1229 Exam 5: Sexually Transmitted Infections Flashcards

1
Q

An infection that can be transferred from one person to another through sexual contact
Can be bacterial, viral, protozoa, or ectoparasites
Organisms that can live outside the body like lice

A

Sexually Transmitted Infections

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2
Q

Means that a germ that can cause sickness is present inside a person’s body and may not cause any adverse effects

A

Infection

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3
Q

Means that the infection is actually causing the infected person to feel sick, or to notice something is wrong

A

Disease

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4
Q
Chlamydia
Gonorrhea
Syphilis
PID
Group B Strep
A

Bacterial

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5
Q

Caused by infection

Most common STI

A

Chlamydia (Chlamydia trachomatis)

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6
Q

Risk Factors of Chlamydia

A

Sexually active women under 20
Women or men with multiple sex partners
People who do not use a barrier form of birth control

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7
Q

Symptoms of Chlamydia

A
Often asymptomatic and lack abnormal findings (Silent Disease)
If symptoms present, usually appear several weeks after exposure:
-Cervicitis
-Urthritis
Lower back pain
Painful sex
Burning urination
Bleeding between periods
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8
Q

Complications of Chlamydia

A
PID (Pelvic Inflammatory Disease)
Ectopic pregnancy
Infertility
Increase risk for other STIs
Reactive arthritis
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9
Q

Screening for Chlamydia

A

CDC recommends screening:

  • All sexually active women 25 yrs or younger
  • All pregnant women
  • Men who have sex with men
  • Anyone with symptoms
  • Anyone who had sex with someone recently treated/tested positive for Chlamydia
  • Multiple sex partners
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10
Q

Diagnosis for Chlamydia

A

Culture testing
NAAT (nucleic acid amplification test)
-Vaginal swabs
-Urine specimen

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11
Q

Treatment for Chlamydia

A
Doxycycline 100mg BID x 7 days
Azithromycin 1 gram PO x 1 dose
Abstain from sex for 1 week
Pregnant:
-Erythromycin for 7 days
-Amoxicillin for 7 days
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12
Q

Management for Chlamydia

A

Treat all partners
Do not need retested unless pregnant
Abstain from sex until finished with antibiotics
Take all medications as directed
Can get it again even after being treated, so just retreat them with antibiotics

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13
Q

Newborn Chlamydia

A

Neonatal conjunctivitis
-Clear water discharge
-Develops 5 days to 2 weeks after birth
-Complications: Conjunctival scarring, corneal microgranulations
Pneumonia:
-Repetitive staccato cough, tachpnea, rales, hyperinflation
Treatment:
-Erythromycin orally or Sulfonamide orally for 2-3 weeks

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14
Q

Caused by a sexually transmitted bacterium, neisseria gonorrhoeae that can infect both males and females
Oldest communicable disease
Reportable to the CDC

A

Gonorrhea

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15
Q

Risk Factors for Gonorrhea

A

Sexually active teens and young adults

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16
Q

Symptoms of Gonorrhea

A

May be asymptomatic
Women: Painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods
Men: burning sensation when urinating, or a white, yellow, or green discharge from the penis that usually appears 1 to 14 days after infection, occasional swollen testicles
Can get in the throat

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17
Q

Complications of Gonorrhea

A
PID
Infertility
Chronic pelvic pain
Internal abscess
Ectopic pregnancy
Epididimytitis
Increase the risk of contracting HIV
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18
Q

Diagnosis for Gonorrhea

A
Culture testing
Gram stain (males)
NAAT
-Vaginal swabs
-Urine specimen
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19
Q

Treatment for Gonorrhea

A
Ceftriaxone 125mg IM x 1 
OR
Cefisime 400mg PO x 1
PLUS:
Azithromycin 1 gram PO x 1
OR
Doxycycline 100mg PO BID x 7 days
PREGNANT:
Azithromycin 2 grams
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20
Q

