Ch. 41 Sexually Transmitted Infections Flashcards by Rachel Wiebe

How are STI’s transferred?

Person to person:

Oral, genitalia, urinary meatus, rectum, skin, mother to fetus

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How are STI’s transferred?

Person to person:

Oral, genitalia, urinary meatus, rectum, skin, mother to fetus

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What is the treatment for an STI?

Sexual partners must be identified and treated

Abstinence during therapy

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How are genital warts transferred?

Fomites (ie: contaminated clothing)
Mother to newborn
Mucosal/skin to mucosal/skin

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What are the risk factors for genital warts?

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Describe the progression of genital warts

Transient or persistent
Incubation is 1-8 months
May be asymptomatic
Associated with genital cancers

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Describe the appearance of external genital warts.

Soft raised fleshy lesions, or small bumps or flat rough surfaced areas on external genitalia (male and female)

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Describe the appearance/manifestations of internal genital warts

Cauliflower-shaped lesions causing discomfort, bleeding, painful intercourse

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What are the treatments for genital warts?

Vaccine recently developed
Antimitotic agent necrosing wart tissue
Cryotherapy: treatment of choice
Surgical excision
Laser vaporization
Electrocautery 
**Notification of partners**

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How is herpes a neurotropic virus?

Grows in neurons, latent form moves up via peripheral nerves; dormant in dorsal root ganglia

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What is a neurotropic virus?

Grows in neurons, latent form moves up via peripheral nerves

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What is the treatment for an STI?

Sexual partners must be identified and treated

Abstinence during therapy

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How are genital warts transferred?

Fomites (ie: contaminated clothing)
Mother to newborn
Mucosal/skin to mucosal/skin

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What are the risk factors for genital warts?

less than 25 years old
Early first intercourse (less than 16 years old)
Increased number of partners

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Describe the progression of genital warts

Transient or persistent
Incubation is 1-8 months
May be asymptomatic
Associated with genital cancers

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Describe the appearance of external genital warts.

Soft raised fleshy lesions, or small bumps or flat rough surfaced areas on external genitalia (male and female)

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Describe the appearance/manifestations of internal genital warts

Cauliflower-shaped lesions causing discomfort, bleeding, painful intercourse

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What is the treatment for vaginal candidiasis?

Antifungal

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What is the incubation period for herpes simplex virus 2?

2-12 days

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What is a neurotropic virus?

Grows in neurons, latent form moves up via peripheral nerves

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What are the possible complications of trichomoniasis?

Human Immunodeficiency Virus (HIV)
Infertility, Pelvic Inflammatory Disease & premature births (women)
Infertility, chronic prostatitis & urethritis (men)

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What are the symptoms of genital herpes?

Itching, tingling, painful to touch
Dysuria, dyspareunia
“wet” vesicle eventually crusts over

What are the symptoms that accompany a primary (first time) infection of herpes?

Headache, malaise, muscle aches, lyphadenopathy

What are the triggers for a herpes outbreak?

Stress, sleep loss, overexertion, other infections, prolonged coitus, menstrual distress

What is vaginal candidiasis (yeast infection)?

Present in healthy women Activated when vaginal environment is altered 75% of women at some point in their life Usually not transmitted sexually (not an “official” SDI)

What are the risk factors for vaginal candidiasis?

``` Decreased normal bacterial flora Altered hormonal levels Decreased immune system Diabetes Mellitus HIV infection ```

What are the manifestations for vaginal candidiasis?

Thick, white, odorless discharge | Irritation, swelling, erythema, dysuria

What is the treatment for vaginal candidiasis?

Antifungal

How is gonorrhea transmitted?

Entry via genitals, urinary tract, eyes, oropharynx, rectum, skin Neonates born to infected mothers (can cause blindness in neonates)

What are the manifestations of trichomoniasis in men?

Harbour organisms in urethra & prostate but are almost always asymptomatic

What are the possible complications of trichomoniasis?

Human Immunodeficiency Virus (HIV) Infertility, Pelvic Inflammatory Disease & premature births (women) Infertility, chronic prostatitis & urethritis (men)

Describe the two distinct morphologies of chlamydial infections. (It is bacterial, but how does it behave like a virus?)

Elementary body (survives outside the cell) attaches and is ingested & activates the reticulate body (can’t survive outside cell) which divides and forms new “elementary bodies” released when cell bursts

What is the most common STI in North America?

Chlamydia trachomatis

What are the manifestations of chlamydia in women?

Can be asymptomatic Frequency, dysuria, vaginal discharge Mucopurulent cervical discharge Cervix becomes hypertrophied, edematous, friable

What are the manifestations of chlamydia in men?

Urethritis, meatal erythema/tenderness, itchiness, discharge | Dysuria, prostatitis, epididymitis

What are the complications of chlamydia in women?

``` Pelvic inflammatory disease (40%) Infertility (20%) Chronic pain (18%) Conjuctivitis Damaged fallopian tubes (tubal pregnancy) ```

What are the complications of chlamydia in men?

Infertility | Reiter’s syndrome: reactive arthritis, conjunctivitis, urethritis

What bacterium causes gonorrhea?

Neisseria gonorrhoeae

How is gonorrhea transmitted?

Entry via genitals, urinary tract, eyes, oropharynx, rectum, skin Neonates born to infected mothers (can cause blindness in neonates)

What occurs during the secondary stage of syphilis?

2-6 wks after initial chancre, lasts1 wk to 6 months Rash on palms/soles Fever, sore throat, malaise, stomatitis, nausea, eye inflammation, arthralgias Alopecia Elevated lesions on genitals: highly infectious

What are the symptoms of gonorrhea in women?

Sometimes asymptomatic | Women: genital or urinary discharge, dysuria, dyspareunia, pelvic pain, bleeding, fever, proctitis, uterine infection

What are the complications of gonorrhea in males?

spread to prostate, epididymis Pharyngitis if oral-genital contact Conjunctivitis

What are the complications of gonorrhea in females?

uterine infection, salpingitis (fallopian tubes), scarring, infertility Pharyngitis if oral-genital contact Conjunctivitis

What can happen if gonorrhea enters the bloodstream?

(bacteremia): joint, heart valves, meninges

How is syphilis transmitted?

Direct contact with infectious moist lesion Kissing/intimate contact Skin abrasions Mother to fetus invitro/transplacental

What are the complications of syphilis during pregnancy?

Prematurity, stillbirth, congenital defects, active infection

What occurs during the primary stage of syphilis?

Chancre at site of exposure (within 3 weeks, but can incubate longer) Buttonlike papule erodes skin

Where does a syphilis chancre appear on a male?

Penis or scrotum

Where does a syphilis chancre appear on a female?

Cervix, vagina, sometimes external

What occurs during the secondary stage of syphilis?

What occurs during the latent phase of syphilis?

Symptoms resolve but still seroreactive 1 in 3 progress to this stage Others have minimal symptoms or spontaneous cure

What occurs during the tertiary stage of syphilis?

Gumma lesions: CV: aortic valve, aortic aneurysm CNS (neurosyphilis): dementia, blindness Skin/Liver/Bone

How long does the latent phase of syphilis last?

1-2-20 years

What is the treatment for syphilis?

Penicillin