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 CDC – opt-out testing, all patients  ACOG – routine for women ages 19–64  Provide and document post-test counseling  Conform to HIPAA regulations.

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Presentation on theme: " CDC – opt-out testing, all patients  ACOG – routine for women ages 19–64  Provide and document post-test counseling  Conform to HIPAA regulations."— Presentation transcript:

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2  CDC – opt-out testing, all patients  ACOG – routine for women ages 19–64  Provide and document post-test counseling  Conform to HIPAA regulations  conditions/ss/slideshow-std-pictures-and- facts conditions/ss/slideshow-std-pictures-and- facts

3  Psychosocial issues  Gynecologic problems related to immunocompromise ◦ Vulvovaginal candidiasis ◦ Human papillomavirus ◦ Herpes simplex virus

4  Most common bacterial STD  Leading cause of preventable infertility  Complications include ectopic pregnancy, pelvic inflammatory disease  Usually asymptomatic in women  qGRw&feature=relmfu

5  Diagnosis ◦ Culture ◦ Direct immunofluorescence ◦ Nucleic acid hybridization/amplification (NAAT) ◦ Enzyme immunoassay  Treatment ◦ Antibiotics (e.g., doxycycline, azithromycin)

6  Causative bacterium: Neisseria gonorrhoeae  Second most commonly reported STD  Women often asymptomatic  May progress to pelvic inflammatory disease

7  USPSTF, CDC: Annually screen all sexually active women ages 25 and younger  Testing: culture, nucleic acid hybridization, NAAT (cervical or urine sample)  Treatment: antibiotics (cefixime, ceftriaxone); include partners

8  Causative protozoan: Trichomonas vaginalis  Most common curable STD in U.S.  May be asymptomatic  Symptoms: frothy vaginal discharge (gray, green) with foul odor

9  Diagnosis ◦ Wet mount (+ motile trichomonad parasites) ◦ Rapid trichomoniasis test, affirm VP III test  Treatment ◦ Metronidazole; tinidazole  Treat partners simultaneously

10  Acute infection of uterus, fallopian tubes  May cause scarring, adhesions, blockage  Common causative organisms: C. trachomatis, N. gonorrhoeae  Symptoms: pain, bleeding, N & V  Treatment: combined drug therapy

11  Cause of condylomata acuminata  Over 100 viral types identified  Usually asymptomatic, sub-clinical  Vaccine available for certain types  Treatment of external warts: topical chemical agents, cryotherapy, laser surgery, electrosurgery  cancer/slideshow-cervical-cancer-overview cancer/slideshow-cervical-cancer-overview

12  HSV-1 associated with cold sores  HSV-2 associated with genital lesions ◦ Occurs more frequently in women ◦ Primary infection: flu-like symptoms, pain, appearance of multiple blister-like lesions ◦ Recurrent outbreaks less severe ◦ Transmission possible during viral shedding

13  Diagnosis: viral culture, serum testing  Treatment goal: hasten healing, reduce symptoms ◦ Antiviral medications ◦ Complementary care measures  Patient education

14  Causative spirochetal bacterium: Treponema pallidum  Transmission: sexual intercourse, transplacental (maternal-fetal)  Increased incidence since 2001  Understanding Syphilis (STDs #1) You tube

15  Primary: chancre  Secondary: fever, rash, malaise, headache, weight loss, condylomata lata  Tertiary: gummas, joint disease, neurosyphilis, C-V syphilis  Treatment: penicillin G, doxycycline, tetracycline

16  Leading cause of liver cancer  Most common reason for liver transplantation  May be caused by Hepatitis A virus (HAV), Hepatitis B virus (HBV), or Hepatitis C virus (HCV)

17  Highest incidence in persons 20–49 years  More contagious than HIV  Causes liver disease, may be fatal  Transmission: sexual intercourse, blood-to- blood contact, maternal-fetal transfer  You tube Hepatitis B

18 A nurse is providing discharge instructions to a client who has just been diagnosed with human papillomavirus (HPV) on her cervix. Which of the following is the most important discharge instruction for this client? a. Take a multivitamin every day. b. Check for external lesions around the vagina every month. c. Have Pap smears done as recommended by her practitioner. d. Avoid use of the intrauterine device (IUD).

19 Which of the following sexually transmitted infections can be cured with antibiotics? a. Human papillomavirus b. Chlamydia c. Herpes simplex virus d. Hepatitis B


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