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NURS617 EXAM 7 Questions and
Correct Answers the Latest Update
normal vag pH + flora
✓ -4.0-4.5; naturally more acidic to protect against bacteria
✓ -lactobacilli=normal vag bacteria; low=increased infection risk (abx=low lactobacilli,
increased risk of yeast infection)
Condylomata acuminata (genital warts)
✓ -caused by HPV; high risk strains (16 + 18)=increased risk of cervical cancer, cervical
hyperplasia, genital warts
✓ -prevented w/ gardisil & cervarix vaccines, yearly pap smear
✓ -incubation period=6 weeks-8mo, may be asymptomatic
✓ -can resolve spontaneously & reactive years later
✓ -warts can appear wherever contact with virus has occurred
✓ -tx: cryotherapy, trichloroacetic acid, imiquimod cream
genital herpes
✓ -caused by the herpes simplex type II virus; F=increase risk of infection d/t greater
mucosal surface area
✓ -incubation=2-10 days; spread through asymptomatic shedding (no warts=can still
spread)
✓ -first episode=worst, painful, more vesicles; recurrent=more mild (remains dormant
in sacral dorsal root ganglia)
✓ -lesions can involve cervix, vag, urethra, anus, scrotum, and inguinal lymph nodes
✓ -tx: antivirals (valtrex)
Trichomoniasis: cause, s/s, dx, tx
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✓ -cause: trichomonas vaginalis (protozoan); associated w/ high risk sexual behaviors
✓ -s/s: men=usually asymptomatic, women=vaginitis, frothy green/yellow discharge w/
foul odor, strawberry spots on cervix
✓ -dx: wet-mount; pH usually more on basic side (6.0+)
✓ -tx: flagyl (metronidazole)
✓ -increased risk of PID & infertility, premature births
Molluscum contagiosum
✓ -wart-like growths that look like small pimples filled with kernels of corn; express
curd-like material (infection risk)
✓ -cause=poxvirus; transmitted skin to skin
✓ -tx: imiquimod cream, cryo, laser, silver nitrate
candidiasis: cause, s/s, dx, tx
✓ -infection of the skin, mouth, or vagina caused by the yeast-type fungus; not spread
sexually
✓ -risk factors: ABX, HIV/immunodeficiency, uncontrolled DM
✓ -s/s: pruitis, swelling, thick/white/odorless discharge (cottage cheese!! yum), dysuria,
dyspareunia
✓ -dx: acidic pH (bacteria=more basic)
✓ -tx: fluconazole, antifungal creams (clotrimazole, -zole)
Bacterial Vaginosis (BV): cause, s/s, dx, tx
✓ -cause: d/t low lactobacillus (normal bacteria) and overgrowth of other organism(s)
✓ -s/s: more basic pH, thin, white discharge w/ foul fishy odor; lack of inflammation
(not -itis)=no burning/pruitis
✓ -tx: flagyl PO or topical, clindamycin cream
Chalmydia trachomatis: s/s, dx, tx
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✓ -chlamydia; causes nongonococcal urethritis in men, PID in women
✓ -s/s: M=urethritis + pruitis, meatal tenderness/erythema. F=mucopurulent
clear/white discharge; both can be asymptomatic
✓ -reiter syndrome=if untreated, causes urethritis, conjuctivitis, arthritis
✓ -dx: urine NG/CT (NAAT)
✓ -tx: azithromycin or doxy
gonorrhea: cause, s/s, dx, tx
✓ -cause= neisseria gonorrhoeae; can also cause conjuctivitis in newborns
(Erythromycin ophthalmic ointment=prophylactic)
✓ -s/s: may be asymptomatic; discharge=THICKER THAN CHLAMYDIA
✓ -M=urethral pain, creamy yellow or bloody discharge, chronically effects
prostate/epididymis/periurethral glands.
✓ -F=dysuria, dyspareunia, chronic scarring of GU resulting in sterility AND/OR PID
✓ -complications: disseminated gonococcal infections (conjuctivitis, heart valves, joint
spaces)
✓ -dx: urine NG/CT (NAAT)
✓ -tx: ceftriaxone IM
3 stages of syphilis
✓ 1. Primary: Painless chancre spontaneously gone w/i 8 wks; highly contagious during
1st stafe
✓ 2. Secondary: Condyloma lata, Maculopapular rash red-brown color (palms, soles of
feet), LAD 6wks-18 months after infection
✓ - Latent phase (years)
✓ 3. Tertiary: granuloma-like lesions form d/t localized destruction; can cause
dementia, blindness, ataxia, aortic valve insufficiency
syphilis: cause, risks, dx, tx
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✓ -cause: treponema pallidum (spirochete); spread d/t direct contact w/ moist lesion
✓ -risks: untreated in pregnancy after 16 weeks=increased chance of stillbirth,
congential defects, active infection in utero
✓ -dx: serology (rapid plasma reagin)
✓ -tx: PCN IM, long term tetra/doxycycline
3 layers of uterus
✓ 1. perimetrium- serosa layer
✓ 2. myometrium - major portion; contracts during period (cramps)
✓ 3. endometrium - what sheds during period
role of estrogen in vaginal mucosa
✓ -stimulates proliferation + maturation of vaginal mucosa; low estrogen=more dry,
vaginitis, dyspareunia
✓ -low estrogen=retrogression of previously built endometrium + bleeding; causes
much thicker layer w/ richer blood supply
✓ -missed period=thicker endo lining can lead to hyperplasia, can cause abnormal
bleeding patterns
✓ -increases glycogen content; allows lactobacilli to convert into lactic acid & maintain
acidic pH
menstrual cycle phases
✓ 1. follicular phase (as estrogen increases, FSH decreases and LH increases)
✓ 2. ovulation (most fertile; high estrogen, high FSH/LH)
✓ 3. luteal phase (progesterone slowly increasing, FSH/LH decrease, estrogen peaks
half way through luteal phase; PMS/PMDD s/s occur during this phase)
✓ 4. menstruation (progesterone slow decreases); towards end, increase of FSH and
LH to re-enter follicular phase
✓ -on average-28 day cycle; 2 estrogen peaks=before ovulation, middle of luteal phase
puberty: development of first period
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