N330 Exam 1 questions with correct answers
Primary dysmenorrhea occurs mainly in Correct Answer-women under
25
Secondary dysmenorrhea develops in Correct Answer->25 yo
associated with pelvic abnormalities (endo, PID, polyps etc)
dysmenorrhea Correct Answer-painful menstruation beginning 2-6
months after menarche
chlamydia Correct Answer--most common and fastest spreading STI
-often silent and highly destructive and sequelae and complications are
very serious
· Difficult to Dx in women
· Complications: acute salpingitis (infl of fallopian tubes)or pelvic
inflammatory disease (most serious complication, increase risk of
ectopic pregnancy and tubal factor infertility)
· Sexually active women younger <20 y.o. are most likely become
infected, and >30 has lower rate of infection.
· S/S: Asymptomatic; some: spotting or postcoital bleeding, mucoid or
purulent cervical discharge, or dysuria.
· Dx: culture
· Management: doxycycline (100 mg PO 2x/day for 7 days) or
azithromycin (1g single dose, for compliance)
,gonorrhea Correct Answer-o Genital-to-genital; oral to genital and anal
to genital; transmission
o Mother to newborn-cause ophthalmic neonatorum -> give the
erythromycin ophthalmic ointment
· S/S: Asymptomatic, but some: greenish-yellow purulent endocervical
discharge or experience menstrual irregularities, pain or menses that last
longer or are more painful than normal; if it's rectal: profuse purulent
anal discharge, rectal pain, and blood in the stool, rectal itching, fullness,
pressure and pain and diarrhea. -Diffuse vaginitis with vulvitis is most
common in prepubertal girls.
· Risk factors: age <25 y.o. (most important factor), African-American,
early onset of sexual activity, multiple sexual partners, and drug use.
· Management: antibiotic therapy: one dose of ceftriaxone 125 mg IM or
cefixime 400 mg PO.
syphilis Correct Answer-· enters through microscopic abrasions that can
occur during sexual intercourse
· Transplacental transmission may occur at any time during pregnancy
· Can lead to serious systemic disease and even death
· Very bad for baby during pregnancy, tx is penicillin
· S/S: initially is painless lesion, the chancre, that appears 5-90 days
after infection and then erodes to form a nontender, shallow, indurated,
clean ulcer several mm to cm in size;
o 2nd syphilis: 6 weeks-6 month: widespread, symmetric maculopapular
rash on the palms and soles and generalized lymphadenopathy. fever,
headache, and malaise. Condylomata (wartlike infectious lesions)
develop on the vulva, perineum or anus.
, o Latent phase: asymptomatic.
o 3rd syphilis: neurologic and cardiovascular, musculoskeletal or
multiorgan system complications.
· Screening and Dx:
o Pregnant women
o Serologic tests
o False positive -> 2nd test.
· Management: Penicillin for all stages of syphilis. 1 IM of benzathine
penicillin G (2.4 million units); NEED LT serologic testing at 6 and 12
months to assess the response to the treatment even in the absence of
symptoms. Sexual abstinence during treatment.
pelvic inflammatory disease Correct Answer-· An infectious process that
most commonly involves the uterine tubes (salpingitis), uterus
(endometritis), and ovaries and peritoneal surfaces.
· Single most frequent serious infection encountered by women, happens
at end of or just after menses after reception of bacteria.
· Results from ascending spread of microorganisms from vagina and
endocervix to upper genital tract.
· Increased risk for: Ectopic pregnancy, Infertility, Chronic pelvic pain,
dyspareunia, pyosalpinx (pus in uterine tubes), tubo-ovarian abscess, and
pelvic adhesions.
· S/S:
o pain
§ Subacute: dull, cramping and intermittent
§ Acute: severe, persistent and incapacitating