GU: STIs - I Flashcards
STIs in general
- are most common / severe in what populations?
- usually present how?
- can lead to what complications?
adolescents/adults
- demographics
- m/c in adolescents / young adults
- complications typically more severe in women
- can lead to
- inc risk of acquiring HIV
- in women
- PID (which can cause → infertility/ectopic pregnancies)
- fetal STI
what STIs can cause genital ulcer? which is the m/c in the US?
- genital herpes, syphilis, chancroid, granuloma inguinale, lymphogranuloma venerum
- genital herpes = m/c in US
genital herpes is
- caused by what agents?
- transmitted how?
-
HSV-2 (m/c).
- transmitted either
- sexually
- from mother to newborn
- transmitted either
-
HSV-1
- transmitted by genital contact with infected saliva / oral lesions
genital herpes - presentation
- usually is asymptomatic
- if symptomatic, typically most severe in initial infection:
-
painful genital lesions progressing from red base → vesicles → ulcers
- in women: these lesions can cause “external dysuria” painful urination right at external urethra
- lymphadenopathy in inguinal / pelvic / femoral nodes
-
systemic affects
- headache/malaise myalgia
-
painful genital lesions progressing from red base → vesicles → ulcers
genital herpes - complications
HSV can be passed from a mother to her fetus during delivery
during delivery, newborns can develop disseminated infections from what etiological agents?
TORCH:
T- Toxoplasma gondii
O- other: HIV, VZV, Parvovirus, Syphilis, Borrelia
R- Rubella
C- CMV
H- HSV
transmission of HSV to neonate in HSV + pregnant women
- what makes transmission risk high/low?
- what measures are taken to prevent transmission?
- high vs low risk
- high risk:
- acquired HSV (primary infection) near delivery
- low risk: if mother has
- recurrent herpes
- acquired HSV (primary infection) in 1st half of pregnancy
- high risk:
- preventative measures
-
asymptomatic pt: cervicovaginal swab during delivery just to check
- if + for virus: treat neonate with antiviral
-
pt with genital herpes dx:
- if not currently active: treat neonate with antiviral
- if prodrome/active lesions: delivery by C-SECTION
-
asymptomatic pt: cervicovaginal swab during delivery just to check
what role does therapy have in the management of HSV?
- anti-virals
- do
- make recurrences less frequent/less severe
- reduce risk of sexual transmission of HSV-2 to another person
- do not
- have any affect on latency
- do
syphilis - etiological agent
treponema pallidum
syphilis - presentation
syphilis has 3 phases of presentations
- primary (right after infection)
-
chancre + regional lymphadenopathy
- chancre = PAINLESS, indurated (hard)
-
chancre + regional lymphadenopathy
- secondary (6-8 weeks after chance)
- non-systemic
- patchy alopecia
- mucous patches on tongue
- condyloma lata - wart like lesions
- systemic - malaise /arthralgia / fever
- non-systemic
- tertiary (if secondary not cured) - gummas, CV affects
syphilis - primary presentation
-
painless chancre + regional lymphadenopathy
- chancre = painless, hard, indurated
syphilis - secondary presentation
- non-systemic
- patchy alopecia
- mucous patches on tongue
- skin presentations
- maculopapular rashes on palms, soles
- condylomata lata (wart like lesions)
- systemic - malaise /arthralgia / fever
what can happen is syphilis is untreated and becomes latent?
- relapse of secondary
- tertiary syphilis
congenital syphilis - presentation
- stillborn, or
- is a “secondary” syphilis presentation that occurs in 2 phases
- early presentation
- skin manifestations: maculopapular rash / condyloma lata, tongue mucous patch
-
organ defects - liver/kidney/spleen/bone
- hepatosplenomegaly
- glomerulonepphritis
- osteochondritis
- late presentation = developmental defects
-
bone
- clutton’s joints
- saber shins
- saddle nose
-
teeth
- Hutchinson teeth
- mulberry molars
-
bone
- early presentation
congenital syphilis - early presentation
skin manifestations + organ defects
-
skin manifestations (same as adults)
- maculopapular rash
- condyloma lata
- tongue mucous patch
-
organ defects
-
liver / kidney / spleen/ bone
- hepatosplenomegaly
- glomerulonephritis
- osteochondritis
-
liver / kidney / spleen/ bone
congenital syphyllis - late presentation
= developmental defects
-
bone
- clutton’s joints
- saber shins
- saddle nose
-
teeth
- Hutchinson teeth
- mulberry molars
- rhagades
what is this image showing?
when is this seen?
chancre
primary syphilis in adult (painless)
what is this image showing?
when is it seen?
condyloma lata - wart like lesions
secondary syphilis / early presentation congenital syphilis