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Questions and Answers
Which of the following statements about syphilis stages is correct?
Which of the following statements about syphilis stages is correct?
What is the appropriate treatment for all stages of syphilis?
What is the appropriate treatment for all stages of syphilis?
Which of the following is a correct statement regarding discharge instructions for genital herpes?
Which of the following is a correct statement regarding discharge instructions for genital herpes?
What makes a patient more susceptible to STIs?
What makes a patient more susceptible to STIs?
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Which test is effective in detecting a urethral infection with gonorrhea?
Which test is effective in detecting a urethral infection with gonorrhea?
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Which of the following is NOT a complication of genital warts caused by the human papillomavirus (HPV)?
Which of the following is NOT a complication of genital warts caused by the human papillomavirus (HPV)?
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What is the purpose of the HPV vaccine?
What is the purpose of the HPV vaccine?
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Which of the following is a characteristic of the primary stage of syphilis?
Which of the following is a characteristic of the primary stage of syphilis?
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In which stage of syphilis is the disease most contagious?
In which stage of syphilis is the disease most contagious?
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How is syphilis typically diagnosed?
How is syphilis typically diagnosed?
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Which of the following statements about HPV vaccines is true?
Which of the following statements about HPV vaccines is true?
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Which of the following is NOT a treatment option for genital warts mentioned in the text?
Which of the following is NOT a treatment option for genital warts mentioned in the text?
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What is the primary stage of syphilis characterized by?
What is the primary stage of syphilis characterized by?
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Which of the following tests is used to confirm a diagnosis of syphilis after screening with VDRL or RPR?
Which of the following tests is used to confirm a diagnosis of syphilis after screening with VDRL or RPR?
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Which stage of syphilis is characterized by asymptomatic periods that can last throughout life?
Which stage of syphilis is characterized by asymptomatic periods that can last throughout life?
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What is the major precipitating cause of Mitral Valve Stenosis?
What is the major precipitating cause of Mitral Valve Stenosis?
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Which condition can Mitral Valve Prolapse lead to during systole?
Which condition can Mitral Valve Prolapse lead to during systole?
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What is a primary symptom of Mitral Valve Stenosis?
What is a primary symptom of Mitral Valve Stenosis?
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Which condition can lead to cardiogenic shock in Mitral Valve Regurgitation?
Which condition can lead to cardiogenic shock in Mitral Valve Regurgitation?
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What symptom may be asymptomatic for years in chronic Mitral Valve Regurgitation?
What symptom may be asymptomatic for years in chronic Mitral Valve Regurgitation?
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In Mitral Valve Stenosis, what shape do the deformities typically take on?
In Mitral Valve Stenosis, what shape do the deformities typically take on?
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What causes a pressure difference between the atrium and left ventricle in Mitral Valve Stenosis?
What causes a pressure difference between the atrium and left ventricle in Mitral Valve Stenosis?
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Which structure is affected in Mitral Valve Regurgitation, leading to blood flow back from left ventricle to left atrium?
Which structure is affected in Mitral Valve Regurgitation, leading to blood flow back from left ventricle to left atrium?
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What is a less common symptom of Mitral Valve Stenosis?
What is a less common symptom of Mitral Valve Stenosis?
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What is the primary cause of acute aortic valve regurgitation?
What is the primary cause of acute aortic valve regurgitation?
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Which of the following is NOT a clinical manifestation of chronic aortic valve regurgitation?
Which of the following is NOT a clinical manifestation of chronic aortic valve regurgitation?
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What is the primary etiology of tricuspid valve stenosis?
What is the primary etiology of tricuspid valve stenosis?
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Which of the following is a common clinical manifestation of pulmonary valve stenosis?
Which of the following is a common clinical manifestation of pulmonary valve stenosis?
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What is a potential complication of valve replacement surgery?
What is a potential complication of valve replacement surgery?
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Which of the following is a goal of cardiac surgery for valvular heart disease?
Which of the following is a goal of cardiac surgery for valvular heart disease?
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What is the primary concern with using nitroglycerin in patients with aortic valve stenosis?
What is the primary concern with using nitroglycerin in patients with aortic valve stenosis?
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Which of the following is a common postoperative nursing intervention for patients who have undergone valve replacement surgery?
Which of the following is a common postoperative nursing intervention for patients who have undergone valve replacement surgery?
