week seven mastering

What diagnosis will you make for this patient?

Secondary syphilis

The two most common STI organisms associated with PID in the United States are Chlamydia trachomatis and Neisseria gonorrhoeae. There are many similarities between these STIs. Which of the following statements comparing chlamydia and gonorrhea are true?

-Chlamydia is found more often in women, whereas gonorrhea is found more often in men. -Chlamydia and gonorrhea can infect a patient and be transmitted without causing obvious symptoms -Patients may be coinfected with both gonorrhea and chlamydia.

What will you recommend for your patient before you discharge her from the clinic?

A full TORCH panel.

STI home test kits are still relatively new on the market. Given their newness, it is necessary to weigh the benefits and the risks to doing the tests at home. Place each statement below in the appropriate bin.

Advantage- anyone can purchase and use -improved communication -increased treatment Disadvantage -kits can make mistakes -information leaks -increased costs

Which disease(s) did your patient have/received vaccinations for in the past?

Hepatitis B Varicella-zoster virus Rubella

The at-home tests work similarly to pregnancy tests and are based on antigen-antibody reactions between the infectious agent and the patient's antibodies. Which class of antibody is most likely to give a result in the assay?

IgG

Nicole received her diagnosis at her physician's office. Which of the following procedures was most likely used by the physician to confirm her infection?

Nucleic Acid Amplification Testing (NAAT)

You would like to perform some diagnostics to help you confirm your hypothesis. Which of the following would you like to do to help you make a diagnosis of genital herpes? Select all that apply.

PCR testing on fluid from vesicle culture of fluid from vesicle serology

Which diagnostics would you like to use?

Rapid plasma reagin test Flourescent treponemal antibody absorption test Visual brightfield micrograph inspection (with silver stain) of ulcer exudate

Nicole is very upset after receiving news that her ex-boyfriend Paul had tested positive for syphilis and gonorrhea. She makes an appointment with her physician. Nicole receives her test results, which indicate that she is positive for syphilis, but not for gonorrhea. What treatment will her doctor most likely prescribe?

antibiotics

"If I can never be cured, how can I avoid passing the disease to my girlfriend?" your patient cries. You assure him that it is still possible for him maintain a relationship, although he will potentially have to form some new habits and take some extra precautions. You recommend that if the pair mutually agrees to continue dating, then he and/or his girlfriend should ______.

avoid sex when the infected partner is symptomatic use additional protection during oral sex (dental dam, saran wrap) take a daily prescription for valacyclovir use a condom during intercourse

The physician performs a pelvic exam, which reveals the presence of an abnormal thin, watery vaginal discharge and inflammation of the cervix. The physician then palpates the abdomen (examines by touch and pressure) and finds that the uterus, fallopian tubes, and ovaries are enlarged and tender. The physician takes a swab sample of the cervix and sends it to the laboratory to determine the causal organism. Light microscopy and simple staining of the sample in the lab reveal an organism with a very unique life cycle. The organism is classified as gram-negative, but it stains very poorly compared to other classic gram-negative STI pathogens. The stain shows both a nonreplicating, extracellular infectious elementary body and a replicating, noninfectious reticulate body inside mucosal cells from the cervical epithelium swab. Based on the symptoms and these new laboratory findings, which of the following would be the most likely diagnosis for the patient?

chlamydia

Given your current information, which of the following diseases do you think could be responsible for your patient's symptoms? Select no more than six answers.

genital herpes

Of the two strains of virus that cause genital herpes, which strain is more likely to be responsible for your patient's outbreak?

herpes simplex virus 2

Based upon these results, which disease(s) could your patient have CURRENTLY?

none of these

you would like to ask your patient about scenarios where he could have contracted the virus. Which of the following could he have acquired genital herpes from? Select all that apply.

skin-to-skin contact with infected oral or genital area oral sex unprotected vaginal sex vaginal sex with condom anal sex physical contact with an asymptomatic person with latent genital herpes

Given your current information, which of the following diseases do you think could be responsible for your patient's symptoms? Select no more than six answers.

there is not enough information

If you assume that this is your patient's first outbreak and that his condition had an incubation period, when would you guess that he acquired the virus?

three weeks ago

Chlamydia PID is just part of the overall spectrum of disease caused by Chlamydia organisms. Even though we now understand more about STIs and their complications, we are still exploring how the organisms "branch out" beyond just a single infection. Which of the following diseases have Chlamydia infection as an etiology?

trachoma pneumonia infertility cervical cancer inclusion conjunctivitis lymphogranuloma venereum (LGV)

Your patient's girlfriend looks shocked when you deliver the news. She immediately runs out to your patient, exclaiming: "How could you cheat on me??!" Your patient stammers that he hasn't and wouldn't cheat on her. Is it possible that he is telling the truth?

yes he could telling the truth

Your patient tries to sheepishly smile at his girlfriend and reaches out for her. She is still clearly upset, but she takes his hand and sighs loudly. She turns to you and asks how you plan to cure her boyfriend. You reply that ______

you cannot cure your patient's disease

Of the possibilities you identified, which disease would you like to test for first?

Syphilis

Given your current information, which of the following diseases do you think could be responsible for your patient's symptoms? Select no more than six answers.

Syphilis Chancroid Genital herpes Genital warts AIDS Candidiasis

Based upon these diagnostics, which pathogen is responsible for your patient's disease?

Treponema pallidum

Nicole knew that these were both sexually transmitted infections caused by bacteria. Which of the following is correct regarding the causative agents for these diseases?

Treponema pallidum causes syphilis, while Neisseria gonorrhoeae causes gonorrhea.

Our patient needs antibiotics to overcome this infection and prevent any further complications. Which of the following would be the best choice?

a combination therapy of cephalosporin-class AND macrolide-class.

How will you treat your patient?

Azithromycin