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