Newborn Gonorrhea

A
Blindness or Conjunctivitis
Gonococcal joint infections
Septicemia
TREATMENT:
-0.5% Erythromycin ointment to eyes within first hour of birth
-Ceftriaxone IM
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21
Q

Caused by a sexually transmitted Treponema pallidum that can infect both males and females
Earliest described STI
Reportable to the CDC

A

Syphilis

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22
Q

Risk Factors for Syphilis

A

Sexually active individuals with out use of barrier methods

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23
Q

Primary Syphilis

A

Primary lesion (at site where Syphilis entered the body)
-The Chancre lasts for 5-90 days
-Begins as a painless papule and then progresses to shallow ulcer
Symptoms will resolve without treatment and progress to next stage

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24
Q

Secondary Syphilis

A

Widespread, maculopapular rash on the palms and soles
-Rough, red or reddish-brown
Lymphadenopathy
Fever, headache, malaise, patchy haïr loss
6 weeks to 6 months
-May appear when primary chancre is healing or weeks after primary chancre
Condylomata
-Large raised grey or white lesions to the vulva, perineum, or anus
Symptoms will resolve without treatment and progress to next stage

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25
Latent Syphilis
Begins when Primary and Secondary disappear Can last for years and can appear 10-30 years after infection 15% of people not treated will develop Latent Syphilis
26
Symptoms of Latent Syphilis
``` Difficulty coordinating movements Paralysis Numbness Dementia Disease damages the internal organs: brain, nerve, eyes, heart, blood vessels, liver, bones, joints Can lead to death ```
27
Screening for Syphilis
CDC recommends: - All who have another STI - All pregnant women - Men who have sex with men - Persons with HIV/AIDS - Persons with partner tested positive Syphilis
28
Diagnosis for Syphilis
Nontreponemal Tests: VDRL (Venereal Disease Research Laboratories) and RPR (rapid plasma reagin) are screening tests -False-positive tests are not uncommon due to acute infections, autoimmune disorders, malignancy, pregnancy, drug addiction Microscopic Examination of primary and secondary lesions Treponemal Tests for T. Pallidum are used to confirm positive results and seroconversion usually takes place 6-8 weeks after exposure
29
Treatment for Syphilis
Penicillin G 2.4 million units IM x 1 dose Monitor for Jarisch-Herxheimer Reaction Pregnant: -Skin Testing or desensitized
30
Management for Treatment
Monthly follow-up Long-term serologic testing even in the absence of symptoms Practice sexual abstinence until treatment completed Notify all partners
31
Newborn Syphilis
If Syphilis is left untreated, 40-50% of newborns will have symptomatic congenital syphilis 25% of untreated syphilis can result in fetal death, miscarriage, or stillbirth Can occur 5-15 years after a baby is born
32
Newborn Syphilis Symptoms
Poor feeding, slight hyperthermia Snuffles: copious, clear serosanguineous mucus discharge from the neonates nose Copper colored maculopapular rash
33
Complications of Syphilis
``` Neurosyphilis Deafness Hutchinson's teeth Saber skins Saddle nose Gummas Interstitial keratitis Seizures ```
34
Most commonly involves the uterine tubes and uterus | Caused by bacteria, Chlamydia, and Gonorrhea
Pelvic Inflammatory Disease (PID)
35
Risk Factors of PID
Sexually active women Young age (> 25 yrs) Multiple sexual partners History of STI
36
Symptoms of PID
``` Vary from mild to severe If caused by Chlamydia, may have no signs at all Low abdominal pain Fever Adnexal tenderness on exam Urethral or cervical discharge Elevated WBC and ESR ```
37
Complications of PID
``` Permanent damage to female organs Scar tissue in the fallopian tubes Infertility Ectopic pregnancy Chronic pelvic pain Painful sex ```
38
Screening & Diagnosis for PID
No precise test to detect PID Thorough history and physical exam Screening for potential organisms Ultrasound