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What happens in valvular dysfunction when a valve becomes stenosed?
What happens in valvular dysfunction when a valve becomes stenosed?
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Which valve lies between the right atrium and right ventricle?
Which valve lies between the right atrium and right ventricle?
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What is the alternative name for the Mitral valve?
What is the alternative name for the Mitral valve?
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What is valvular dysfunction called when the valve does not close completely?
What is valvular dysfunction called when the valve does not close completely?
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Which of the following describes Valvular Regurgitation?
Which of the following describes Valvular Regurgitation?
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Where does the Aortic valve lie?
Where does the Aortic valve lie?
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In Valvular Dysfunction, what happens when a valve is insufficient?
In Valvular Dysfunction, what happens when a valve is insufficient?
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What is the characteristic outcome of Valvular Regurgitation?
What is the characteristic outcome of Valvular Regurgitation?
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Which system is the first to be affected in the initial stage of shock?
Which system is the first to be affected in the initial stage of shock?
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Which system is primarily responsible for activating compensatory mechanisms in the compensatory stage of shock?
Which system is primarily responsible for activating compensatory mechanisms in the compensatory stage of shock?
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Which system is the most affected in the progressive stage of shock?
Which system is the most affected in the progressive stage of shock?
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Which system is the most severely affected in the irreversible (refractory) stage of shock?
Which system is the most severely affected in the irreversible (refractory) stage of shock?
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Which system is primarily targeted for supportive care in the collaborative management of shock?
Which system is primarily targeted for supportive care in the collaborative management of shock?
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What is a common cause of absolute hypovolemia?
What is a common cause of absolute hypovolemia?
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Which shock classification is associated with severe pain and vasomotor center depression?
Which shock classification is associated with severe pain and vasomotor center depression?
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In distributive shock, which type of shock presents with hypotension, tachycardia, and decreased venous oxygen saturation?
In distributive shock, which type of shock presents with hypotension, tachycardia, and decreased venous oxygen saturation?
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What diagnostic finding is common in distributive shock regardless of the cause?
What diagnostic finding is common in distributive shock regardless of the cause?
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What is a potential clinical manifestation of shock-distributive related to the skin?
What is a potential clinical manifestation of shock-distributive related to the skin?
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What is the most common type of shock according to the text?
What is the most common type of shock according to the text?
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Which of the following is NOT a cause of shock according to the text?
Which of the following is NOT a cause of shock according to the text?
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What is the normal range for mixed venous oxygen saturation (SvO2) in the pulmonary artery according to the text?
What is the normal range for mixed venous oxygen saturation (SvO2) in the pulmonary artery according to the text?
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What is the definition of shock according to the text?
What is the definition of shock according to the text?
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What is the normal range for lactate levels according to the text?
What is the normal range for lactate levels according to the text?
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Study Notes
Sexually Transmitted Infections (STIs)
- STIs are infectious diseases spread through sexual contact with the penis, vagina, anus, mouth, or sexual fluids of an infected person
- Types of STIs:
- Bacterial: gonorrhea, syphilis, chlamydial
- Viral: genital herpes, genital warts, human immunodeficiency virus (HIV) infection, hepatitis B and C
- Parasitic/Protozoan Infection: trichomoniasis
Syphilis
- Caused by Treponema pallidum bacterium
- Transmission: direct contact with a syphilitic ulcer (chancre)
