Ch 8 STI Flashcards
what is an STI
infection of an individual with a sexually transmitted pathogen
- many are asymptomatic
who is at risk for STI
anyone who is sexually active
10 groups who are at increased risk of an STI
- sexual contact with people with know STD
- youth <25 with multiple partners
- street involvement (homeless)
- intercourse with new partner in last 2 months
- more than 2 partners in last 12 months
- no contraception/barrier methods
- injection drug use
- persons immigrating or having sex in countries with STD endemic
- MSM
- commercial sex workers (survival sex)
5 common presentations of common STDs
- lumps and bumps
- discharge and burning
- blisters and ulcers
- itching
- pain during sex
lumps and bumps 3 infectious causes
- warts
- herpes
- molluscum
lumps and bumps 4 non-infectious causes
- pearly penile papules
- seborrheic karatoses
- moles
- skin tags
what is the cause of molloscum contagiosum
caused by “pox” virus
- not necessarily a STD
treatment of molloscum contagiosum
- often resolve on their own
- liquid nitrogen
full name of HPV
human papillomavirus
what is the most common HPV
warts and cancer
HPV divided into?
high and low risk groups
what are high risk groups of HPV
cause cervical cancer, cancer of the throat
are is a low risk group of HPV
cause warts
oral HPV more common in?
3x more common in men
how is oral HPV transmitted?
from genitals to mouth
what is recurrent respiratory papillomatosis
- benign growths
- HPV 6 and HPV 11
many patients require multiple surgeries
how do you acquire recurrent respiratory papillomatosis
- child acquires at birth
- adult related to oral sex
natural history of HPV
- fluctuation in size and number of warts
- sometimes clear on own
- no therapy guarantees cure HPV infections
- removal of wart does not absolutely prevent transmission
prevalence of HPV
- not reportable STI in Canada
- high rates of incidence among university aged women/men
- readily acquired from first-time sexual partners
4 routes of transmission of HPV
- skin to skin contact between infected and uninfected individual
- genital-genital
- genital-anal
- genital-oral
symptoms of HPV
- most dont know they are infected
- develop warts (genital/non-genital)
- abnormal PAP tests
- some cervical, penile, or other precancerous conditions
diagnosis of HPV
- visual inspection
- diligent about yearly PAP smears
- biopsy
treatment of genital warts due to HPV
immune stimulating drug or drug that kills cells on surface of skin (applied locally)
treatment of HPV precancerous lesions
surgically removed
ways to prevent HPV
- 2 vaccines (Gardasil, cervarix)
4 clinical applied treatments for genital warts
- podophyllin resin
- cryotherapy
- trichloroacitis acid
- excisional treatments
2 patient applied treatments for genital warts
- podofilox
- imiquidmod
2 main types of infectious causes of discharges
urethritis (infection of urethra)
vaginitis/cervicitis
what are 4 causes of urethritis
- gonorrhea
- chlamydia
- less common: HSV, mycoplasma, ureaplasma
what are 5 causes of vaginitis/cervicitis
- gonorrhea
- chlamydia
- bacterial vaginosis
- trichomonas
- candida (yeast)
6 non infectious causes of discharges
- excessive physiological secretions
- allergic reaction
- skin conditions
- foreign body
- trauma
- lack of proper vaginal lubrication during intercourse
bacterial vaginosis common among
WMW
what is bacterial vaginosis
- not an STD
- due to alteration of normal vaginal flora, caused by overgrowth of bacteria that normally live in vagina
symptoms of bacterial vaginosis
- fishy smell
- vaginal discharge
- itching around vagina
- pain during intercourse
diagnosis of bacterial vaginosis
- high pH
- odour
- presence of clue cells under microsope
- chemical tests
(KOH whiff test)
treatment of bacterial vaginosis
- oral medication
- clindamycin vaginal cream
- vaginal gel
- long-acting vitamin C tablets (inserted)
consequences of bacterial vaginosis if left untreated
- cause pregnancy complications (preterm delivery)
- inc susceptibility to acquiring/transmitting HIV, chlamydia, gonorrhea, herpes
prevention of bacterial vaginosis
- abstinence
- avoid multiple partners
- avoid douching
what is trichomonas
parasitic infection
transmission of trichomonas
trichomonas vaginalis
- protozoa that causes infection
- spread through sexual contact
3 symptoms of trichomonas
- profuse gray/yellow discharge
- pain urination
- genital itching
- asymptomatic (usually in men)
5 consequences if trichomonas untreated
- infertility
- inc risk of cervical cancer
- inflammation of uterus
- endometriris
- premature delivery
diagnosis of trichomonas
swab vagina/urethra to identify the parasite
treatment of trichomonas
oral drug (metronidazole)
prevention of trichomonas
condoms
what is gonorrhea?
