Exam (elaborations)
SANE-P certification exam prep 2018
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SANE-P certification exam prep 2018
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SANE-P CERTIFICATION EXAM PREP2018
k STDs inconclusive for child sexual abuse - bacterial vaginosis (BV) and Hepatitis B (HBV)
HIV testing timeline - initial exam
6 weeks
3 months
6 months
STDs suspicious for child sexual abuse (not perinatally acquired) - HPV
HSV (autoinoculation must be ruled out)
STDs suspcicious for child sexual abuse (not perinatally acquired) - Trichomonis vaginalis (TV)
How to test for trichomonis vaginalis (TV) - swab genitals, test swab via wet mount microscopy and
culture
* look for yellow-green discharge
* NAAT is highly sensitive and used in the adult population but has not been confirmed in peds
STDs diagnostic of child sexual abuse (not perinatally acquired) - HIV, syphilis, gonorrhea, chlamydia
Perinatal transmission timeline for chlamydia - up to 3 years perinatal transmission timeline
Perinatal transmission timeline for gonorrhea - up to 1 year perinatal transmission timeline
Perinatal transmission timeline for syphilis - up to 6 months perinatal transmission timeline
perinatal transmission timeline for trichomonas - 6 months up to 3 years perinatal transmission timeline
perinatal transmission timeline for herpes simplex virus (HSV) - up to 4 weeks perinatal transmission
timeline
perinatal transmission timeline for human papilloma virus (HPV) - up to 3 years perinatal transmission
timeline
How to test for chlamydia - NAAT test- girls urine
-vaginal swab
, Culture- boys urine
- boys urethral discharge
- vagina
- anus
no test for pharyngeal site
Signs and symptoms, or evidence of STD infection in children- what is the next step? - Test, don't treat
until tests have been confirmed
How to test for gonorrhea - NAAT test- girls urine
Culture- boys urine
- pharynx
- anus
- urethral discharge (boys)
- vagina
How to test for bacterial vaginosis - *swab genitals and test with wet mount microscopy
*look for "clue cells" ( vaginal epithelial cells studded with coccoobacilli) under the microscope
*10 % KOH whiff test
* visually examine for thin white discharge that smoothly coats the vaginal walls
How to test for HSV - culture of lesions
How to test for HPV - visual exam
How to test for syphilis - serology testing for t. pallidium
Follow up testing timeline for syphilis - serology testing 6 weeks post assault
Follow up testing timeline for Hep B - serology testing 6 weeks and 3 months post assault
Do we test all children for STDs who present for a sexual assault exam? - no, case- by case basis
s/p sexual assault: if the assailant's Hep B status is unknown and the child is unvaccinated, what do we
give - Hep B Vaccine
s/p sexual assault: if the assailant is known to be Hep B positive (HBS-Ag +) and the child is unvaccinated,
what do we give? - Hep B vaccine and Hep B immunoglobulins (HBIG)
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