BHS Test Prep

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Questions and Answers

What is the purpose of determining the number and gender of sexual partners when taking a sexual history?

To determine the patient's relationship status

To establish the patient's social network

To assess the risk of STD transmission (correct)

To identify the patient's preferred gender for sexual partners

Why is it important to explore subjects like abstinence, monogamy, condom use, and STD testing when taking a sexual history?

To understand the patient's cultural background

To identify potential risk factors for STDs (correct)

To determine the patient's knowledge of safe sex practices

To assess the patient's religious beliefs

Why may protection from STDs not be needed for patients in a monogamous relationship for more than 12 months?

The patient's perception of risk is usually accurate

The likelihood of exposure to new STDs is reduced (correct)

The patient's immune system is less susceptible to STDs

The patient has likely received vaccinations for STDs

What is the significance of exploring a patient's past history of STDs when taking a sexual history?

To guide assessment of the patient's current risk for STDs Signup and view all the answers

Why might physicians be reluctant to address sexual health issues with their patients?

Due to a lack of specialized training in sexual health Signup and view all the answers

How does routine assessment of sexual health provide opportunities for preventative health care?

By enabling early detection and management of sexually transmitted infections Signup and view all the answers

When approaching history taking and physical examination with LGBT patients, what should the physician do?

Reassure the patient that these questions are asked for safety and health reasons Signup and view all the answers

What should be avoided when taking sexual orientation and practices history from LGBT patients?

Assuming the patient's sexual orientation and gender Signup and view all the answers

What is an effective verbal or non-verbal strategy to identify sexual orientation and gender identity in the clinical environment?

Smiling and leaning forward to the patient Signup and view all the answers

What should the physician do when tailoring health promotion strategies to the needs of LGBT patients?

Relate everything back to the importance of the patient’s safety/health Signup and view all the answers

What is one of the methods to engage LGBT patients in the clinical environment?

Ask for permission before asking about sexual history Signup and view all the answers

What should be avoided when taking history from LGBT patients?

"Are you single, married, boyfriend." - assuming relationships Signup and view all the answers

What should the physician do when approaching history taking and physical examination with LGBT patients?

"Thank everyone for what they decide to disclose" - show gratitude for disclosure Signup and view all the answers

What is an ineffective method when engaging LGBT patients in the clinical environment?

"Assuming all patients have similar health promotion needs" Signup and view all the answers

What should be avoided when taking history from LGBT patients?

"Assume what gender they prefer to be called based on appearance" Signup and view all the answers

What is the current definition of rape?

Sexual contact or behavior that occurs without explicit consent Signup and view all the answers

Why is it important for physicians to ask patients about their sexual health history?

To help with early diagnosis of depression and diabetes Signup and view all the answers

What are the common concerns and considerations when addressing sexuality in the disabled?

Fear of losing independence and being viewed as 'sick' Signup and view all the answers

Which of the following represents an impact of hormones, low desire, and physical limitations on sexuality in individuals with disabilities?

Lack of estrogen can limit genital arousal and cause dyspareunia Signup and view all the answers

What is drug facilitated sexual assault?

Rape facilitated by the use of alcohol or substances to incapacitate the victim Signup and view all the answers

What are some factors affecting the rate of reporting sexual assault?

Fear of reprisal or getting the offender in trouble Signup and view all the answers

What is a crucial facet of care in regards to sexual health with disabled individuals?

Recognition of sexuality and provision of information to enable safe expression of sexuality Signup and view all the answers

What is the lifetime rate of rape for adult women according to the text?

19.3% Signup and view all the answers

What is a significant predictor of longevity according to the text?

the frequency and enjoyment of sexual intercourse Signup and view all the answers

What is considered drug facilitated sexual assault?

Rape facilitated by the use of alcohol or substances to incapacitate a woman. Signup and view all the answers

What are some factors that affect the rate of reporting sexual assault according to the text?

Fear of reprisal or getting the offender in trouble. Signup and view all the answers

What is a crucial facet of care in regards to sexual health with disabled individuals?

Recognition of sexuality and provision of information to enable safe expression of sexuality. Signup and view all the answers

What is the optimal timing for evidence collection after a sexual assault?

72 hours Signup and view all the answers

What should the provider document in the case of a sexual assault survivor?

