Ch. 41 Sexually Transmitted Infections Flashcards
How are STI’s transferred?
Person to person:
Oral, genitalia, urinary meatus, rectum, skin, mother to fetus
How are STI’s transferred?
Person to person:
Oral, genitalia, urinary meatus, rectum, skin, mother to fetus
What is the treatment for an STI?
Sexual partners must be identified and treated
Abstinence during therapy
How are genital warts transferred?
Fomites (ie: contaminated clothing)
Mother to newborn
Mucosal/skin to mucosal/skin
What are the risk factors for genital warts?
Describe the progression of genital warts
Transient or persistent
Incubation is 1-8 months
May be asymptomatic
Associated with genital cancers
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)
Describe the appearance/manifestations of internal genital warts
Cauliflower-shaped lesions causing discomfort, bleeding, painful intercourse
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**
How is herpes a neurotropic virus?
Grows in neurons, latent form moves up via peripheral nerves; dormant in dorsal root ganglia
What is a neurotropic virus?
Grows in neurons, latent form moves up via peripheral nerves
What is the treatment for an STI?
Sexual partners must be identified and treated
Abstinence during therapy
How are genital warts transferred?
Fomites (ie: contaminated clothing)
Mother to newborn
Mucosal/skin to mucosal/skin
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
Describe the progression of genital warts
Transient or persistent
Incubation is 1-8 months
May be asymptomatic
Associated with genital cancers
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)
Describe the appearance/manifestations of internal genital warts
Cauliflower-shaped lesions causing discomfort, bleeding, painful intercourse
What is the treatment for vaginal candidiasis?
Antifungal
What is the incubation period for herpes simplex virus 2?
2-12 days
What is a neurotropic virus?
Grows in neurons, latent form moves up via peripheral nerves
What are the possible complications of trichomoniasis?
Human Immunodeficiency Virus (HIV)
Infertility, Pelvic Inflammatory Disease & premature births (women)
Infertility, chronic prostatitis & urethritis (men)
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?
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 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