39
Treatment for PID
``` Broad spectrum antibiotic -Dependent on bacteria Hospitalization?? -Only if severely ill or pregnant IUD for birth control?? -Generally no!! Increases risk for infections ```
40
Management for PID
``` Treat all partners Take all medications as directed Abstain from sex until finished with antibiotics Education Counseling ```
41
Considered normal vaginal flora in non pregnant women Present in 9-23% of pregnant women Associated with poor outcomes Screen all women at 36-37 weeks
Group B Strep
42
Complications for Group B Strep
Preterm birth > 37 weeks Premature rupture of membranes Intrapartum maternal fever > 101*F
43
Treatment for Group B Strep
PCN G 5 million units IV
44
Newborn Group B Strep
``` Low birth weight Preterm birth Respiratory distress syndrome Septic shock Meningitis ```
45
Viral STIs
HPV Herpes Hepatitis HIV
46
(A.K.A) Genital Warts Can lead to cervical cancer Can be passed through oral and anal sex In 90% of cases the body clears of this naturally within 2 years
Human Papillomavirus (HPV)
47
Risk Factors for HPV
Sexually active persons who do not use barrier birth control Gay and bisexual men People with weaken immune system
48
Symptoms of HPV
``` Genital warts (condylomata acuminata) Chronic vaginal discharge Pruritius Dysparenunia Most women with HPV do not have any symptoms at all ```
49
Complications for HPV
Cervical Cancer Other HPV cancers Recurrent Respiratory Papillomatosis (RRP) *If warts in throat EDUCATE**
50
Screening for HPV
Complaints of profuse, irritating vaginal discharge, itching, dysparenuia, or postcoital bleeding Complaints of "bumps" Known exposure
51
Diagnosis for HPV
``` Thorough history and physical Pap test HPV-DNA No test for men No test to check throat ```
52
Treatment for HPV
NO treatment for the virus itself Visible warts: medication applied directly to lesions Cervical Cancer: most is treatable if found early RRP: treated with surgery or medicines No affect on baby unless mom has large warts and they would do a C-section
53
Management of HPV
Prevention: - Gardasil-vaccine approved for both males and females - Cervarix-vaccine for females
54
HSV-1 (Oral) HSV-2 (Genital) Blisters crust over and heal within 10-15 days Common viral infection Risk Factors: -Contact with lesions, mucosal suffices, genital secretions, or oral secretions Don't have to have symptoms to transmit virus Can get with skin-skin contact even with use of condom
Herpes Simplex Virus
55
Symptoms of Herpes Simplex Virus
``` Can be asymptomatic or have mild symptoms Vesicles on genitals, rectum, or mouth *After exposure takes 4 days for symptoms to show* Systemic symptoms (1st exposure) -Fever -Body aches -Swollen lymph nodes -Headache ```
56
Complications of HSV
``` Painful genital ulcers Rare: -Blindness -Encephalitis -Aseptic Meningitis ```
57
Diagnosis for HSV
Thorough history and physical Viral Culture NAAT
58
Screening for HSV
CDC doesn't recommend screening the general population for HSV-1 or HSV-2: Only screen if they have symptoms or have partner with it. Doctor recommends it or they ask to be tested
59
Treatment for HSV
``` NO CURE Daily suppressive treatment: -Acyclovir -Valacyclovir -Famciclovir ```
60
Management for HSV
``` Clean lesions to prevent secondary infection Oral analegesics Counseling EDUCATION Abstain from sex when symptoms present ```
61
Newborn HSV
HSv-2 most common cause of HSV in newborns Modes of transmission: -Transplacental infection -Ascending infection by way of the birth canal -Direct contamination during passage through an infected birth canal -Direct transmission from infected personnel or family
62
Neonatal Herpes
``` Involves all organs Disseminated infection Localized CNS disease Localized infection Herpes keratitis (high morbidity) ```
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Inflammation of the liver and a group of viral infections that affect the liver
Hepatitis (A, B, C)
64
