Transcript Herpes Simplex Virus (cont`d)

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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
http://www.webmd.com/sexualconditions/ss/slideshow-std-pictures-andfacts
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Psychosocial issues
Gynecologic problems related to
immunocompromise
◦ Vulvovaginal candidiasis
◦ Human papillomavirus
◦ Herpes simplex virus
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Most common bacterial STD
Leading cause of preventable infertility
Complications include ectopic pregnancy,
pelvic inflammatory disease
Usually asymptomatic in women
http://www.youtube.com/watch?v=Eww8tGk
qGRw&feature=relmfu
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Diagnosis
◦ Culture
◦ Direct immunofluorescence
◦ Nucleic acid hybridization/amplification
(NAAT)
◦ Enzyme immunoassay
Treatment
◦ Antibiotics (e.g., doxycycline, azithromycin)
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Causative bacterium: Neisseria gonorrhoeae
Second most commonly reported STD
Women often asymptomatic
May progress to pelvic inflammatory disease
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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
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Causative protozoan: Trichomonas vaginalis
Most common curable STD in U.S.
May be asymptomatic
Symptoms: frothy vaginal discharge (gray,
green) with foul odor
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Diagnosis
◦ Wet mount (+ motile trichomonad parasites)
◦ Rapid trichomoniasis test, affirm VP III test
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Treatment
◦ Metronidazole; tinidazole
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Treat partners simultaneously
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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
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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
http://www.webmd.com/cancer/cervicalcancer/slideshow-cervical-cancer-overview
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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
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Diagnosis: viral culture, serum testing
Treatment goal: hasten healing, reduce
symptoms
◦ Antiviral medications
◦ Complementary care measures
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Patient education
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Causative spirochetal bacterium: Treponema
pallidum
Transmission: sexual intercourse,
transplacental (maternal-fetal)
Increased incidence since 2001
Understanding Syphilis (STDs #1) You tube
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Primary: chancre
Secondary: fever, rash, malaise, headache,
weight loss, condylomata lata
Tertiary: gummas, joint disease,
neurosyphilis, C-V syphilis
Treatment: penicillin G, doxycycline,
tetracycline
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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)
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Highest incidence in persons 20–49 years
More contagious than HIV
Causes liver disease, may be fatal
Transmission: sexual intercourse, blood-toblood contact, maternal-fetal transfer
You tube Hepatitis B
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).
Which of the following sexually transmitted
infections can be cured with antibiotics?
a. Human papillomavirus
b. Chlamydia
c. Herpes simplex virus
d. Hepatitis B