 85-95% of primary and 100% of secondary cases. STDs: Genital Herpes diagnostics HSV PCR Seroconversion can take up to six months -repeat the testing in six months if the initial IgG is negative False positives may occur, so you should repeat the testing in three months if there's a low positive, such as 1.1 to 3.5. A Tzanck smear can be done, ELISA can be done, and you should do a syphilis serology as well to rule out syphilis. STDs: Gonorrhea diagnostics -Nucleic acid amplification (NAAT) test use in urine sample is the gold standard for diagnosing gonorrhea. -Gram stain can be done of the discharge smear, and it will show gram-negative diplococci and white blood cells. -Cervical culture for N. gonorrhea using a modified Thayer-Martin media may also be done. STDs: Genital warts diagnostics -The diagnostics are based on clinical findings. - acetowhitening, which can make subclinical lesions visible, but this is not diagnostic for HPV. -Anoscopy may be wanted for intra-anal warts. -Biopsy for persistent warts if the diagnosis is uncertain should be done. -There needs to be a careful vulvar inspection to assess for HPV-related vulvar intraepithelial neoplasia or VIN. -Pep testing or an HPV screening if compelling indication for testing exists. STDs: Chlamydia diagnostics -The nucleic acid amplification test (NAAT) is the gold standard for diagnosing -The Gen-Probe is a test that is for both chlamydia and gonorrhea. -antigen detection tests: done via cervical or urethral swab or by first catch urine. This is 80-95% sensitive compared to culture. STDs: Chancroid diagnostics -inspection or culture with, co-existing tender inguinal lymphadenopathy. -This is suggestive of chancroid. [Show More]

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