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NURO510 Exam 2 Questions And
100% Correct Answers

Transgender - Answer broad term used for people whose gender identity or gender
expression differs from assigned sex at birth

DSM4 Transgender Definition - Answer Only est. for those individuals w/ clinically
significant distress & functional impairment caused by persistent discomfort w/ one's
assigned sex & primary/secondary sex characteristics

If untreated can result in psychologic dysfunction, depression, SI, death

Individuals w/ disturbance in sexual or gender identity

What negative outcomes are commonly found among the transgender population? -
Answer Homelessness, sex in exchange for food, clothing, shelter, basic needs,
increased risk for STIs and victimization of violence, risk for suicide and use of hormone
injections obtained illegally

Barriers to healthcare among transgenders - Answer failure of insurance plans to cover
cost of mental services, cross sex hormone therapy or gender affirmation surgery
despite me evidence showing that this choice for the individual can't be reversed w/
psychiatric tremens

Androgynous - Answer Someone whose gender identity is both male & female or neither

Gay - Answer A person who is emotionally, romantically, sexually, and relationally
attracted to members of same sex

Bisexual - Answer Person emotionally, romantically, sexually, and relationally attracted
to men & women, but not simultaneously necessarily

Queer - Answer Often interchangeable w/ LGBT

Two-spirit - Answer Someone who displays characteristics of both male & female,
sometimes referred to as third gender; derived from native North American

Crossdresser or "transvestite" which shouldn't be used - Answer individual who dresses
in clothing of opposite sex for reasons including need to express femininity or
masculinity, artistic expression, performance, erotic pleasure but not to identify as that
gender

Bigendered - Answer those who identify as both or as no gender or as gender other than
male or female

,Intersex or ambiguous genitalia - Answer individuals with congenital variations of
repordcuctiv system not considered typical for male or female

FTM or transman

MTF or transwoman - Answer someone identified as female at birth but portrays gender
as male; often used after steps taken to express gender as male using hormones or
surgery

Vice versa

Gender identity - Answer person's innate identification as man, woman, or something
else that may not corresponds to external body or assigned birth sex

Sex or natal sex - Answer designation of person at birth as male or female based on
anatomy

Gender expression - Answer how individuals present themselves socially: clothing,
hairstyle, jewelry, physical characteristics: speech, mannerisms

May not be same gender in all settings

Sexual orientation - Answer person's physical, romantic, emotional, and/or spiritual
attraction to individuals of the same or different or both sexes

It doesn't define real life sexual practices and behaviors of someone

Sexual behavior - Answer Sexual encounters and behaviors of the individual

Likely to be most important factor in assessing STI risk

Not all individuals who engage in same-sex behaviors view themselves as gay, lesbian,
or bisexual

Legal sex - Answer sex stated on legal ID, forms, docs

What can providers/clinics do to improve care provided to LGBTs? - Answer Refer if
needed

Include "transgender" check boxes on forms

Don't assume, ask sensitive questions

Assure confidentiality

Address social needs/concerns

Train staff to increase knowledge & sensitivity toward transgender

What are the 3 gender transformation stages: - Answer 1. living gender role consistent
w/ gender identity

,2. use of cross sex hormone therapy

3. Gender affirmation surgery after living in new gender role and using hormone for at
least 12 mo

FTM Treatment & Screening - Answer Hormones: methyltestosterone injections q 2
weeks; usually sufficient to suppress menses & induce masculine secondary sex
characteristics

Before & after androgen, screen for contraindications & periodic lab testing including
H&H (for polycythemia), LFTs, serum testosterone)

**Goal 500 mcg/dL while receiving TX

SX = hysterectomy w/ or w/out sapling-oophorectomy; reconstruction by urologist, GYN,
or surgeon specialized

Continue age appropriate screening for breast & cervical cancer unless mastectomy &
cervix removal

Increased endometrial/ovarian cancer risk for those using androgen w/out complete
hysterectomy

MTF Treatment & Screening - Answer Estrogen results in gynecomastia, reduced hair
grown, fat redistribution, decreased testicular volume

Screen for medical contraindications, after surgery, doses of estradiol 2-4mg/d or
conjugated equine estrogen 2.5mg/d are often sufficient to keep testosterone to normal
female levels (<25ng/dL)

Test annual prolactin level

SX= penile & testicular excision and creation of neovagina

Complications: vaginal & urethral stenosis, fistula formation, problems w/ remnants of
erectile tissue & pain

Vag dilation required for maintenance

Breast implants and facial SX may be done

Screening: breast & prostate cancer

Cytologic exam of neocervix may be needed if glans penis used

Expedited Partner Therapy - Answer Treating sexual partner of patients in whom STIs
are DX (specifically GC or CT); provider can five prescription to patient tot take to
partner w/o first examining the partner with written treatment instruction

Should be accompanied by patient counseling

, Encourage partner to seek medical evaluation ASAP to discuss screening for other STIs
like HIV

NOT INTENDED w/ suspicion of child abuse, assault

TX all partners in last 2 months or most recent partner if not sexually active in past 2 mo

STIs & Women's Fertility - Answer Can create a preventable threat to their fertility

Highest Risk Age Group for GC/CT - Answer 15-24

How long should intercourse be avoided after TX for GC/CT? - Answer 7 days after
completion of TX

ACOG HIV Screening recommendation - Answer All patients 13-64 should be screened
one in lifetime & there after based on RF which should be reviewed annually as should
the need for retesting be assessed

Opportunity for repeat testing should be made available for everyone

Repeat screening after age 64 indicated if going risk of HIV infection based on risk
assessment

Encourage testing prior to initiating new sexual relationship

HIV Annual Screening RF include: - Answer IVDA, sex partners of IVDA, sex worker, sex
partners of HIV persons, sex w/ men who have sex with men since most recent HIV test,
have had more than one sex partner since most recent HIV test

Opt out HIV Screening Approach - Answer Provider notifies patient that HIV screening
will be done as part of routine screening without paper consent; patient can decline and
opt out

Choice and reason should be documented for opting out

HIV notification - Answer Should be done in person and confidentially

Rapid HIV Test - Answer Positive is preliminary and must be confirmed w/ additional
testing; negative does not require F/U

Prevention & control of STIs strategies by CDC - Answer 1. accurate assessment &
education& counseling of at risk persons and ways to avoid STIs through sex behavior
changes and recommended prevention services

2. pre-exposure vaccination of persons at risk for vaccine preventable STIs

3. identification of asymptomatically infected persons & persons w/ symptoms
associated with STIs

4. effective DX, TX, counseling, F/U of infected persons

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