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40 Cards in this Set
- Front
- Back
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How many women will be victim of rape/sexual assault at least once in their life?
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1 in 4
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how many college women report being forced to have sex?
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1 in 5
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how many victims know their assailants?
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66%
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what percent are assaulted by friend/acquaintance? intimate? relative? stranger?
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friend: 48%
intimate: 16% relative: 2% stranger: 30% |
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what % occur in home of someone known?
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60%
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What % of victims require emergency medical attention?
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36%
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what % contract STD's?
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up to 40%
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what % become pregnant?
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1-5%
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Components of Forensic Exam?
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Medical Care for Injuries
Comprehensive Medical Interview Collect Forensic Evidence Evaluate/Rx STDs Evaluate/Rx pregnancy Crisis Intervention/Referrals |
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General areas of Proper Documentation by Health Care Provider:
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Physical Facts about Sexual Assault
Post-Assault Activity Did Assault occur > 72hrs ago Risk factors for STD's Active Medical Problems etc |
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4 purposes for forensic evidence collection?
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ID assailant
Confirm recent sexual contact Establish force or threat Corroborate victim's story |
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what's up w/ consent of care?
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forensic exam is not a medical emergency, so any part can be refused
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Steps of the Victim Evidence Collection Kit?
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1: authorization forms
2: Medical and assault history 3: Clothing removal and collection 4: Debris collector for nails 5: Towel and comb for pubes 6: Pulled pubes 7: Slides, swabs, boxes for vaginal swabs 8: same stuff for rectal swabs 9: same stuff for oral swabs 10: pulled head hairs 11: Saliva sample 12: Two blood vials 13: anatomical drawings |
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What can be concluded from forensic evidence?
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Recent sexual contact
Recent trauma consistency between findings and story |
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What can't be concluded?
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validity of claim
Dx of rape degree of force presence of consent |
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Top 4 sites of genital trauma?
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Posterior Fourchette (70%)
Labia minora (53%) Hymen (29%) Fossa navicularis (25%) |
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Reasons for genital trauma?
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Lack of pelvic tilt
Lack of partner assistance Lack of lube Lack of relaxation Inc force of penetration Male sexual dysfxn Lack of communication |
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Three main date rape drugs?
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GHB
Rohypnol Ketamine |
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STD preventative therapies?
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Post Exposure Hep B Vaccine
Empiric Regimen for bacterial STD's Possibly HIV post-exposure prophylaxis |
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What is in the empiric regimen for chlamydia, gonorrhea, etc?
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Metronidazole
Ceftriaxone Azithromycin |
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When is HIV prophylaxis recommended?
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<72 hrs after high risk exposure
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Regimen of HIV post-exposure prophylaxis?
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Efavirenz (not for pregs)
PLUS Lamivudine or emtricitabine PLUS Zidovudine or tenofovir 4 WEEKS |
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Why is compliance w/ HIV prophylaxis low?
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LOTS of SE's
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Rate of false reports?
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2-3%
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% of reports deemed unfoundable?
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8%
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How many of those arrested are convicted?
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fewer than half
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percent of those convicted who serve less than a year?
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25%
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Types of EC?
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Yuzpe Regimen
Plan B |
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What's in the Yuzpe REgimen?
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Combined estrogen and progesterone pills
ethinylestradiol levonorgestrel (0.5mg) 2 doses, 12 hrs apart |
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What's in Plan B?
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1 or 2 doses of 1.5 mg of Levonorgestrel
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Which EC works better?
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Plan B
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MOA of EC?
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Inhibit or Delay Ovulation
Prevent Sperm migration Prevent Fertilization Prevent Implantation |
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How do EC's prevent fertilizaiton?
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Interfere w/ corpus luteum fxn
Thicken cervical mucus Alter tubal transport of sperm and egg |
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How do EC's prevent implantation?
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Alter endometrial receptivity
Alter tubal transport of fertilized egg |
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Efficacy based on time for Plan B?
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within 24hrs: 95%
24-48 hrs: 85% 48-72 hrs: 58% Greater than 72: nearly none |
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SE's of EC?
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Nausea (50%)
Vomiting (20%) Abd Pain Breast Tenderness Fatigue HA |
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What does EC NOT do?
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Result in punting of implanted embryo
Have neg. impact on implanted embryo Inc risk of stroke, heart disease, or blood clots |
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Another possibility for EC?
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IUD's (copper bearing)
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How IUD's work as EC?
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Detrimental effects on sperm
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Efficacy of IUD's?
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99% reduction in chance of pregnancy following unprotected sex.
can be inserted up to 5 days after sex |
