SANE-P certification exam prep 78 Questions with Verified Answers,100% CORRECT

SANE P certification exam prep 78 Questions with Verified Answers STDs inconclusive for child sexual abuse - CORRECT ANSWER bacterial vaginosis (BV) and Hepatitis B (HBV) HIV testing timeline - CORRECT ANSWER initial exam 6 weeks 3 months 6 months STDs suspicious for child sexual abuse (not perinatally acquired) - CORRECT ANSWER HPV HSV (autoinoculation must be ruled out) STDs suspcicious for child sexual abuse (not perinatally acquired) - CORRECT ANSWER Trichomonis vaginalis (TV) How to test for trichomonis vaginalis (TV) - CORRECT ANSWER swab genitals, test swab via wet mount microscopy and culture * look for yellow-green discharge * NAAT is highly sensitive and used in the adult population but has not been confirmed in peds STDs diagnostic of child sexual abuse (not perinatally acquired) - CORRECT ANSWER HIV, syphilis, gonorrhea, chlamydia Perinatal transmission timeline for chlamydia - CORRECT ANSWER up to 3 years perinatal transmission timeline Perinatal transmission timeline for gonorrhea - CORRECT ANSWER up to 1 year perinatal transmission timeline Perinatal transmission timeline for syphilis - CORRECT ANSWER up to 6 months perinatal transmission timeline perinatal transmission timeline for trichomonas - CORRECT ANSWER 6 months up to 3 years perinatal transmission timeline perinatal transmission timeline for herpes simplex virus (HSV) - CORRECT ANSWER up to 4 weeks perinatal transmission timeline perinatal transmission timeline for human papilloma virus (HPV) - CORRECT ANSWER up to 3 years perinatal transmission timeline How to test for chlamydia - CORRECT ANSWER NAAT test- girls urine -vaginal swab Culture- boys urine - boys urethral discharge - vagina - anus no test for pharyngeal site Signs and symptoms, or evidence of STD infection in children- what is the next step? - CORRECT ANSWER Test, don't treat until tests have been confirmed How to test for gonorrhea - CORRECT ANSWER NAAT test- girls urine Culture- boys urine - pharynx - anus - urethral discharge (boys) - vagina How to test for bacterial vaginosis - CORRECT ANSWER *swab genitals and test with wet mount microscopy *look for "clue cells" ( vaginal epithelial cells studded with coccoobacilli) under the microscope *10 % KOH whiff test * visually examine for thin white discharge that smoothly coats the vaginal walls How to test for HSV - CORRECT ANSWER culture of lesions How to test for HPV - CORRECT ANSWER visual exam How to test for syphilis - CORRECT ANSWER serology testing for t. pallidium Follow up testing timeline for syphilis - CORRECT ANSWER serology testing 6 weeks post assault Follow up testing timeline for Hep B - CORRECT ANSWER serology testing 6 weeks and 3 months post assault Do we test all children for STDs who present for a sexual assault exam? - CORRECT ANSWER no, case- by case basis s/p sexual assault: if the assailant's Hep B status is unknown and the child is unvaccinated, what do we give - CORRECT ANSWER Hep B Vaccine s/p sexual assault: if the assailant is known to be Hep B positive (HBS-Ag +) and the child is unvaccinated, what do we give? - CORRECT ANSWER Hep B vaccine and Hep B immunoglobulins (HBIG) What is the usual Hepatitis B vaccination schedule? - CORRECT ANSWER birth, 2 months, and 6 months s/p sexual assault: if the assailant is known to be Hep B positive (HBs-Ag +) and the child is vaccinated, what do we give? - CORRECT ANSWER Hep B vaccine booster dose x1 HIV prophylaxis - CORRECT ANSWER nPEP x 28 days must be started within 72 hours nPEP for children < 45kg - CORRECT ANSWER 3 drug regime: zidovudine lamivudine raltegravir nPEP for children >45kg - CORRECT ANSWER treat as an adult 3 drug regime: emtricitabine tenofovir raltegravir treatment for syphilis for children < 45 kg - CORRECT ANSWER IM Benzathine penicillin G 50 units/kg x1 dose (max 2.4 million units) treatment for syphilis for children > 45 kg - CORRECT ANSWER adult dosing IM benzathine penicillin G 2.4 million units x 1 dose treatment for chlamydia for children <45kg - CORRECT ANSWER PO erythromycin 50mg/kg/day x 14 days QID divided doses treatment for chlamydia for children > 45 kg - CORRECT ANSWER adult dosing PO Azithromycin 1 g x1 dose side effects: nausea, vomiting treatment for gonorrhea for children <45kg - CORRECT ANSWER IM ceftriaxone x1 dose 50mg/kg (max 125mg) treatment for gonorrhea for children >45kg - CORRECT ANSWER IM ceftriaxone 250mg x 1 dose alternate medication to treat gonorrhea if IM ceftriaxone can't be taken - CORRECT ANSWER PO cefixime 400mg x1 alternate medication to treat chlamydia if PO azithromycin can be taken - CORRECT ANSWER Doxycycline 100 mg BID x 7 days child must be at least 8yo treatment for trichomonas - CORRECT ANSWER PO metronidazole 2 g x 1 dose metronidazole education instructions - CORRECT ANSWER side effects: nausea, may cause a weird taste in your mouth must wait at least 24-72 hours since the last ingestion of alcohol to avoid a disulfiram like reaction (severe vomiting) hymenal findings commonly seen in nonabused children - CORRECT ANSWER *hymen with tags, mounds *hymen with a notch or cleft regardless of depth on the anterior rim (above 9 o'clock and 3 o'clock) * hymen with a superficial notch or cleft on the posterior rim (below 9 o'clock and 3 o'clock) *smooth posterior rim that appears to be relatively narrow along the entire rim Linea vestibularis (midline avascular area) is a normal variant? (yes or no) - CORRECT ANSWER yes, commonly seen in nonabused children genital erythema is commonly caused by medical conditions other than trauma or sexual contact (yes or no) - CORRECT ANSWER