Incubation period of 28 days Acquired primarily through fecal-oral route Can be transmitted sexually Can live outside the body Killed by heating to 105 degrees Transmitted by food if contaminated after cooking
Hepatitis A
65
Risk Factors for Hepatitis A
Living in western US, Native Americans, Alaskan Natives, and Children/Employees in daycare centers
66
Symptoms for Hepatitis A
Flu-like: - Malaise - Fatigue - Anorexia - Nausea - Abdominal Pain - Dark Urine - Clay Colored Stools - Jaundice
67
Hepatitis A is...
Self limiting May need hospitalization due to dehydration Avoid medications metabolized in liver Get Hep A vaccine
68
Transmitted through sex, injection drug use, birth to infected mother, contact with blood or open sores of an infected person, needle sticks, sharing personal items of infected person Can live outside body for 7 days Incubation period of 90 days
Hepatitis B
69
Risk Factors for Hepatitis B
``` Infants born to infected mothers Sex partners with infected persons Men who have sex with men Injection drug users Household contacts with infected person Healthcare workers Hemodialysis patients Travelors ```
70
Symptoms of Hep B Symptoms typically last from several weeks to 6 months Hep B vaccine
``` Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Clay colored stools Joint pain Jaundice ```
71
Serology
``` HBsAg IgM anti HBc (recent or acute infection) Anti-HBs HBeAg HBeAB ```
72
HbsAg negative anti-HBc positive anti-HBs positive
Immune due to natural infection
73
HBsAg negative anti-HBc negative anti-HBs positive
Immune due to vaccination
74
HBsAg positive anti-HBc positive anti-HBs negative IgM anti-HBc positive
Acute infection
75
HBsAg positive anti-HBc positive IgM anti-HBc negative anti-HBc negative
Chronic infection
76
Treatment for Hep B
Acute- no medication available | Chronic- antiviral drugs
77
Newborn Hep B
Increased risk for preterm birth Rate for transmission highest when mother contracts while pregnant Increased mortality High risk of chronic hepatitis, cirrhosis, or liver cancer Hep B vaccine given before discharge from hospital
78
Most common blood borne infection in the US 3.2 million people chronically infected No vaccine available
Hepatitis C
79
Risk Factors for Hep C
``` Current/former injection drug users Recipients of blood transfusions before 1992 Chronic hemodialysis patient Health care workers Persons with HIV infection Children born to Hep C + mothers ```
80
Transmitted by:
``` Injection drug use Receipt of blood products Needle sticks Birth to an Hep C + mother Sex with Hep C + person Sharing personal care items ```
81
Symptoms of Hep C | Average time from exposure to symptoms is 4-12 weeks
``` Fever Fatigue Dark urine Clay colored stools Abdominal pain Loss of appetite Nausea Vomiting Joint pain Jaundice ```
82
Testing Hep C
Anti-HCV RIBA HCV RNA Liver enzyme tests
83
Most infants infected with Hep C at birth have no symptoms and do well during childhood
I LOVE Y'ALL!!! :)
84
Protozoa STIs
Trichomoniasis
85
Very common STI | Caused by protozoan Trichomonas vaginalis
Trichomoniasis
86
Risk Factors for Trichomoniasis
Unprotected sex | Older women
87
Symptoms for Trichomoniasis
70% do not have symptoms | Unpleasant sex
88
Symptoms continued...
Men: - Itching/irritation in the penis - Burning after urination or ejaculation - Penile discharge
89
Symptoms for Trichomoniasis
Women: - Itching, burning, redness, or soreness of the genitals - Discomfort with urination - Thin discharge with unusual smell that can be clear, white, yellow, or green - Strawberry spots to cervix
90
Diagnosis for Trich
Thorough history and physical Pap tests Wet prep Vaginal culture
91
Treatment for Trich
Metronidazole 2 gram PO x 1 dose Treat all partners Use barrier form of birth control
92
``` An acronym for a group of five infectious diseases: Toxoplasmosis Other (Hepatitis B) Rubella (German measles) Cytomegalovirus (CMV) Herpes Simplex Virus (HSV) ```
TORCH
93
Each disease may be teratogenic
Each crosses the placenta Each may adversely affect the developing fetus The effect of each varies, depending on developmental stage at time of exposure