**HPV MODULE**

**TEST QUESTIONS**

1.  It is estimated that at least \_\_\_of sexually active adults are
    infected with genital HPV during their lifetime.

    a.  10%

    b.  25%

    c.  40%

    d.  50%

2.  All of the following are true about transmission of genital HPV,
    except:

    a.  Transmission is associated with sexual activity.

    b.  Transmission via fomites has been documented.

    c.  Transmission can occur from asymptomatic and subclinical
        patients.

    d.  Transmission probably requires contact with viable HPV and
        microtrauma to skin/mucous membranes.

3.  HPV types \_\_ and \_\_\_ account for more than half of HPV types
    found in genital cancers.

    a.  6 and 11

    b.  6 and 18

    c.  16 and 18

    d.  11 and 16

4.  Genital HPV types are characterized in terms of their oncogenic
    potential (ability to cause cervical cancer).

    a.  True

    b.  False

5.  Most women infected with high-risk HPV types:

    a.  Develop cervical cancer

    b.  Have normal Pap test results

    c.  Have abnormal Pap test results

    d.  Have genital warts

6.  Which of the following is the most important risk factor associated
    with development of cervical cancer precursors (high-grade cervical
    cell changes) and cervical cancer?

    a.  Older age

    b.  High-risk HPV types

    c.  Persistence of HPV infection

    d.  Immunodeficiency

7.  If left untreated, visible warts may:

    a.  Resolve on their own

    b.  Remain unchanged

    c.  Increase in size and number

    d.  Any of the above

8.  Which factor should guide genital wart treatment?

    a.  The preference of the patient

    b.  The available resources

    c.  The experience of the health care provider

    d.  All of the above

9.  Which of the following is not a presentation of genital warts?

    a.  Condylomata acuminata

    b.  Smooth papules

    c.  Flat papules

    d.  Keratotic warts

    e.  All of the above are presentations of genital warts

10. Acetic acid evaluation of external genital warts is of limited value
    because:

    a.  It has low sensitivity (many false negatives).

    b.  It has low specificity (many false positives).

    c.  It is not cost effective.

    d.  All of the above

11. Manifestations of genital HPV infection include:

    a.  Genital warts

    b.  Cervical cell abnormalities

    c.  Anogenital squamous cell cancers

    d.  Respiratory papillomatosis

    e.  All of the above

12. Most genital HPV infections are transient and have no clinical
    manifestations or sequelae.

    a.  True

    b.  False

13. Which HPV types usually cause cervical cancer?

    a.  Low-risk types

    b.  High-risk types

    c.  Both low-risk and high-risk types

    d.  Neither low-risk nor high-risk types

14. Diagnosis of external genital warts is usually made by:

    a.  Visual inspection

    b.  Biopsy

    c.  Acetic acid evaluation

    d.  HPV DNA test

15. The FDA has approved the HPV DNA test for use in:

    a.  Cervical cancer screening for women under 30 years

    b.  Triage of women with ASC-US Pap test results

    c.  Triage of women with LSIL Pap test results

    d.  External genital wart diagnosis

16. Cervical cellular abnormalities are detected by which of the
    following?

    a.  Serologic test

    b.  Pap test

    c.  Wet mount

    d.  HPV DNA test

17. Which of the following statements is true about the treatment of
    genital warts?

    a.  In most patients treatment does not induce wart-free periods.

    b.  Current treatment decreases future transmission.

    c.  The primary goal is removal of symptomatic warts.

    d.  Available therapies eradicate infectivity.

18. Which of the following is a patient-applied treatment for external
    genital warts?

    a.  Podofilox

    b.  Podophyllin

    c.  Trichloroacetic acid (TCA)

    d.  Bichloroacetic acid (BCA)

19. Which of the following is a provider-administered treatment for
    external genital warts?

    a.  Cryotherapy with liquid nitrogen or cryoprobe

    b.  Trichloroacetic acid (TCA) or bichloroacetic acid (BCA) 80%-90%

    c.  Podophyllin resin 10%-25% in compound tincture of benzoin

    d.  All of the above

20. All of the following external genital wart treatments may be used in
    pregnancy, except:

    a.  Surgical removal

    b.  Trichloroacetic acid (TCA) or biochloroacetic acid (BCA) 80%-90%

    c.  Imiquimod 5% cream (Aldara)

    d.  Cryotherapy

21. Which of the following is true of HPV infection in immunodeficient
    patients?

    a.  Genital warts occur more frequently.

    b.  Genital warts are more resistant to conventional therapy.

    c.  The occurrence of atypical lesions (e.g., oral warts) is more
        likely.

    d.  All of the above

22. Patient counseling and education should cover:

    a.  The nature of HPV infection

    b.  Transmission issues

    c.  Risk reduction

    d.  All of the above

23. All of the following are appropriate patient education messages
    about the nature of HPV infection except:

    a.  Genital HPV is a viral infection which is one of the most common
        STDs.

    b.  High-risk HPV types are associated with external genital warts.

    c.  Genital warts have a high recurrence rate after treatment.

    d.  The majority of women with high-risk HPV types do not develop
        cervical cancer.

24. Which of the following is correct about partner management for
    patients diagnosed with genital warts?

    a.  Sex partner examination is not necessary for management of
        genital warts because no data indicate that reinfection plays a
        role in recurrences.

    b.  Providing treatment solely for the purpose of preventing future
        transmission cannot be recommended because the value of
        treatment in reducing infectivity is not known.

    c.  The counseling of sex partners provides an opportunity for these
        partners to learn about the implications of having a partner who
        has genital warts and about the potential for future disease
        transmission and receive STD and Pap screening if necessary.

    d.  All of the above

25. The presence of genital warts is an indication for:

    a.  Change in Pap test frequency

    b.  Cervical colposcopy

    c.  Both of the above

    d.  Neither of the above

26. Which of the following actions should be considered for patients
    with newly diagnosed genital warts?

    a.  Screening of all current and former sex partners for genital
        warts

    b.  Immediate Pap smear, regardless of when last Pap screening was
        performed

    c.  Screening for other STD (e.g., chlamydia, gonorrhea, HIV,
        syphilis)

    d.  HPV DNA test