Details of the assault in the provider's words Signup and view all the answers

What is the most commonly associated drug implicated in sexual assault?

Alcohol Signup and view all the answers

What are potential long-term manifestations of sexual assault?

Decreased perception of health Signup and view all the answers

What are the 5 stages of psychological and physiological changes of normal sexual function?

Desire, Arousal, Plateau, Orgasm, Resolution Signup and view all the answers

What changes in sexual function can be observed in women during menopause?

Decreased uterine and vaginal size Signup and view all the answers

What are potential contributing factors to sexual dysfunction in older adults?

Low rates of use of barrier contraceptives Signup and view all the answers

What is recommended for medical treatment for survivors of sexual assault?

Emergency contraception and STD prevention Signup and view all the answers

What is the role of SANE and SAFE programs in assisting survivors of sexual assault?

Offering medical and forensic examination services Signup and view all the answers

What are the risks and incidence of sexually transmitted infections in the older adult population?

Higher rates compared to younger age groups Signup and view all the answers

What are potential manifestations of rape trauma syndrome?

Behavioral, somatic, and psychological reactions Signup and view all the answers

What is recommended for survivors unable to give consent due to intoxication?

Delay evidence collection until consent is possible Signup and view all the answers

When assessing sexual dysfunction in older adults, what is the most important fact to consider?

Comorbid psychiatric illness Signup and view all the answers

What is a common cause of loss of sexual function following an acute illness?

Anticipating pain, injury, or death during sex Signup and view all the answers

What should be considered if one or both partners suffer from chronic medical illness or disability?

Allowing extra time for foreplay Signup and view all the answers

For LGBT patients, what method should be used to sensitively approach history taking and physical examination?

"Do you want to talk a little bit more about what happens during a PAP." Signup and view all the answers

What should be discussed when tailoring health promotion strategies to the needs of LGBT patients?

"What parts of your body do you use or 'receive' during sex." Signup and view all the answers

What should the physician do to make the patient feel more comfortable during cervical cancer screening?

"Reassure the patient that they were in control of the exam and it can be stopped at any time" Signup and view all the answers

What are potential risk factors for health conditions related to sexual orientation and gender identity?

Increased risk for depression, anxiety, and substance use as a coping mechanism Signup and view all the answers

What verbal or non-verbal strategies can be used to identify sexual orientation and gender identity in the clinical environment?

"What name and pronouns do you like to go by." Signup and view all the answers

What should be asked when tailoring health promotion strategies to the needs of LGBT patients?

"Ask about past partners and if male or female" Signup and view all the answers

What should be done when approaching history taking and physical examination with LGBT patients?

"Use patient pronouns properly and ask patient preferred terminology for the genitals" Signup and view all the answers

What should be considered when one or both partners suffer from chronic medical illness or disability?

"Encouraging sexual positions with couples lying side by side" Signup and view all the answers

Which term describes 'how a person identifies themselves in terms of who they are attracted to'?

Sexual identity Signup and view all the answers

What is the term for 'who you’re having sex with'?

Sexual behavior Signup and view all the answers

Discuss one general treatment principle when dealing with sexual dysfunction in older adults.

Provide reassurance to build trust between patient and doctor Signup and view all the answers

What does 'gender expression' refer to?

What an individual shows to the outside world or subconscious behaviors Signup and view all the answers

What is the broad term that describes individuals whose gender expression does not conform to what society expects based on anatomy or secondary sex characteristics?

Gender non-conforming Signup and view all the answers

What does 'DSD' stand for in the context of sexual health?

Differences in Sex Development Signup and view all the answers

Why should clinical terms or terms described in the literature be used cautiously when addressing patients?

They may make patients uncomfortable as they do not match the patient's self-identification Signup and view all the answers

What is an important consideration when dealing with adolescent patients, especially those who come in with their parents?

Respecting the adolescent patient's personal pronouns even in the presence of their parents Signup and view all the answers

How should mishaps in communication regarding patients' sexuality and gender identity be handled?

Always apologize for mistakes and remain open to learning from each patient Signup and view all the answers

Why is it important not to judge LGBT patients based on their symptoms or reasons for visiting the office?

Their symptoms may not necessarily be related to their sexual orientation or gender identity Signup and view all the answers

What is an effective approach to make transgender patients feel welcome in a medical practice?

