Obgyn Chapter 28 Sexually Transmitted Diseases

Front 1

Approximately what percent of patients with a sexually transmitted disease (STD) have more than one STD?

Back 1

20 to 50%

Front 2

In approximately what percent of cases will a single sexual contact with a patient who has an active herpes infection result in transmission of the infection?

Back 2

60 to 80%

Front 3

What percent of genital herpes lesions are caused by the herpes simplex virus type II?

Back 3

85%

Front 4

Approximately what percent of patients with an initial herpes genitalis infection will require hospitalization for pain control or management of urinary complications?

Back 4

10%

Front 5

The normal progression of symptoms in primary herpes infections is a prodromal phase followed by

Back 5

vesicle, ulcer, crusting, resolution

Front 6

Primary herpes genitalis infections are characterized by malaise, low-grade fever, and inguinal adenopathy in approximately what percent of patients?

Back 6

40%

Front 7

Herpes genitalis lesions recur in approximately what percent of patients?

Back 7

30%

Front 8

Compared with primary genital lesions, recurrent herpes lesions are

Back 8

milder

Front 9

A pregnanat patient at term presents in active labor. Her membranes are intact. She has active herpetic lesions in the vagina. If vaginal delivery occurs, what is the likelihood that the newborn will be infected?

Back 9

50%

Front 10

Neonatal herpes infection acquired at the time of delivery is associated with a mortality rate of approximately

Back 10

80%

Front 11

An 18-year-old patient presents with a 5-day history of very painful vulvar ulcers that began as small "blisters." She is now complaining of a low-grade fever, headache, and meningismus. Large, painful vulvar and perineal ulcers and inguinal adenopathy are found on examination. The most likely diagnosis is

Back 11

Primary herpes vulvitis

Front 12

A 23-year-old G3 P2001 patient presents at term in early labor with an active herpes infection of the labia that has been present for the past 3 days. Membranes are intact. Contractions are regular at 3-minute intervals and have been present for the last 3 hours. Her last term labor was 3 years ago and lasted 12 hours, ending in a vaginal delivery of a normal 7-pound infant. Which of the following is the best management of this patient?

Back 12

Immediate cesarean delivery

Front 13

All of the following are caused by infection by Chlamydia species EXCEPT

Back 13

granuloma inguinale

(Associated with Chlamydia are: cervicitis, PID, and lymphogranuloma venereum)

Front 14

Chlamydia infections are frequently associated with co-infections by

Back 14

Neisseria gonorrhoeae

Front 15

Antibodies to Chlamydia are found in approximately what percent of sexually active women?

Back 15

20 to 40%

Front 16

How long does it take to confirm the diagnosis of Chlamydia using the culture technique?

Back 16

48 to 72 hours

Front 17

Outpatient treatment with doxycycline or erythromycin for suspected or confirmed Chlamydia infection is associated with a cure rate of

Back 17

95%

Front 18

A common sequela of infection by Chlamydia trachomatis is

Back 18

involuntary infertility

Front 19

Neisseria gonorrhoeae is a

Back 19

gram-negative intracellular diplococcus

Front 20

Infection of the pharynx is found in what percent of heterosexual women with confirmed Neisseria gonorrhoeae infections?

Back 20

10 to 20%

Front 21

For women, a single encounter with a partner infected with Neisseria gonorrhoeae is estimated to lead to infection in what percent of cases?

Back 21

80 to 90%

Front 22

Following inital infection by Neisseria gonorrhoeae, symptoms first appear in

Back 22

3 to 5 days

Front 23

A 22-year-old G0P0 patient has just been successfully treated for Neisseria gonorrhoeae salpingitis and asks about her chances of infertility. Based on this single infection, her chances of involuntary infertility are approximately

Back 23

15 to 20%

Front 24

A 22-year-old G0P0 patient has just been successfully treated for her thrid episode of Neisseria gonorrhoeae salpingitis and asks about her chances of infertility. Based on this single infection, her chances of involuntary infertility are approximately

Back 24

70 to 80%

Front 25

Lower genital tract infections by Neisseria gonorrhoeae are usually characterized by

Back 25

malodorus, purulent vaginal or urethral discharge

Front 26

Which of the following is the most frequent site of gonrorheal infection in women?

Back 26

Cervix

Front 27

Which of the following criteria is required to make a diagnosis of acute salpingitis?

Back 27

adnexal tenderness

Front 28

All of the following are criteria for the hospitalization of patients with pelvic inflammatory disease EXCEPT

Back 28

patient <20 years of age

(reasons to hospitalize PID patients - coexisting pregnancy, WBC count >20,000, nulliparity)

Front 29

The initiaion of treatment for presumped pelvic inflammatory disease is based on

Back 29

clinical suspicion

Front 30

The development fo cervical cancer is associated with

Back 30

human papillomavirus (HPV)

Front 31

In approximately what percent of cases will a single sexual contact with an individual with an HPV infection result in transmission of the infection?

Back 31

60 - 70%

Front 32

Lesions caused by HPV may be confused with those of

Back 32

secondary syphilis

Front 33

Human papillomavirus infection is associated with

Back 33

kissing lesions

Front 34

The HPV is found in approximately what percent of women?

