Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 27: Sexually Transmitted InfectionsMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. What unique factor causes adolescent girls to have a high risk for sexually transmitted infections (STIs)?a. They are in an experimental phase and believe they are resistant to developing STIs.b. The position of susceptible cells on the adolescent cervix is different than in older women.c. The length of the vaginal canal is short in adolescentsd. In adolescent girls, the anus to the vaginal introitus is in close proximity.ANS: BPartly, perhaps, because of risk-taking behavior (unprotected intercourse or selection of high-risk partners), many adolescents have an increased risk for STI exposure and infection. The unique factor for adolescent women is that they have a physiologically increased susceptibility to infection because of the position of susceptible cells on the surface of the cervix. The remaining options are not considered legitimate risk factors for STIs.PTS: 1 DIF: Cognitive Level: Remembering 2. How is gonorrhea transmitted from a pregnant woman to her fetus?a. Unbound in the blood via the placentab. Attached to immunoglobulin G (IgG) via the placentac. By direct inoculation with the fetal scalp electrodes exposed to maternal body fluidsd. Predominately through infected cervical and secretions during the birth processANS: DA pregnant woman can transmit gonorrhea to her fetus during the birth process. The infection passes from mother to child predominately through infected cervical and vaginal secretions. This vertical transmission is not associated with the causative organism being unbound in the blood, attached to IgG, or through direct inoculation.PTS: 1 DIF: Cognitive Level: Remembering 3. A healthcare professional is learning about how gonococci ascend into a woman’s uterus and fallopian tubes. Which statement is inconsistent about the factors that facilitate this ascent?a. Ascent of gonococci is facilitated because the cervical plug disintegrates during menstruation.b. Ascent of gonococci is facilitated because the vaginal pH decreases to 2 or 3.c. Ascent of gonococci is facilitated because the uterine contractions may cause retrograde menstruation into the fallopian tubes.d. Ascent of gonococci is facilitated because the bacteria may adhere to sperm and be transported to the fallopian tubes.ANS: BSeveral factors can facilitate the ascent of gonococci into the uterus and the fallopian tubes, where they cause pelvic inflammatory disease (PID). Among these factors are (1) disintegration of the cervical mucous plug and (2) a rise in vaginal pH greater than 4.5 during menstruation (not decreases to 2 or 3), and (3) uterine contractions that may cause retrograde menstruation. The bacteria can also adhere to sperm for transport.PTS: 1 DIF: Cognitive Level: Remembering 4. In women, what is the usual site of original gonococcal infection?a. Endocervical canalb. Vaginac. Fallopian tubed. Labia majoraANS: AIn women, the endocervical canal (inner portion of the cervix) is the usual site of original gonococcal infection, although urethral colonization and infection of Skene or Bartholin glands also are common. The original infection does not normally start in the vagina, fallopian tubes, or labia.PTS: 1 DIF: Cognitive Level: Remembering 5. A male comes to the health clinic and reports a recent exposure to gonorrhea. Where should the healthcare professional focus the physical exam on as the priority?a. Epididymisb. Lymph nodesc. Urethrad. ProstateANS: CUncomplicated local infections are observed primarily as urethral infections in men. The healthcare professional would examine this area for signs of the infection as the priority.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?a. Ligase chain reaction (LCR)b. Gram-stain techniquec. Polymerase chain reaction (PCR)d. DNA testingANS: BMicroscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. Diagnosis of gonorrhea is not obtained through LCR, PCR, and DNA testing.PTS: 1 DIF: Cognitive Level: Remembering 7. How does an established gonococcal infection usually express itself in newborns?a. Generalized skin rash 4 to 6 days after birthb. Systemic infection with feverc. Bilateral corneal ulcerationd. Yellow vaginal or penile discharge approximately 10 days after birthANS: CEstablished infection causes bilateral corneal ulceration. Infected infants do not usually present with a generalized skin rash, febrile systemic illness, or discharge.PTS: 1 DIF: Cognitive Level: Remembering 8. A healthcare professional wants to join a research team working on treatments for gonococci infections. What is the major concern regarding the treatment the professional will likely work on?a. Antibiotic resistanceb. Changes in virulencec. Changes in pathogenicityd. Mutations into different strainsANS: AN. gonorrhoeae has developed resistance to many antibiotics and has the real potential to become resistant to all current treatments. The most likely work a researcher in this area would concentrate on would concern this. Changes in virulence, pathogenicity, and strains are not the major concern in treating gonococci infections.PTS: 1 DIF: Cognitive Level: Remembering 9. Which sexually transmitted infection frequently coexists with gonorrhea?a. Syphilisb. Herpes simplex virusc. Chlamydiad. ChancroidANS: CThe coexistence of chlamydial infection with gonorrhea frequently occurs and has led to the recommendation that a person being treated for one of these STIs needs treatment for both.PTS: 1 DIF: Cognitive Level: Remembering 10. During which stage of syphilis do bloodborne bacteria spread to all the major organ systems?a. Primaryb. Secondaryc. Latentd. TertiaryANS: BBloodborne bacteria spread to all major organ systems during only stage II, secondary syphilis. Primary syphilis is characterized by the development of a local lesion and migration of the
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