yes, commonly seen in nonabused children venous pooling, partial dilation of external anal sphincter which internal sphincter closed, and visualization of anal pectinate line, and rectal prolapse- are these consistent with abuse? - CORRECT ANSWER no, these are conditions mistaken for abuse and are commonly seen in nonabused children complete anal dilatation of both internal and external sphincters in the absence of predisposing factors (constipation, anesthesia)- is this consistent with abuse? - CORRECT ANSWER unknown, this a finding with no expert consensus with respect to sexual contact or trauma perianal scar- is this consistent with abuse? - CORRECT ANSWER this is a finding caused by trauma or sexual contact, which could be accidental or inflicted scar of the posterior fourchette or fossa navicularis- is this consistent with abuse? - CORRECT ANSWER this is a finding caused by trauma or sexual contact, which could be accidental or inflicted notch or cleft in the hymen rim at or below the 3 or 9o'clock location which is deeper than a superficial notch but is not a complete transection- is this consistent with abuse? - CORRECT ANSWER unknown, this a finding with no expert consensus with respect to sexual contact or trauma bruising, petechiae or abrasions on the hymen- are these consistent with abuse? - CORRECT ANSWER these are findings caused by trauma or sexual contact, which could be accidental or inflicted absence of hymenal tissue extending to the base of the posterior rim of the hymen.- is this consistent with abuse? - CORRECT ANSWER these are findings caused by trauma or sexual contact, which could be accidental or inflicted acute partial laceration of the hymen- is this consistent with abuse? - CORRECT ANSWER these are findings caused by trauma or sexual contact, which could be accidental or inflicted acute complete laceration of the hymen- is this consistent with abuse? - CORRECT ANSWER these are findings caused by trauma or sexual contact, which could be accidental or inflicted genital warts observed in the absence of other indicators of abuse- is this consistent with abuse? - CORRECT ANSWER unknown, this a finding with no expert consensus with respect to sexual contact or trauma suspicious but not diagnostic anal fissures- are these consistent with abuse? - CORRECT ANSWER anal fissures are a finding commonly caused by medical conditions other than trauma or sexual contact vaginal discharge- is this consistent with abuse? - CORRECT ANSWER discharge is a finding commonly caused by medical conditions other than trauma or sexual contact why do we not prophylactically treat STDs in prepubertal children? - CORRECT ANSWER decreased risk for ascending infections follow up can be reasonably assured low incidence what factors place a child a increased risk for contracting an STD? - CORRECT ANSWER * high incidence of STDs in the community * household member with an STD * perpetrator has an STD (even higher risk if the perpetrator has an open lesion) * perpetrator is in a high risk population: men who have sex with men, IV drug use, transgender, incarceration, sex work) * mucosal injury * mucosal contact with ejaculate * multiple perpetrators are pre pubertal children are at a higher risk of contracting HIV? - CORRECT ANSWER yes decreased elasticity increases the likelihood of a break in skin/bleeding which increases the likelihood of transmission Is a girl at risk for pregnancy prior to menarche (her 1st period)? - CORRECT ANSWER yes, any female tanner stage 3 and above can transgender males (female to male) who are taking testosterone become pregnant? - CORRECT ANSWER yes risk of pregnancy s/p sexual assault is: - CORRECT ANSWER 2-5 % similar to the risk of pregnancy after a one time sexual encounter recommended emergency contraception pill - CORRECT ANSWER levonorgestrol less nausea must take within 72 hours, sooner the more effective 1.5mg x1 reduces the risk of pregnancy up to 89% when will a urine pregnancy test detect a pregnancy? - CORRECT ANSWER 8 to 9 days after conception counseling: is emergency contraception the same as an abortion pill? - CORRECT ANSWER no ECP delays or inhibits ovulation there is no evidence that ECP works after an egg has been fertilized Counseling: emergency contraception pill - CORRECT ANSWER Will not treat STDs ECP will not work if you are already pregnant ECP will not harm you or your baby if you are already pregnant who can give assent - CORRECT ANSWER prepubescent children who can understand and participate in care how do SANEs respond effectively to aggressive or condescending questions when testifying? - CORRECT ANSWER disagree without argument or interruption assent vs consent - CORRECT ANSWER Children can give assent adults give consent ( parents, judge, CPS) Up to what point in time can DFSA blood sample be collected? - CORRECT ANSWER <24 hours Up to what point in time can DFSA urine be collected? - CORRECT ANSWER up to 96 hours How should DFSA blood be collected? - CORRECT ANSWER grey top tube (sodium fluoride and potassium oxalate preservatives) at least 20mL of blood How should DFSA urine be collected? - CORRECT ANSWER >100mL of urine collected within 96 hours Incubation period of chlamydia - CORRECT ANSWER 1-3 weeks or longer incubation period of gonorrhea - CORRECT ANSWER 2-7 days incubation period of syphilis - CORRECT ANSWER primary- 10 to 90 days secondary- 6 wks to 6 months incubation period of HIV - CORRECT ANSWER 6 weeks to 6 months incubation period of trichomonas - CORRECT ANSWER 5-28 days incubation period of HSV - CORRECT ANSWER 2 to 5 days incubation period of HPV - CORRECT ANSWER 4 to 12 weeks, up to 18 months