Chlamydia/Syphilis/Gonorrhoea Flashcards
Incidence
of people (cases) that are newly infected during a specified time period
Prevalence
of people within population with the disease
already positive
_____________ is when you acquire the disease, then you become part of ________________
incidence
prevalence
Rate
frequency of event compared to # of people at risk
events / population size
what age group are STIs most common in? why?
15-24
more sexual partners
higher turnover
what 3 factors determine rate of STI spread?
- rate of exposure of susceptible people
- efficiency of transmission per exposure
- duration of infectivity
how can STIs spread?
sexual intercourse
oral-genital contact
IV drugs
congenital
what causes syphilis?
treponema pallidum
where are syphilis outbreaks most common?
male-male sex
sex workers
long term care
how do HSV, HPV, chlamidyia and gonorrhoea spread? what about HIV?
orally
not orally
- semen
- vaginal fluid
___________ tend to be more biologically prone to STIs. why?
women
biological anatomy
- less surface area
- men with foreskin have increased SA
what are some harm reduction strategies for preventing STI acquisition?
safe sex (condoms)
less sexual partners
HPV vaccination
what are the 3 bacterial STIs?
treponema pallidum
chlamydia trachoma’s
neisseria gonorrhoea
what are the 3 viral STIs?
HIV
HPV
HSV
what is the one parasitic STI?
trichomonas vaginalis
syphylis is often called ________________
the great imitator
primary syphilis
following inoculation via micro abrasions
painless, non-purulent chancre (sore)
don’t know you have it
secondary syphilis
disseminated rash on hands and feet
- not itchy
- painless
sore throat
muscle aches
malaise
weight loss
tertiary syphilis
gumma
soft gummy lesion
leads to degeneration of blood vessels in brain and heart
- stop making sense
how does secondary syphilis manifest systemically?
hepatitis
kidney damage
when does tertiary syphilis occur?
20-40 years after initial infection
how is syphilis treated?
penicillin
where does the syphilis chancre present in women?
labia or cervix
where does the syphilis chancre present in men?
penis (most)
oral cavity
anus
rectum
how is syphilis diagnosed?
testing syphilis specific antibodies
- treponema tests (IgG and IgM)
testing for non-syphilis specific proteins
- non-treponema tests (RPR and VDRL)
what are RPR titers used for in syphillus?
to monitor response to therapy
RPR titers will fall with therapy
What causes chlamydia?
intracellular bacteria called Chlamydia trachomatis
How is chlamydia transmitted?
sexual contact (oral, vaginal or anal)
ocular exposure to sexual fluid
mother to child (during birth)
How is chlamydia detected?
PCR
can’t be grown
Most chlamydia is ___________
asymptomatic
what are the 3 manifestations of Chlamydia trachomatis?
- Trachoma
- Lymphogranuloma venereum
- Genital infection
What is the incubation period for Chlamydia trachomatis?
1-3 weeks
40% of women and 20% of men infected with Chlamydia trachomatis are also co-infected with ________________
Neisseria gonorrhoea
Chlamydia trachomatis increases risk of acquiring __________
other STIs (including HIV)
Chlamydia causes the highest disease burden in what age groups?
15-19 and 20-24
Chlamydia rates are higher in men or women?
women
What cell type does Chlamydia trachomatis infect?
columnar epithelial cells
Why does infection of columnar epithelial cells by CT in adolescent females increase risk?
1) columnar epithelium extends further into ectocervix in adolescent females
- more exposed
- not tucked into cervical canal
2) thin and less protective mucus plug
- easier penetration
What happens once CT has infected columnar epithelial cells?
epithelial ells recruit neutrophils causing inflammatory response
What are the consequences of CT genital tract infections for females?
ectopic pregnancies
pelvic inflammatory disease
preihepatitis
infertility
Most cases of Chlamydia are asymptomatic, but what symptoms can MEN present with?
penile itching
pain with urination
swelling of testicles
Most cases of Chlamydia are asymptomatic, but what symptoms can WOMEN present with?
burning with urination
abnormal discharge
bleeding
pain during intercourse
abdominal lower back pain
fever and chills
What kind of specimen used to be collected for Chlamydia?
What kind of sample do we collect now?
What should not be sent for diagnosis?
OLD: swab into urethra
NOW
-urine sample (pee in cup)
- endocervix samples
DON’T send semen or discharge
Anyone that is tested for CT should also be tested for ______________
neisseria gonorrhoea
What kind of bacteria is neisseria gonorrhoea?
gram negative diplococci
gonorrhoea is more ____________
inflammatory
NG is always considered ___________
pathogenic
the ONLY hosts for NG are __________
humans
where does NG cause infection?
mucous membranes
- genital tract
- cervix
- fallopian tubes
- uterus
- rectum
- pharynx
- eyes
- mouth
- throat
where does NG cause infection in MALES specifically?
seminal vesicle
prostate
urethral strictures
If left untreated NG can lead to ______________ in females
pelvic inflammatory disease
do yo you have to ejaculate to spread gonorrhoea?
NO
what can pelvic inflammatory disease lead to?
abscesses
fallopian tube damage
ectopic pregnancy
infertility
how is NG transmitted?
sexually
mother to chid (during birth)
what are some symptoms of NG in WOMEN?
green discharge
pelvic pain
burning with urination
conjunctivitis
bleeding
vulvitis (swelling of vulva)
swelling or burning in throat (oral sex)
what are some symptoms of NG in MEN?
green/yellow discharge
burning with urination
burning or swelling in throat (oral sex)
painful or swollen testicles
what are the complications of disseminated gonococcal infection?
arthritis
endocarditis
meningitis
what is the incubation period for gonorrhoea?
2-8 days
when should you seek treatment for NG?
always!
__________ are more likely to be symptomatic with NG and therefore more likely to _______________
men
more likely to seek care
most NG infections occur in what age group?
15-24
most cases of urethritis caused by NG will _______________
spontaneously resolve after several weeks
where do we swab for NG in males?
anterior portion of urethra
where do we swab for NG in females?
endocervical canal after removing mucus plug
how is NG diagnosed?
PCR and culture
which STI is multi-drug resistant?
neisseria gonorrhoea