Being accommodating in terms of bathrooms, paperwork questions, reading material, and ensuring staff is culturally competent Signup and view all the answers

Why is it important for healthcare providers to understand that gender identity can change throughout a person's lifetime?

To avoid making assumptions about a person's gender identity based on their childhood expressions Signup and view all the answers

What is an effective way to handle mishaps in communication regarding sexuality and gender identity?

Apologizing for any mistakes and demonstrating humility in addressing the patient Signup and view all the answers

Which of the following is NOT a unique risk factor for health conditions related to sexual orientation and gender identity?

Feeling completely at ease and accepted in all social settings Signup and view all the answers

Which of the following is NOT a technique for tailoring health promotion strategies to the needs of LGBT patients?

Assuming all LGBT patients have similar health needs Signup and view all the answers

What is a crucial aspect of making a patient feel more comfortable during cervical cancer screening based on the provided information?

Discussing abstinence, monogamy, and condom use Signup and view all the answers

What is an ineffective method when engaging LGBT patients in the clinical environment based on the given context?

Assuming that all LGBT patients share similar experiences and needs Signup and view all the answers

What should the physician do when approaching history taking and physical examination with LGBT patients based on the provided information?

Ask open-ended questions about the patient's partner or partners Signup and view all the answers

What should be avoided when tailoring health promotion strategies to the needs of LGBT patients according to the text?

Assuming homogeneity among LGBT patients Signup and view all the answers

What is sexual orientation?

The general partner preference based on emotional and physical attraction Signup and view all the answers

What does 'gender non-conforming' mean?

Gender expression that does not conform to societal expectations based on anatomy or secondary sex characteristics Signup and view all the answers

Why should clinical terms or terms described in the literature be used cautiously when addressing patients?

Assuming what is acceptable in the literature may make patients uncomfortable Signup and view all the answers

What is gender identity?

Internal sense of who a person is on a spectrum Signup and view all the answers

Why is it important to respect a patient's gender identity?

To foster trust and confidence in the patient-physician relationship Signup and view all the answers

What is sexual behavior?

Who you're having sex with Signup and view all the answers

What is DSD in the context of sexual health?

Differences in Sexual Development Signup and view all the answers

Why should mishaps in communication regarding patients' sexuality and gender identity be handled with humility?

To maintain open communication with the patient Signup and view all the answers

When tailoring health promotion strategies to the needs of LGBT patients, what should the physician ask about?

The patient's sexual practices and use of sex toys Signup and view all the answers

How can the physician sensitively approach history taking and physical examination with LGBT patients?

By reassuring the patient that these are questions asked for safety/health reasons Signup and view all the answers

What is an important technique for engaging LGBT patients in the clinical environment?

Asking for permission to ask about sexual history Signup and view all the answers

What should be avoided when taking sexual orientation and practices history from LGBT patients?

Assuming patient is a female or has ever had a pelvic or PAP Signup and view all the answers

What is a key strategy to avoid ineffective history taking and physical examination with LGBT patients?

'Are you single, married, boyfriend.' Signup and view all the answers

What should the physician do to make the patient feel more comfortable during cervical cancer screening?

Tell the patient they are in control of the exam and it can be stopped at any time Signup and view all the answers

What verbal or non-verbal strategies can be used to identify sexual orientation and gender identity in the clinical environment?

'Smile, be calm, leaning forward to the patient' Signup and view all the answers

Why is it important not to judge LGBT patients based on their symptoms or reasons for visiting the office?

Because LGBT patients may have unique health needs that require understanding and acceptance Signup and view all the answers

What should healthcare providers do when approaching history taking and physical examination with LGBT patients?

Use inclusive language, respect privacy, and create an environment free from discrimination and bias Signup and view all the answers

What is the most important factor associated with cancer screenings in the LGBTQ population?

Patient anatomy and risk for cancer Signup and view all the answers

What is the major difference between PrEP and PEP for HIV prevention?

PrEP is taken as emergency intervention, while PEP is given to high-risk individuals Signup and view all the answers

What should a physician consider when discussing the use of vaccines with patients?

Patient's sexual practices and partner's practices Signup and view all the answers

What is the best way to discuss family planning with LGBTQ patients?

Ask about family goals, finances, and social/legal challenges Signup and view all the answers

What are the social determinants of health as mentioned in the text?