- Can be transmitted to the fetus
- Can cause irreversible damage to skin, bone, and liver, and heart problems and neuro problems if it invades corresponding areas
- Stages:
- Primary: highly infectious, development of chancre
- Secondary: highly infectious, a few weeks after chancre heals, maculopapular rash on hands/feet, flu-like symptoms
- Latent: lasts throughout life, asymptomatic
- Late: non-infectious, organ damage, personality changes, heart valve issues, gummas (destructive lesions)
- Diagnosis: Venereal Disease Research Laboratory (VDRL) and Rapid Plasma Reagin (RPR) tests, confirmed by fluorescent treponemal antibody absorption (FTAAbs) test
- Treatment: Penicillin G benzathine
Gonorrhea
- Caused by Neisseria gonorrhea bacterium
- Diagnosis: Nucleic Acid Amplification Test (NAAT) urine test
- Treatment: IM ceftriaxone with oral Azithromycin
- Complications: disseminated gonococcal infection, neonatal gonococcal conjunctivitis
Chlamydia
- Most common reportable STI
- Often poorly managed, inaccurately diagnosed, or undiagnosed until complications occur
- Diagnosis: NAAT urine test
- Treatment: Azithromycin or Doxycycline
- Complications: infertility, pelvic inflammatory disease (PID)
Trichomoniasis
- Parasitic infection
- Transmission: through sexual fluids
- Diagnosis: NAAT test, cultures
- Treatment: Metronidazole (Flagyl) or Tinidazole (Tindamax)
- Complications: inflammatory reaction, increased risk of HIV transmission
Genital Herpes
- Caused by herpes simplex virus (HSV) 1 or 2
- Transmission: contact with infected person
- Viral reactivation occurs when virus goes back to initial site of infection
- Diagnosis: culture of lesions
- Treatment: Antiviral medications, such as acyclovir, valacyclovir, or famciclovir
- Complications: asymptomatic viral shedding, transmission during asymptomatic periods### Shock
- Inadequate tissue perfusion leading to cellular, organ, and organ system death
- Causes: problem with the pump, problem with the tubes, or problem with oxygen delivery
- Reversible if caught in time
Types of Shock
- Cardiogenic: 16% of shock cases, occurs when systolic or diastolic dysfunction of the heart's pumping action results in reduced cardiac output, stroke volume, and blood pressure
- Hypovolemic: 16% of shock cases, absolute or relative hypovolemia, external loss of whole blood or other body fluids, or fluid shifts
- Distributive: 66% of shock cases, includes neurogenic, anaphylactic, and septic shock
- Obstructive: 2% of shock cases, physical obstruction impedes the filling or outflow of blood, resulting in reduced cardiac output
Distributive Shock
- Neurogenic: hemodynamic consequence of spinal cord injury and/or disease at or above T5, spinal anesthesia, vasomotor center depression, severe pain, drugs, hypoglycemia, or injury
- Anaphylactic: hypersensitivity (allergic reaction) to contrast media, blood/blood products, drugs, insect bites, or anesthetic agents
- Septic: infection, pneumonia, peritonitis, urinary tract, respiratory tract, or invasive lines, at risk patients include older adults, children < 12 months, patients with chronic diseases, patients receiving immunosuppressive therapy, malnourished, diabetes mellitus, and debilitated patients
Clinical Manifestations of Shock
- Cardiovascular: decreased cardiac output, decreased CVP and PAOP, decreased SVR, decreased venous oxygen saturation (SvO2 or ScvO2), hypotension and bradycardia or tachycardia
- Pulmonary: tachypnea, dyspnea, and crackles
- Renal: decreased urine output, increased BUN and creatinine
- Skin: cool, clammy, and pale
- Neurologic: altered mental status, anxiety, and confusion
- Gastrointestinal: nausea, vomiting, and abdominal pain
Diagnostic Findings
- CBC-D: decreased hematocrit and hemoglobin, increased lactate
- Electrolytes: changes, hypovolemic/hemorrhagic shock
- Septic shock: increased WBC, decreased platelets, increased lactate (2.0-4.0 mmol/L)
Collaborative Care
- Identification of patients at risk for developing shock
- Integration of patient's history, physical examination, and clinical findings to establish a diagnosis
- Interventions to control or eliminate the cause of the decreased perfusion
- Provision of multisystem supportive care
Resuscitation
- Targeted to normalize lactic acid, increased blood glucose, increased urine specific gravity, decreased urine NA+, and positive blood cultures
- Interventions include oxygen and ventilation, fluid resuscitation, and drug therapy
Stages of Shock
- Initial: occurs at the cellular level, no clinical signs, lactic acid is a waste product that is removed by the liver, but this process requires oxygen
- Compensatory: body activates neural, hormonal, and biochemical compensatory mechanisms to overcome the increasing consequences of anaerobic metabolism and maintain homeostasis
- Progressive: begins as the compensatory mechanisms fail, multiple organ dysfunction syndrome
- Irreversible (refractory): multiple organ failure occurs, and death is imminent
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Description
Test your knowledge on syphilis and genital herpes with this quiz. Choose the correct statements about the symptoms, treatment, and stages of these sexually transmitted infections.