aka “the clap”
- inflammatory condition
- incubation period 2-7 days
gonorrhea caused by
bacteria (neisseria gonorrhoeae)
prevalence of gonorrhea
- highest among canadian MSM and travelers
4 routes of transmission of gonorrhea
- penile-vaginal
- penile-anal
- oral
- mother to baby in childbirth
2 common symptoms of gonorrhea
- pus like yellow/green discharge vagina, urethra, anus
- throat pain
consequences of gonorrhea
- spread to uterus, fallopian tubes causes PID (affect fertility)
- enter bloodstream, affect joints, skin, tissues around liver, heart, brain
diagnosis of gonorrhea
- swab cervix, vagina, urethra, anus, pharynx
- blood/urine sample
- women: self test kit
treatment of gonorrhea
- oral/injectable antiobiotics
prevention of gonorrhea
condoms
4 other sites of infection of gonorrhea
- throat
- rectum
- eye
- disseminated infection
prevalence of chlamydia
- highest prevalence of any STI in canada (most common bacterial STI)
- sexual individuals 20-24
what is chlamydia
intracellular bacterial infection
incubation period 2-6 weeks
- can have long term carriage
routine screening of chlamydia
- all sexual active women 25 and under
- pregnant women with sexual partner 3rd trimester
- not recommended for men
- considered throat/rectal in MSM
4 routes of transmission of chlamydia
- penile-vaginal
- penile-anal
- oral
- mother to baby in childbirth
3 symptoms of chlamydia
- 70% females asymptomatic (less than 50% males)
- mild discharge from vagina/penis/anus
- urinary symptoms (burn/itch)
- vaginal bleeding
consequences of women with chlamydia if left untreated
- spread to uterus, fallopian tubes
- cause pelvic inflammatory disease (PID) – leads to ectopic pregnancy, infertility, pain with intercourse
consequences of men with chlamydia if left untreated
- cause epididymitis
- infertility
- urethritis (inflamamtion)
3 diagnosis of chlamydia
- swab of cervix, vagina, urethra, pharynx
- urine sample
- women: self test kit
treatment of chlamydia
- oral antibiotics (azithromycin)
- single dose of cefixime, ceftriaxone
prevention of chlamydia
- condoms
- abstain from sex for 7 days
- partner notification
2 other sites of infection of chlamydia
- conjunctivitis
- trachoma
3 types of blisters/ulcers
- herpes simplex virus
- syphulis
- chancroid
what is syphillis
humans are the host of an organism
latent stage of syphillis
- no clinical manifestations
- 60-85% remain asymptomatic years without treatment
early= < 1 yr late= > 1 yr
prevalence of syphillis
- higher among MSM, travellers
4 common routes of transmission of syphillis
- penile-vaginal
- penile-anal
- oral
- mother to baby in childbirth
initial symptoms of syphillis
- swelling of lymph nodes near sites of contact
- ulcers
secondary syphillis
- untreated primary symptoms may subside
- rask (palms hands, feet, trunk)
- warty lesions in angenital area (anus)
- patches of erosions, white skin in mouth/anus
- fever
- jaundice
- muscle/joint aches
- patchy hair loss
consequences of syphillis
if untreated may lead to tertiary stage
- affects blood vessels, heart, eyes, sensory/brain damage
- cause gummas on bones/internal organs
- lead to death
diagnosis of syphillis
- serology
- blood test (detect antibodies)
treatment of syphillis
- injected penicillin
treponemal/non-treponemal tests
what is herpes caused by
herpes simplex virus
- virus remains in body for lifetime
3 stages to herpes
1) start with vesicles
2) ulcer formation
3) crust/heal
6 routes of transmission of herpes
- genital-genital
- penile-anal
- oral-genial
- oral-oral
- infants from mother in childbirth
- asymptomatic shedding
symptoms of oralabial herpes
lesion on/around lips
cold sores
symptoms fo angenital infection (herpes)
