Infections Flashcards
STI’s
Includes more than 25 infectious organisms transmitted sexually
20 mil affected annually with new STI in the United States
5 P’s of STI
Partners
Practices
Prevention of pregnancy
Protection from STI
Past-history of STI
Bacterial STIs
Chlamydia
Gonorrhea
Syphillis
Pelvic Inflammatory Disease (PID)
Bacterial Vaginosis
Chlamydia
Most frequently reported STI
Asymptomatic until…
- PID
- ectopic pregnancies
- Infertility
- breaks down epithelial cells of cervix
Screening:
- sexually active women under 25
- postcoital bleeding
- mucoid or purulent discharge
- dysuria
- painful urinations
- white cloudy or watery discharge from tip of penis
- culture
Management:
- treat both pt and partner
- axithromyacin
- doxycycline
Gonorrhea
Oldest communicable disease
Drug resistant neisseria gonorrhoeae
Almost exclusively contracted during sex
- genital/genital
- oral/genital
- anal/genital
Can be asymptomatic or…
- greenish yellow purulent endocervical discharge
- menstrual irregularities
- vaginitis
- vulvitis
- painful urination
- white, yellow, or green drainage from penis
- maybe infertility
Screening:
- teens and under 25 y/o adults
- screen all pregnant women
- cultures
Management:
- ceftriaxone (IM once)
- treat both partners
Syphilis
Treponema pallidum
Transmitted through micro abrasions in submucosa of vagina but also through kissing, biting, or oral/genital sex
Systemic disease
Primary
- characterized by primary lesions, appears 5-90days after infection. Painless papule that erodes to form a non-tender shallow, indurated, clean ulcer several mm in size
Secondary
- appears 6weeks to 6months after the appearance of the first papule. Characterized by widespread, symmetric, maculopapular rash on the palms and soles and generalized lymphadenopathy
Condylomata lata
- broad, painless, pink-gray, wartlike infectious lesions
Screening:
- anyone with a diff STI should be tested
- pregnant women
- venereal disease research lab (VDRL)
- rapid plasma regain (RRR)
Manage:
- Pen G preferred… May have allergy
- monthly follow up necessary
- notify all partners
- practice abstinence until treatment completed
Pelvic Inflammatory Disease
PID
Infectious process that involve uterine tubes, uterus, ovaries, and sometimes peritoneal surface
Caused by multitude of different bacteria
Women have inc risk of ectopic pregnancy, infertility, and chronic pelvic pain
S/S
- pelvic pain
- cramping
- fever
- chills
Screening and DX
- difficult to diagnose
- screen with all women with pelvic pain or symptoms
- culture discharge
- CBC shows elevated WBC
Manage
- prevention counseling
- broad spectrum antibiotics
Bacterial Vaginosis
A syndrome in which normal hydrogen peroxide producing lactobacilli are replaced with high concentrations of anaerobic bacteria
associated with pre-term labor and birth
Treat:
- flagyl
- trinidazole
- metrogel
- Cleocin
Human Papillomavirus (HPV)
Viral STI
condylomata acuminata or genital wart
Causes genital cancers (types 16 and 18)
Women… lesions seen in posterior portion of the introtius, also seen in buttocks and vulva, vagina, anus, and cervix
Lesions are small, soft, papillary swellings occurring singularly or in clusters (cauliflower masses)
Lesions are flesh colored or slightly darker
Usually painless unless inflamed
Screening:
- profuse discharge, itching, postcoital bleeding
- small bumps may be seen in the vagina, labia, anus, or valve (W)
- bumps anywhere in the general genital-anal region (M)
- found in Pap smear for women
- confirm with biopsy and histologic exam
Manage:
- prevention
- vaccines: cervarix and gardasil
- vaccines are for men and women
- symptom treatment (lesions can be removed)
- bathing in oatmeal
Hep B Virus
- most lifethreatening to fetus and neonate
- disease of liver
- transmitted parenterally, prenatally, orally, and intimate contact
- vaccination series
Hep C virus
- most common bloodbourne infection in the US
- risk factor for pregnant women is he of injecting IV drugs
- currently no vaccine
Herpes Simplex virus (HSV)
Painful, recurrent ulcers
HSV1 = non sexually transmitted and usually fever blisters on mouth and oral cavity (cold sores)
HSV2 = sexually transmitted
75% contamination rate
Primary genital herpes
- multiple, painful lesions, fever, chills, and malaise
- lesions progress from macules to papules then pustules and ulcers that crust and heal without scarring
Recurrent episodes commonly only have local symptoms and is less severe
Men have overall a less severe reaction
Screening:
- viral culture
Management
- no cure
- acyclovir, famciclovir, and valacyclovir
- prevent infection
- no vaginal delivery with outbreak
- eduction
Human immunodeficiency virus (HIV)
25% of ppl living with HIV
Gay, bisexual, and other men having sex with men at highest risk
Transmission of HIV occurs primarily through exchange of body fluids
Severe depression of cellular immune system associated with HIV infection characterizes AIDS
S/S
- fever
- headache
- night sweats
- malaise
- generalized lymphadenopathy
- myalgias
- N/V/D
- weight loss
- sore throat
- rash
Pregnancy and HIV
- transmission to infant may occur at any time
- definitive diagnosis of children is less than 18 months is done based on lab evidence of HIV present
- proper treatment leads to 1% to 2% transmission to baby
- c section vs vaginal delivery depends on viral load
Management:
- antiretroviral prophylaxis
- triple drug antiviral therapy
- lab monitoring
- vaccinations
Zika Virus
Spread by Aedes Mosquito
Spread through sexual contact in semen
Pregnant Women at higher risk
Causes microcephaly
Trichomonaisis
Protozoan STI
Trichomoniasis - trichomoniasis vaginalis
- common cause of vaginal infection
Asymptomatic or
- yellowish greenish, frothy, macopurulent, copious, malodorous discharge
Screening
- specular examination
- wet prep/smear
Manage:
- metronidazole or tinidazole orally
- sexual transmission must be communicated to infected women
