RTI vs STI

Question 1

RTI vs STI

Answer 1

o Some reproductive tract infections ARE sexually transmitted, others are NOT
o Many RTIs are asymptomatic – even serious ones requiring treatment
o Women typically suffer more severe and long term consequences than men

Question 2

example STI’s:

Answer 2

Trichomoniasis, Chlamydia, Gonorrhea, Syphillis, Pediculosis pubis, HIV, HPV, HSV 1 &2, HBV

Question 3

Normal Vaginal pH:

Answer 3

3.8-4.5

Question 4

pH of Sperm:

Answer 4

7.5

Question 5

Role of lactobacilli in the vagina:

Answer 5

Inhibits growth of anaerobes & other organisms

Question 6

lactobacilli If low

Answer 6

other bacteria (garnerella, Group B strep) overgrow → amino acids production →
increased vaginal pH →squamous cell desquamation → classic discharge

Question 7

Elevated pH kills…

Answer 7

normal flora (lactobilli) while anaerobes and other bacteria flourish

Question 8

Most common bacterial vaginitis is?

Answer 8

Gardnerella

Question 9

Gardnerella

Answer 9

▪ Amine-induced fishy odor d/t overgrowth of normal vaginal bacteria
▪ Must have 3 of 4: pH >4.5; (+) whiff test; (+) clue cells; Homogenous discharge
▪ Follows pathogenesis of lactobacilli

Question 10

Gardnerella Complications

Answer 10

High recurrence rate (60%), cervicitis, pID, Increased risk of HIV/STI transmission, prego
complications

Question 11

Second most common bacterial vaginitis is?

Answer 11

Candidiasis (yeast infection)

Question 12

Candidiasis

Answer 12

▪ Up to 25% of vaginitis cases
▪ Overgrowth of fungus that lives in healthy vaginas
▪ Candida albicans is most common

Question 13

Candidiasis SXs

Answer 13

pruritis, white-yellow d/c, erythematous tissue, often vulvar component

Question 14

What can treat both Gardnerella & Candidiasis?

Answer 14

Boric Acid

Question 15

T/F Gardnerella and Candidiasis are not STI’s

Answer 15

T

Question 16

Trichomonas

Answer 16

▪ STI
▪ Assoc. w/ presence of other STIs
▪ Facilitates transmission of HIV & other STIs
▪ Increased PMNs
▪ Infects vagina, Skenes ducts & lower urinary tract in men & women
▪ Many women & men may remain Asx for years (50%)
▪ Examine, test and treat partners regardless of whether Sxs are present or not

Question 17

Herpes:

Answer 17

▪ Condoms help prevent transmission but are not 100% effective
▪ Asymptomatic viral shedding spreads most HSV (>70%)
▪ HSV-1 & 2 can both be oral or genital
▪ Not everyone requires acyclovir or other anti-viral meds

Question 18

Herpes: Classic progression…

Answer 18

● Erythematous papule
● Vesicle
● Pustule
● Ulceration
● Encrustation

Question 19

Herpes: Virus does what?

Answer 19

replicates in ganglia→migrates to mucosa→replicates in epithelium→lesions

Question 20

Onset of herpes

Answer 20

Onset typically 4 days after sexual contact

Question 21

Syphillis:
▪ Capable of infecting almost any organ and system
▪ Progression:

Answer 21

● Can spread through bloodstream to all parts of the body
● If not treated, progresses through 4 stages, over many years (affects behavior)
● Last stage: can cause severe heart disease, brain damage, spinal cord damage, and death

Question 22

Primary Syphillis:

Answer 22

● Chancre
● Usually occurs within 3 weeks
● Very contagious, painless, can be anywhere on the body, is an early sign of syphilis, can also present as
full body rash

Question 23

Secondary Syphillis:

Answer 23

Secondary Syphillis:
● 2-8 weeks after chancre pts often develop a RASH
● Once syphilis has spread through the body
● Rash: Diffuse, macular, popular, combinations
● Diffuse: Palms, soles
● Patterned Hair Loss

Question 24

Secondary Syphillis: Latent Period:

Answer 24

o After secondary-stage rash goes away, no symptoms = latent period; may be as brief as 1 year
or range from 5 to 20 years
o A person who is contagious during early part of latent stage & may be contagious even when
no symptoms are present

Question 25

Syphillis Tertiary (late) stage:

Answer 25

Complications: Gummata (sores inside body or skin), CV affects heart & BV’s, Neurosyphilis

Question 26

Syphillis dx

Answer 26

o Screening antibody testing/VDRL/RPR (for non-specific ‘reagin’ antibody)
o More specific/ confirmation test: FTA-ABS; MHA-TP)

Question 27

Pubic Lice:

Answer 27

Only STI that can be transmitted via bedding, clothing
▪ Eggs hatch in 7-9 days attaches to host skin for survival
▪ Untreated ova can live on fomites for a month

Question 28

Reiter’s:

Answer 28

Is associated with Chlamydia

Question 29

Gonorrhea:

Answer 29

Asymptomatic, cervicitis, urethritis, PID, pharyngitis, ARTHRITIS (can manifest as jt. Pain)

Question 30

PID:

Answer 30

May be asymptomatic, not only caused by STI’s, may cause long-term complications, if diagnosed partner must
be screened/treated (if caused by STI)

Question 31

Sequelae of untreated Gonorrhea or Chlamydia: Women

Answer 31

Asymptomatic, vaginal discharge, dysuria, dyspareunia, low abdominal pain, CPP, unusual bleeding
(metrorrhagia, menorrhagia)

Question 32

Sequelae of untreated Gonorrhea or Chlamydia: men

Answer 32

Asymptomatic, penile discharge, dysuria, burning/pruritis around urethral meatus, pain with
ejaculation, pain and swelling in testicles

Question 33

Gonorrhea or Chlamydia is a reportable DZ in oregon T/F

Answer 33

T