NR 602 Final Exam - Verified Questions and Answers, 100% Correct HEP B -caused by Hep B virus, transmitted via blood with other concentration in wound
... [Show More] exudate, semen vag secretions, and saliva. Transmitted via percutaneous or mucous mem w/exposure to blood or body fluid. Reportable disease. Can cause liver failure and death Risk factors- unprotected sex w/ infected partner, hx of STD, illegal injection drug use. Hep B prevention Prevention: Hep B immune globulin-provides 3-6 mo protection and used post exposure prophylaxis in adjunct to vaccine or in unvaccinated person and Hep B vaccine. Hep B Vaccine- contains HBsAg provides protection from pre and post exposure, require series. Routinely screen ALL preg women. Unvaccinated or those ho do not respond to Hep b vaccine series should be given HBIG and vaccine if exposed. Hep B diagnosis Dx-presence of igM antibody is dx Hep B symptoms Sx- asymptomatic. Constitutional @ first- anorexia, N, jaundice, RUQ pain HEP TX Tx- supportive care. No effective antiviral drugs Hep C -Caused by Hep C virus through parenteral exposure of contaminated blood Hep C prevention Prevention-no vaccine, reducing transmission and chronic liver disease. + pt do not donate blood, , don't use razors or toothbrushes Hep C symptoms Sx- asymptomatic or mild illness. Hep C diagnosis Dx-nucleic acid PCR Hep C treatment Tx- interferon and ribavirin HIV -wide spectrum of disease that begins w/ acute viral illness and transitions to chronic and latent illness. Will progress to AIDS. It depletes CD4 lypmphocyetes which maintains immunity and when falls below 200 pts are @ risk for lifethreatening infections HIV transmission Transmitted- sexual contact, parenteral exposure to blood or body fluid infected woman to fetus. Heterosexual HIV prevention Prevention- condom use, avoid sharing needles, universal precautions w/ jobs, good prenatal care, Screen high risk populations HIV symptoms Sx-wt loss, fever, night sweats, pharyngitis, lymphadenopathy, reddened maculopapular rash, extragenital lymphadenopathy HIV diagnosis Dx-HIV-1 antibody. Ppl develop detectable levels after 12 wks of exposure. ELISA. Viral load/CD4 count is useful in determining activity of disease HIV treatment Tx-managed by specialist. Use high active antiretroviral therapy (HAART) -maternal transmission of HIV can occur transplacentally before birth, peripartum via blood and bodily fluid exposure or thru BF. Lichen Sclerosus severe itching -Dryness/irritation, labia adhered -benign chronic inflamm process. Lichen Sclerosus causes Causes- vit A deficiency, autoimmune, excess enzyme elastase, decreased activity of 5-alpha reductase Lichen Sclerosus symptoms Sx- itching, vulvar pain, pain w/ sex, or white lesions. Starts as erythema and edema over vulvar skin, then white plaques and hyperkeratosis, then uniting of plaques, and itching Lichen Sclerosus diagnosis Dx- fixed labia, adhesions, vulvar biopsy to confirm Lichen Sclerosus Treatment Tx- stop itch scratch cycle and minimize inflamm. General hygiene avoid tight undies, cleanse daily w/ soap and dry. Oral antihistamine @ HS, clobetasole (Dermovate) potent topical steroid twice daily x2 wks then once daily x2 wks, taper down ****Can progress to vulvar carcinoma Lichen Simplex Chronicus -chronic eczematous disease characterized by intense and unrelenting itching and scratching Lichen Simplex Chronicus symptoms Sx- benign epithelial thickening and hyperkeratosis from chronic irritation EX- perfume pads, chronic vulvovaginal infect. Itching leads to rubbing and scratching Lichen Simplex Chronicus Treatment Tx- vulvar hygiene, sitz bath, lubricants, oral antihistamine for itching, medium potency steroids. Should resolve in 4-6 wks to heal Vulvodynia persistent pain/burning Vulvodynia Symptoms Sx- introital pain on vestibular or vag entry (entry dyspareunia) vestibular tenderness -Commonly affects 20-30 yr Vulvodynia Tx Tx- pelvic floor PT, maintain vulvar hygiene, avoid constricting clothes and irritating agents. 5% lido cream for pain relief, topical estrogen prep, after 3 months and no relief tx w/ TCA Amenorrhea Primary Primary (no menses by 13 w/o 2ndary sex characteristics OR 15 w/ secondary sex; Amenorrhea Primary Causes causes- chromosomal defect, anatomic anomalies, hormone imbalance, tumor, trauma) Amenorrhea Secondary No menses x6 mo, pelvic pathology, most common cause=pregnancy --- eating disorder most frequent etiology no menses for 3 or more cycles OR 6 consecutive months in previous menstruation. Amenorrhea Secondary causes Causes- pregnancy (most common), hypothalamic amenorrhea, pit amenorrhea, androgen disorders (PCOS, adult onset adrenal hyperplasia), galactorrhea- amenorrhea syndrome.---female athlete triad (anorexia, amenorrhea, osteoporosis) ASCUS/HSIL results from Paper Test Report- CDC--- Amenorrhea Primary (no menses by 13 w/o 2ndary sex characteristics OR 15 w/ secondary sex; causes- chromosomal defect, anatomic anomalies, hormone imbalance, tumor, trauma) For non-pregnant women between 25 and 65 years of age with ASCUS cytology who have not had HPV co-testing already, HPV testing is the preferred next step (high-risk HPV testing only). With a negative HPV test (either on co-test or after cytology), repeat co-testing Vulvar Carcinoma post menopausal women, pruitus 4th most common gyn malignancy -90% of tumors are squamous cell carcinoma -disease in postmenopausal women 60-70 yrs Vulvar Carcinoma symptoms Sx- vulvar itching, mass, vulvar bleeding/pain and tumor found incidentally during pelvic Colposcopy exam- procedure that visualizes vaginal, vulvar, or cervical epithelium w/ magnification to id abnormal area to be bx Painful menstruation that prevents normal activity and requires medication 3 types: primary (no organic cause), secondary (pathologic cause) and membranous - causes intense cramping pain due to passage of a cast of endometrium through undilated cervix Dysmenorrhea Dysmenorrhea treatment Tx- NSAIDs/tyelnol, heat, antiprostaglandins, OCP w/ increased estrogen- pain relief r/t absence of ovulation, decreased prostaglandin production; surgery Dysmenorrhea mechanism prostaglandin activity Vaginal wall weakens and stretches and allows the bladder to bulge into the vagina Cystocele Sx-felling of fullness or pressure in vagina, increased discomfort when you strain/cough/bear down, feeling of incomplete empty, repeated bladder infection, pain or urinary leak during sex, bulge of tissue into vaginal opening Cystocele Cystocele prevention [Show Less]