Back 34

2.5 to 4%

Front 35

All of the following modalities are used to treat simple condylomata acuminata EXCEPT

Back 35

acyclovir

(Can tx condylomata acuminata with podophyllin in tincture of benzoin, trichloracetic acid, and 5-fluorouracil)

Front 36

Which of the following does NOT make a patient more resistant to therapy for condylomata acuminata?

Back 36

overweight

Front 37

Vaginal delivery of a patient with extensive condylomata acuminata of the vulva may result in

Back 37

infant laryngeal papillomas

Front 38

Transplacental spread of Treponema pallidum can occur

Back 38

at any time during pregnancy

Front 39

The chancre of primary syphilis will

Back 39

spontaneously heal in 3 to 9 weeks

Front 40

Which of the following is characteristic of primary syphilis?

Back 40

Chancre is often asymptomatic

Front 41

The most contagious stage of syphilis is

Back 41

secondary

Front 42

The mucous patches of seconary syphilis will

Back 42

spontaneously heal in 2 to 6 weeks

Front 43

Which of the following is a nontreponemal test?

Back 43

All of the above (Rapid plasma reagin (RPR), Venereal Disease Research Laboratory (VDRL), & Automated reagin test)

Front 44

Which of the following is the approximate sensitivity of the VDRL test in detecting primary syphilis?

Back 44

75%

Front 45

Which of the following is the sensitivity of the RPR test in detecting primary syphilis?

Back 45

85%

Front 46

Which of the following is the sensitivity of teh fluoorescent treponemal antibody absorption (FTA-ABS) test in detecting primary syphilis?

Back 46

85%

Front 47

Which of the following is the sensitivity of the microhemagglutination assay-Treponema pallidum (MHA-TP) test in detecting primary syphilis?

Back 47

75%

Front 48

Which of the following serologic tests for syphilis has a sensitivity of approximately 100% for secondary sypphilis?

Back 48

All of the above (

VDRL, RPR, FTA-ABS, and MHA-TP)

Front 49

Which of the following does NOT result in a false-positive VDRL or RPR test?

Back 49

gonorrhea

Front 50

Which of the following is characteristic of secondary syphilis?

Back 50

Low-grade fever, headache, malaise, sore throat, anorexia, and generalized lymphadenopathy

Front 51

Without intervention, the risk of transmission of the HIV to a fetus is approximately

Back 51

50%

Front 52

The diagnosis of HIV infection is established on the basis of

Back 52

Western blot testing

Front 53

Painless, ulcerated vulvar lesions are characteristic of infections with

Back 53

Treponema pallidum

Front 54

Which of the following conditions ahs an incubation period (from infection to clinical symptoms) of >1 month?

Back 54

Condyloma acuminata

Front 55

Multiple vulvar vesicles are typical of which of the following infections?

Back 55

Genital herpes

Front 56

Which of the following is the incubation period for herpes?

Back 56

3 to 7 days

Front 57

Which of the following is the incubation period for genital warts?

Back 57

1 to 8 months

Front 58

Which of the following is the incubation period for syphilis?

Back 58

10 to 60 days

Front 59

Which of the following is the cuasative agent for genital warts?

Back 59

Human papillomavirus

Front 60

Which of the following is the cuasative agent for syphilis?

Back 60

Treponema pallidum

Front 61

Which of the following is the causative agent for chancroid?

Back 61

Haemophilus ducreyi

Front 62

Which of the following is the causative agent for lymphogranuloma venereum?

Back 62

Chlamydia trachomatis

Front 63

Which of hte following is the causative agent for granuloma inguinale?

Back 63

Calymmatobacterium granulomatis

Front 64

Which of the following STDs is generally NOT associated with lymphadenopathy?

Back 64

Genital warts

(associated with lymphadenopathy are herpes, syphilis, chancroid, and lymphogranuloma venereum)

Front 65

Which of the following STDs is associated with a purulent, hemorrhagic secretion?

Back 65

Chancroid

Front 66

Which of the following STDs is characteristically associated with multiple vesicular lesions that often coalesce?

Back 66

Herpes

Front 67

Which of the following is NOT associated with acute cervicitis?

Back 67

Treatment of the acute phase is surgical

Front 68

What percent of normal women with Neisseria gonorrhoeae cervicitis will develop acute pelvic inflammatory disease?

Back 68

15%

Front 69

A Word catheter being used to drain a Bartholin gland abcess should be left in place for a minimum of

Back 69

1 week

Front 70

Condyloma acuminata that exceed 2 cm in size are best treated with

Back 70

Laser therapy

Front 71

The initial involvement in pelvic tuberculosis typically is

Back 71

tubal

Front 72

A false-positive screening test for AIDS is more likely in what women who

Back 72

are taking oral contraceptives

Front 73

Measures to prevent HIV include use of latex condoms containing

Back 73

Nonoxynol 9

Front 74

When neurosyphilis is clinically suspected, a VDRL should be obtained on what fluid?

Back 74

Cerebrospinal fluid

Front 75

What is the additional risk for ectopic pregnancy in patients with a history of salpingitis?

Back 75

Eightfold