Relationships, genetics, community, institutional, systemic factors like poverty and racism Signup and view all the answers

What are the guiding principles of trauma-informed care for physical exams?

Engage in shared decision-making of exam options Signup and view all the answers

What is the single most important question a physician can ask a patient before performing a sensitive patient exam?

'How do you refer to your body parts?' Signup and view all the answers

What are some strategies for providers to optimize comfort for all patients during sensitive exams?

'Remind the patient they can stop the exam at any time' Signup and view all the answers

What is recommended for survivors unable to give consent due to intoxication?

Provide medical treatment and support without evidence collection Signup and view all the answers

What does 'gender expression' refer to?

'How a person externally communicates their gender identity' Signup and view all the answers

What are some potential barriers to family planning options for LGBTQ patients?

Clinician assumptions about how families are made Signup and view all the answers

What should a physician consider when tailoring health promotion strategies to the needs of LGBT patients?

Understand the unique healthcare needs and experiences of LGBT patients Signup and view all the answers

What is the primary approach to making transgender patients feel welcome in a medical practice?

Make everyone in the practice (nurses, PAs, receptionists) sensitive to the transgender’s preferences Signup and view all the answers

How should transgender and gender nonconforming patient health content be integrated into the learner’s institution?

Integrate clinical relevancies when relevant, don’t just make a separate course on how to deal with them Signup and view all the answers

What should providers avoid when it comes to treating the topic of transgender medicine?

Treating the topic of transgender medicine as “just how you do things” rather than a special or foreign topic Signup and view all the answers

What is the impact of social and behavioral determinants on LGBT individuals' health?

Trans people are impacted socioeconomically and are not paid as much for how much they have accomplished Signup and view all the answers

What are some potential risk behaviors prevalent in LGBT populations?

Mental health Depression, no support or capital Signup and view all the answers

What is a potential health risk due to electronic records being coded with only 'M' or 'F' as options?

Difficulty finding providers they trust Signup and view all the answers

What is an important consideration when dealing with sexual orientation and gender identity in the clinical environment?

Avoiding stereotyping perception of patient identity Signup and view all the answers

What should be avoided when taking history from LGBT patients?

Making assumptions about how kids express themselves Signup and view all the answers

What is recommended when assessing sexual dysfunction in older adults?

Including resiliency in framing and assessing LGBT health Signup and view all the answers

Implicit biases are created through unconscious, automatic associations that rely on:

Societal messages Signup and view all the answers

How can implicit biases be assessed?

Through examination of behavior and neurological assessment Signup and view all the answers

What is a strategy to address implicit bias and its negative impact?

Using mindfulness techniques Signup and view all the answers

What is a targeted approach to addressing the negative effects of implicit bias in schools?

Incorporating Implicit Association Tests (IAT) into the curriculum Signup and view all the answers

What is one way to improve objectivity in decision-making processes and policies in the context of implicit bias?

Using data to inform decisions Signup and view all the answers

Which factor contributes to the manifestation of implicit bias in schools?

Institutional and historic patterns of inequity within the education system Signup and view all the answers

What approach is recommended to address assumptions or microaggression in patient care?

Explaining the importance of asking gender questions Signup and view all the answers

What should be included in an inclusive intake for LGBTQ/DSD individuals?

"How would you like me to address you" and "What is your gender identity" Signup and view all the answers

"What does WPATH say about gender-affirming procedures for transgender patients who desire them as part of their transition?"

"Gender-affirming procedures are medically necessary" Signup and view all the answers

"What treatment may benefit children struggling with their gender identity before puberty?"

"Puberty blockers" Signup and view all the answers

"What should be considered when one or both partners suffer from chronic medical illness or disability?"

Their sexual health needs and challenges Signup and view all the answers

"What is an essential aspect of care regarding sexual health with disabled individuals?"

Understanding their unique challenges and needs Signup and view all the answers

What screening is not recommended for individuals who have had their cervix removed as part of gender-affirming surgery or other conditions?

Pap test Signup and view all the answers

When should low-dose computed tomography (LDCT) be considered for screening?

Ages 55-80 for individuals with a 20 pack-year smoking history Signup and view all the answers

What standard screening is recommended for all patients regarding mental health?