- lesions present on both sides of genitals when first infected
- recurs= blistery lesions on one side only
consequences of herpes
- blisters may become infected, cause temporary scarring
- infection cause urinary tract symptoms,
- inc risk of HIV acquisition/transmission
diagnosis of herpes
- swabbing lesions (viral identification test)
- blood test
treatment of herpes
oral antiviral (acyclovir) to limit length of initial herpes outbreak
transmission of pubic lice
- direct sexual contact
- non-sexual contact with infected person
- contact of contaminated surfaces (sheets, towels)
3 symptoms of pubic lice
- itchiness (night)
- visible, white eggs at base of hair
- scabies (rash where parasite burrowed)
consequences of pubic lice
- severe itchiness, lead to bacterial infection, cause breakdown of skin
2 diagnosis of pubic lice
- visual inspection
- skin biopsy
treatment of pubic lice
- permethrin/other cream/shampoo to treat parasites
what is moniliasis
aka thrush
- vaginal yeast infection
cause of moniliasis
- overgrowth of naturally occurring vaginal organisms
3 symptoms of moniliasis
- pain during intercourse
- vaginal itchiness
- white/clumpy discharge
2 consequences of moniliasis if left untreated
cause eczema reaction in genital area
- pain during sex/urination
diagnosis of moniliasis
visual inspection
lab tests
treatment of moniliasis
- oral/topical drugs
prevent of moniliasis
- avoidance of wide-spectrum antibiotics reduce developing moniliasis
name of HIV
human immunodeficiency virus
prevalence of HIV
more common in MSM
- drug users share needles
- countries with endemic
routes of transmission HIV
- blood/bodily fluids of infected indivudla when come in contact oral, genital, anal mucosa and blood stream of uninfected individual
- penile-vaginal
- penile-anal
- oral sex
- share toys
- presence of genital skin lesions
- from infected mother during childbirth
initial symptoms of HIV
flu like symptoms
enlarged lymph nodes
later symptoms of HIV
if untreated, moderate to severe immune system damage
consequences if HIV is not treated
- HIV progresses to AIDS (acquired immune deficiency syndrome)
- severe damage to immune system
- opportunistic infections, cancers
- neurological and cardiac diseases
- physical wasting
- death
diagnosis of HIV
blood test to detect antibodies (takes 3 months)
treatment of HIV
ARV therapy
- combination of drugs, stopping replication of HIV
- preserving HIV infected individuals health and lifespan
3 types of viral hepatitis
A, B, C
prevalence of Hep A
closed communicites (prisons)
- contaminated food with virus
- MSM
prevalence of Hep B
- MSM
- injection drug users
- individuals from countries where prevalent
prevalence of Hep C
- drug injection users
- prevalent in HIV positive MSM
routes of transmission of Hep A
- fecal-oral routes
- oral-anal sex
- injection of food/water contaminated with feces
routes of transmission of Hep B
- sexual contact
- sharing contaminated drug injection equipment
- share toys
routes of transmission Hep C
- blood contact
- sharing contaminated drug injection equipment
- sexual activities cause trauma to sites of sexual contact
- not transmissible through most sexual activities
symptoms of viral hepatitis
- jaundice
- flu like symptoms
- abdominal pain
consequence of Hep A if left untreated
- most survive and clear virus after treatment
consequence of Hep B/C if left untreated
- may remain in individuals body
- results in development of cirrhosis of liver/liver cancer
diagnosis of viral hepatitis
blood test
treatment of viral hepatitis
A= sympton-specific treatment
B/C= interferon injections, antiviral drugs
prevention of Hep A/B
vaccine
prevention of Hep B/C
safe recreational drug-injection practices help prevent
