CMN 572 Final Exam – Questions With Accurate
Solutions
Chlamydia Correct Answer - gold standard of testing is CX
NAAT can be used to also test for gonorrhea
Treatment: azithromycin 1 g PO once (doxy if PCN allergy);
azithromycin is OK with pregnancy
Gonorrhea Correct Answer - NAAT, cx, or gram stain for
testing
Treatment: 250 mg ceftriaxone IM once PLUS azithromycin 1 g PO
once
Gonorrhea and chlamydia often occur together
Gonorrhea is resistant to fluoroquinolones- treat with
cephalosporins ONLY
Syphilis Correct Answer - requires 2 test for diagnosis
Nontreponemal test: not specific for t.pallidum, seropositive (rx for
life); VDRL, RPR
Treponemal: specific for t. pallidum antibodies; usually reactive for
life
treatment: PCN G
,Primary: painless ulcer/chancre; perform nontreponemal test and
treat with PCN G 2.4 million units while awaiting results; if +
confirm with treponemal
Secondary: rash to palms/soles; all tests + and titers are highest
latent: asx with + tests
HPV Correct Answer - cytology is used to detect cervical
dysplasia and provide indirect evidence to HPV
cotest with Pap and HPV if >30 yrs or >25 yrs with ASC-US
can dx if genital warts obvious
patient applied tx: podofilox, imiquimod, sinecathechins; do NOT
use with pregnancy
provider administered tx: cryotherapy, trichloracetic acid,
bichloracetic acid, surgical excision
warts are more friable and proliferative during pregnancy
presence of warts is NOT an indication for c section
herpes Correct Answer - culture is gold standard for testing
polymerase chain reaction is used to test spinal fluid
antiviral medications are used to control sx- will not eradicate virus,
and does not effect risk/freq/severity of outbreaks when DC'd
acyclovir 400 mg TID or 200 mg 5x/day
1st episode: 7-10 days of treatment
,recurrent episode: 2-5 days of treatment
suppression therapy: daily
treatment may be extended if healing is not complete
bacterial vaginosis Correct Answer - overgrowth of bacteria
due to changes in normal vaginal bacterial flora
always treat pregnant women with BV, it can cause pre-term labor
metronidazole or clindamycin
goal is to re-establish normal vaginal pH or lactobacillis
PID Correct Answer - usually caused by STD (gonorrhea or
chlamydia)
treatment MUST cover gonorrhea, chlamydia, anaerobes, gram -
bacteria, and strep
ROCEPHIN, AZITHROMYCIN, METRONIDAZOLE
treat partners within 60 days of sx onset
IUD insertion and STDs Correct Answer - do not insert if pt is
sx
if asx, can test for STD and insert IUD- if tests return + treat
appropriately
conventional pap Correct Answer - wooden spatula is used to
scrape cells and examine for abnormalities
does not test for HPV
, liquid prep Correct Answer - endocervical brush is used to
collect sample, can be used for co-testing and can identify high risk
HPV
cervical polyps Correct Answer - large, friable (bleed easily)
caused by cervical hyperplasia
rarely dev into malignancy
cervical papillomas Correct Answer - solid, benign
usually asx
true: unknown cause
condyloma: HPV- bx these
combo oral contraceptives Correct Answer - estrogen and
progesterone
pills
nuvaring: left in place x 3 weeks, remove for one; can be left out for
3 hrs without losing efficacy
patch: applied weekly, less effective in obese
extended use pills: delay/eliminate menstruation to decrease
anemia, dysmenorrhea, premenstrual depression; menstruation is
not required bc endometrial lining does not build up
+: increase BMD; decrease menorrhea, acne, PCOS, ovarian cysts,
PID, ovarian and endometrial CA, benign breast dx, and ectopic
pregnancy
Solutions
Chlamydia Correct Answer - gold standard of testing is CX
NAAT can be used to also test for gonorrhea
Treatment: azithromycin 1 g PO once (doxy if PCN allergy);
azithromycin is OK with pregnancy
Gonorrhea Correct Answer - NAAT, cx, or gram stain for
testing
Treatment: 250 mg ceftriaxone IM once PLUS azithromycin 1 g PO
once
Gonorrhea and chlamydia often occur together
Gonorrhea is resistant to fluoroquinolones- treat with
cephalosporins ONLY
Syphilis Correct Answer - requires 2 test for diagnosis
Nontreponemal test: not specific for t.pallidum, seropositive (rx for
life); VDRL, RPR
Treponemal: specific for t. pallidum antibodies; usually reactive for
life
treatment: PCN G
,Primary: painless ulcer/chancre; perform nontreponemal test and
treat with PCN G 2.4 million units while awaiting results; if +
confirm with treponemal
Secondary: rash to palms/soles; all tests + and titers are highest
latent: asx with + tests
HPV Correct Answer - cytology is used to detect cervical
dysplasia and provide indirect evidence to HPV
cotest with Pap and HPV if >30 yrs or >25 yrs with ASC-US
can dx if genital warts obvious
patient applied tx: podofilox, imiquimod, sinecathechins; do NOT
use with pregnancy
provider administered tx: cryotherapy, trichloracetic acid,
bichloracetic acid, surgical excision
warts are more friable and proliferative during pregnancy
presence of warts is NOT an indication for c section
herpes Correct Answer - culture is gold standard for testing
polymerase chain reaction is used to test spinal fluid
antiviral medications are used to control sx- will not eradicate virus,
and does not effect risk/freq/severity of outbreaks when DC'd
acyclovir 400 mg TID or 200 mg 5x/day
1st episode: 7-10 days of treatment
,recurrent episode: 2-5 days of treatment
suppression therapy: daily
treatment may be extended if healing is not complete
bacterial vaginosis Correct Answer - overgrowth of bacteria
due to changes in normal vaginal bacterial flora
always treat pregnant women with BV, it can cause pre-term labor
metronidazole or clindamycin
goal is to re-establish normal vaginal pH or lactobacillis
PID Correct Answer - usually caused by STD (gonorrhea or
chlamydia)
treatment MUST cover gonorrhea, chlamydia, anaerobes, gram -
bacteria, and strep
ROCEPHIN, AZITHROMYCIN, METRONIDAZOLE
treat partners within 60 days of sx onset
IUD insertion and STDs Correct Answer - do not insert if pt is
sx
if asx, can test for STD and insert IUD- if tests return + treat
appropriately
conventional pap Correct Answer - wooden spatula is used to
scrape cells and examine for abnormalities
does not test for HPV
, liquid prep Correct Answer - endocervical brush is used to
collect sample, can be used for co-testing and can identify high risk
HPV
cervical polyps Correct Answer - large, friable (bleed easily)
caused by cervical hyperplasia
rarely dev into malignancy
cervical papillomas Correct Answer - solid, benign
usually asx
true: unknown cause
condyloma: HPV- bx these
combo oral contraceptives Correct Answer - estrogen and
progesterone
pills
nuvaring: left in place x 3 weeks, remove for one; can be left out for
3 hrs without losing efficacy
patch: applied weekly, less effective in obese
extended use pills: delay/eliminate menstruation to decrease
anemia, dysmenorrhea, premenstrual depression; menstruation is
not required bc endometrial lining does not build up
+: increase BMD; decrease menorrhea, acne, PCOS, ovarian cysts,
PID, ovarian and endometrial CA, benign breast dx, and ectopic
pregnancy