Performing PHQ2 and/or PHQ9 Signup and view all the answers

What is recommended for patients struggling with unhealthy eating/body image behaviors?

Referring to applicable support services Signup and view all the answers

What is recommended if the patient lacks social support?

Referring to LGBTQ social networks Signup and view all the answers

What is the more inclusive or less-gendered term used for 'Pap test' in the context of transgender care?

'Reproductive parts test' Signup and view all the answers

'Chestfeeding' is a more inclusive or less-gendered term for what natural process?

'Breastfeeding' Signup and view all the answers

'Bills of the speculum' is the neutral term used instead of what?

'Speculum blades' Signup and view all the answers

'Front' is a more inclusive or less-gendered term used instead of what reproductive part?

'Penis/Testes' Signup and view all the answers

'Absorbent product' is the inclusive term used instead of what?

'Pads, Tampons' Signup and view all the answers

'Frontal pelvic opening' is the inclusive term used instead of what anatomical part?

'Vulva, Labia' Signup and view all the answers

Which cancer screening approach should be considered for individuals at high risk over the age of 50 with feminizing hormone use?

Biennial screening mammography Signup and view all the answers

What should be considered for men at high risk when it comes to breast cancer screening?

Annual breast exam Signup and view all the answers

Which individuals should have anal Pap tests as part of cancer screening?

Cis men and women, trans men, and trans women Signup and view all the answers

What is the recommended cancer screening approach for individuals over the age of 50 without hormone use?

Annual Pap test Signup and view all the answers

In which population should biennial mammography begin at an earlier age due to the increased risk of breast cancer?

Transgender women over the age of 50 Signup and view all the answers

What is indicated for individuals with no cervix, even after vaginoplasty, as part of cancer screening?

Annual visual inspection of neovagina Signup and view all the answers

Study Notes

Sexual History and Health

Determining the number and gender of sexual partners is crucial in taking a sexual history to identify risk factors for STDs and to provide appropriate guidance on prevention and testing.
Exploring subjects like abstinence, monogamy, condom use, and STD testing helps to assess a patient's risk for STDs and provides opportunities for preventative health care.
Patients in a monogamous relationship for more than 12 months may not need protection from STDs, as the risk is lower.

Importance of Sexual History

Exploring a patient's past history of STDs helps to identify potential risks and provides guidance on prevention and testing.
Physicians may be reluctant to address sexual health issues due to discomfort or lack of knowledge.

LGBT Patients

When approaching history taking and physical examination with LGBT patients, the physician should use sensitive and non-judgmental language.
Avoid making assumptions about a patient's sexual orientation or gender identity.
Effective verbal or non-verbal strategies to identify sexual orientation and gender identity include using open-ended questions and respecting the patient's identity.
When tailoring health promotion strategies to the needs of LGBT patients, the physician should ask about their specific needs and concerns.

Sexual Assault and Rape

The current definition of rape is any sexual act or attempt directed against a person without their consent.
Physicians should ask patients about their sexual health history to identify potential risks and provide guidance on prevention and testing.
Drug facilitated sexual assault is a common form of sexual assault.
Factors affecting the rate of reporting sexual assault include fear, shame, and lack of trust in authorities.

Sexual Health and Disability

Common concerns and considerations when addressing sexuality in the disabled include physical limitations, low desire, and impact of hormones on sexual function.
A crucial facet of care in regards to sexual health with disabled individuals is to provide personalized guidance and support.

Sexual Dysfunction

The 5 stages of psychological and physiological changes of normal sexual function are excitement, plateau, orgasm, resolution, and refraction.
Changes in sexual function can be observed in women during menopause, including decreased libido and vaginal dryness.
Potential contributing factors to sexual dysfunction in older adults include chronic medical illness, disability, and medication side effects.

Care for Survivors of Sexual Assault

The optimal timing for evidence collection after a sexual assault is within 72 hours.
The provider should document the patient's history and physical examination findings in the case of a sexual assault survivor.
Recommended medical treatment for survivors of sexual assault includes antibiotic prophylaxis and emergency contraception.
SANE and SAFE programs play a crucial role in assisting survivors of sexual assault by providing medical and forensic care.

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Description

This quiz covers the various factors that can influence sexual functioning, including medical illnesses, medications, comorbid psychiatric illness, and stressful life events. It explores how these factors can impact libido and sexual activity.