8 Steps

Who: Residents, Medical Students, Faculty

When: Thursday 0715-0800, GME lecture

Where: FM Conference Room – no ARS, must bring my own computer

What: Knowledge: dermatology sexually transmitted infections and treatment

Skills: sexually transmitted infections – clinical findings

Attitude: Comfort with talking about sex and STI with patients

Why: Sex is common, STIs happen because of sex, therefore STIs are common

What: STI clinical findings and diagnosis, STI treatments, reportable diseases

What for: 1) Reviewed the common dermatology descriptions of lesions 2) Diagnosed 6 STIs through pattern recognition of clinical findings 3) Memorized treatments for those same 6 STIs 4) Distinguished the diseases that are reportable to the CDC

How: See 4 I’s

So What: Learning, Transfer, Impact

4 I’s

Inductive: Grabber, pretest quiz

Input: Powerpoint and Derm cards

Implementation: “Support Group” exercise, Pile sort

Integration: Post test quiz

Timeline

• 0715-0720 Grabber, intro• 0720-0725 pretest, review answers• 0725-0745 support group exercise• 0745-0750 post test, answers

Discomfort with anatomyPersonal

experiences

Culture and religionPatient

discomfortPersonal feelings

Lifestyles different from our own

Discomfort with physiology

STI’s Gone Wild

Amanda Cuda, MD

Faculty Development Fellow

24 January 2013

Logic and Epidemiology

Sex is common

STI’s happen because of sex

Therefore STI’s are common

Objectives

Reviewed dermatology descriptions

Diagnosed 6 STIs

Memorized treatments for those 6 STIs

Named those reportable to the CDC

Primary Cutaneous Lesions

Flat

Macule A circumscribed, flat discoloration that may be brown, blue, red, or hypopigmented

Elevated, Solid

Papule An elevated, solid lesion up to 0.5 cm in diameter of variable color. Papules may become confluent to become plaques.

Nodule A circumscribed, elevated solid lesion >0.5 cm in diameter

Plaque A circumscribed, elevated, superficial, solid lesion >0.5 cm in diameter

Fluid Filled

Vesicle A circumscribed collection of free fluid up to 0.5 cm in diameter

Bulla A circumscribed collection of free fluid >0.5 cm in diameter

Pustule A circumscribed collection of leukocytes and free fluid (pus)

Wheal (hive) A firm erythematous plaque resulting from infiltration of the dermis with fluid (may be transient)

Quiz Instructions

Complete the following on your pretest worksheets:

1. Diagnosis

2. Treatment

3. Reportable to CDC?

Question 1

Most common ulcer infection.

Question 2

Most common cause of urethritis or cervicitis in the United States.

Question 3

Common and underdiagnosed.

Question 4

The only cause of urethritis or cervicitis that is a protozoan.

Question 5

Gram negative diplococci that causes urethritis and cervicitis.

Question 6

This painless ulcer infection is increasing in prevalence worldwide.

Quiz Answers

Quiz Answers

Quiz Finish

Support Group Exercise

1. Take worksheet for condition, walk around, find 5 other support group members

2. Introduce by presentation and treatment

3. Name if it is reportable to the CDC

4. Create a trick to remember the condition, treatment, reportable status. Write on post test worksheet.

5. We’ll share examples of memory tricks.

6. Take 15 minutes, try to meet the 5 other support group members.

Pile Sort Exercises

Work in groups. Sort cards three times, using these three categories:

1. Clinical: ulcers, urethritis/cervicitis, other

2. Microbiology: bacteria, virus, other

3. Reportable to CDC: yes or no

Post Test

Quiz Instructions

Objectives

Reviewed dermatology descriptions

Diagnosed 6 STIs

Memorized treatments for those 6 STIs

Named those reportable to the CDC

Questions?

Please return small group worksheets.

Thank you!

Bonus question 1

Painless ulcer infection.

Bonus question 2

Painful ulcer infection.

Bonus question 3

This condition presents with wavy, elongated papules.

Bonus question 4

Name the 4 infections from those discussed today that facilitate the transmission and infection of HIV.