Lecture 11 Reproductive tract infections Flashcards
The most commonly reported STI in American women is _
Chlamydia trachomatis.
HPV vaccine
- Gardisil (quadrivalent) and Cervarix (bivalent); available between the ages of 9 and 26 and recommended routinely for females at 11 or 12 years of age.
- Administered in 3 doses over a 6-month period.
Antibiotics and antivirals that are contraindicated in pregnancy/lactation
Doxycycline - chlamydia.
Tetracycline - syphilis.
Imiquimod, podophyllin, sinecatechins, podofilox - HPV.
Syphilis is a complex disease that can lead to serious systemic illness and even death if left untreated. Which manifestation differentiates primary syphilis from secondary syphilis?
Appearance of a chancre 2 months after infection. [Primary syphilis is characterized by a primary lesion (the chancre), which appears 5 to 90 days after infection. The chancre begins as a painless papule at the site of inoculation and erodes to form a nontender, shallow, and clean ulcer several millimeters to centimeters in size.]
Secondary syphilis
Occurs 6 weeks to 6 months after the appearance of the chancre (primary lesion) and is characterized by a widespread maculopapular rash.
Latent syphilis
Those infections that lack clinical manifestations, but are detected by serologic testing.
Drugs of choice for the treatment of candidiasis infection
Fluconazole, metronidazole, and clotrimazole.
Which condition is the most life-threatening virus to the fetus and neonate?
Hepatitis B virus (HBV).
Vaginal discharge - bacterial vaginosis
Profuse and thin, with a white, gray, or milky color and a strong “fishy” odor. Some women may also experience mild irritation or pruritus.
Vaginal discharge - candidiasis
Thick, white, and lumpy and resembles cottage cheese.
Vaginal discharge - trichomoniasis
Yellow-to-green, frothy, mucopurulent, copious, and malodorous; some women are asymptomatic.
Vaginal discharge - gonorrhea
A purulent endocervical discharge but usually minimal or absent. Women with gonorrhea are often asymptomatic.
Seroconversion to HIV positivity usually occurs _
Within 6 to 12 weeks after the virus has entered the body.
Clients treated for syphilis with penicillin may experience a Jarisch-Herxheimer reaction. Which clinical presentation would be unlikely if a client is experiencing this reaction?
Vomiting and diarrhea. [The Jarisch-Herxheimer reaction is an acute febrile reaction that occurs within the first 24 hours of treatment and is accompanied by headache, myalgias, and arthralgia. Vomiting and diarrhea are not anticipated. If the client is pregnant, then she is at risk for preterm labor and birth.]
Condylomata acuminata
Genital warts commonly associated with human papillomavirus (HPV).
Condylomata lata
Genital warts commonly associated with syphilis (Treponema pallidum bacterium).
What is the drug of choice for the treatment of gonorrhea?
Ceftriaxone. [Ceftriaxone is effective for the treatment of all gonococcal infections. Penicillin is used to treat syphilis. Tetracycline is prescribed for chlamydial infections. Acyclovir is used to treat herpes genitalis.]
Interventions for reducing transmission of HIV from mother to baby
- Intrapartum treatment with antiviral medications.
- Elective cesarean birth (if mother refuses, she should receive IV antiviral therapy during labor).
- Formula feeding.
“Five Ps” mnemonic for evaluating risk behaviors for STIs
- Partners
- Prevention of pregnancy
- Protection from STIs
- Practices
- Past history
Penicillin treatment for GBS
A loading dose of 5 million units followed by 2.5 or 3 million units every 4 hours.
