1. 8 Steps Who: Residents, Medical Students, Faculty When: Thursday 0715-0800, GME lecture Where: FM Conference Room – no ARS, must bring my own computer What: Knowledge: dermatology sexually transmitted infections and treatment Skills: sexually transmitted infections – clinical findings Attitude: Comfort with talking about sex and STI with patients Why: Sex is common, STIs happen because of sex, therefore STIs are common What: STI clinical findings and diagnosis, STI treatments, reportable diseases What for: 1) Reviewed the common dermatology descriptions of lesions 2) Diagnosed 6 STIs through pattern recognition of clinical findings 3) Memorized treatments for those same 6 STIs 4) Distinguished the diseases that are reportable to the CDC How: See 4 I’s So What: Learning, Transfer, Impact

2. 4 I’s Inductive: Grabber, pretest quiz Input: Powerpoint and Derm cards Implementation: “Support Group” exercise, Pile sort Integration: Post test quiz

3. Timeline 0715-0720 Grabber, intro 0720-0725 pretest, review answers 0725-0745 support group exercise 0745-0750 post test, answers

4. Discomfort with anatomy Personal experiences Culture and religion Patient discomfort Personal feelings Lifestyles different from our own Discomfort with physiology

5. STI’s Gone Wild Amanda Cuda, MD Faculty Development Fellow 24 January 2013

6. Logic and Epidemiology Sex is common STI’s happen because of sex Therefore STI’s are common

7. Objectives Reviewed dermatology descriptions Diagnosed 6 STIs Memorized treatments for those 6 STIs Named those reportable to the CDC

8. Primary Cutaneous Lesions Flat MaculeA circumscribed, flat discoloration that may be brown, blue, red, or hypopigmented Elevated, Solid PapuleAn elevated, solid lesion up to 0.5 cm in diameter of variable color. Papules may become confluent to become plaques. NoduleA circumscribed, elevated solid lesion >0.5 cm in diameter PlaqueA circumscribed, elevated, superficial, solid lesion >0.5 cm in diameter Fluid Filled VesicleA circumscribed collection of free fluid up to 0.5 cm in diameter BullaA circumscribed collection of free fluid >0.5 cm in diameter PustuleA circumscribed collection of leukocytes and free fluid (pus) Wheal (hive)A firm erythematous plaque resulting from infiltration of the dermis with fluid (may be transient)

9. Quiz Instructions Complete the following on your pretest worksheets: 1.Diagnosis 2.Treatment 3.Reportable to CDC?

10. Question 1 Most common ulcer infection.

11. Question 2 Most common cause of urethritis or cervicitis in the United States.

12. Question 3 Common and underdiagnosed.

13. Question 4 The only cause of urethritis or cervicitis that is a protozoan.

14. Question 5 Gram negative diplococci that causes urethritis and cervicitis.

15. Question 6 This painless ulcer infection is increasing in prevalence worldwide.

16. Quiz Answers Quiz Finish

17. Support Group Exercise 1.Take worksheet for condition, walk around, find 5 other support group members 2.Introduce by presentation and treatment 3.Name if it is reportable to the CDC 4.Create a trick to remember the condition, treatment, reportable status. Write on post test worksheet. 5.We’ll share examples of memory tricks. 6.Take 15 minutes, try to meet the 5 other support group members.

18. Pile Sort Exercises Work in groups. Sort cards three times, using these three categories: 1.Clinical: ulcers, urethritis/cervicitis, other 2.Microbiology: bacteria, virus, other 3.Reportable to CDC: yes or no

19. Post Test Quiz Instructions

20. Objectives Reviewed dermatology descriptions Diagnosed 6 STIs Memorized treatments for those 6 STIs Named those reportable to the CDC

21. Questions? Please return small group worksheets. Thank you!

22. Bonus question 1 Painless ulcer infection.

23. Bonus question 2 Painful ulcer infection.

24. Bonus question 3 This condition presents with wavy, elongated papules.

25. Bonus question 4 Name the 4 infections from those discussed today that facilitate the transmission and infection of HIV.