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Kydd - Pathophysiology 2 > Sexually Transmitted Diseases > Flashcards

Sexually Transmitted Diseases Flashcards

1
Q

What are sexually transmitted diseases? Examples? What are the different ways in which they can be spread?

A

Sexually transmitted diseases can be viral and recurring (genital herpes, warts, AIDS) or bacterial and eliminated (syphilis, chlamydia, gonorrhea, chancroid). They can also be protozoa, fungi, and ectoparasites. They can be spread via genitalia, mouth, rectum, skin, and placenta.

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2
Q

What is a protozoa?

A

A one-celled organism that live in water or as parasites.

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3
Q

What is a ectoparasites?

A

A parasite, such as a flea, that lives on the outside of its host.

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4
Q

What high-risk circumstances will increase your likelyhood of contracting an STD?

A

Multiple sexual partners. Unsafe/high risk sexual practices. Drug abuse. Medically underserved. Prior STDs. Non compliant STD Tx.

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5
Q

What low-risk circumstances will help keep an individual STD free?

A

Abstinence. Monogamy.

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6
Q

What are Genital Herpes?

A

A recurrent, systemic viral infection caused by the herpes simplex virus. Genital herpes is caused by type II HSV. It is a neurotopic microbe and is spread via contact with lesions or secretions.

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7
Q

What are the manifestations of genital herpes?

A

Burning at site. Painful vesicles. Fever. Muscle Ache. Can be subclinical.

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8
Q

What is a nerotopic microbe?

A

It is a microb that is capable of infecting nerve cells, and resides in neurons. This is a problem because they become latent, an impossible to fully eradicate.

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9
Q

What is the incubation period and how quickly does herpes manifestat post-contact?

A

2-10 day incubation, Manifests 3-7 days post contact.

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10
Q

How is genital herpes treated?

A

There is no cure. Recurrence is a major problem. Symptomatic treatment. Antivirals in an attempt to eradicate but some will be latent.

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11
Q

What are Genital Warts? What causes them?

A

Genital warts are benign multiple growths that occur on the genitals or anorectal area. They are viral, caused by human papillomavirus (HPV), particularily strains 6 and 11.

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12
Q

What is the incubation period of genital warts?

A

1 - 2 months.

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13
Q

Is there a cure for genital warts?

A

No.

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14
Q

What is treatment for genital warts?

A

Remove warts. Topical drugs. Surgery. Cyrotherapy. Monitor for CA (caused by HPV stains 16 and 18). Typically, the warts are treated and not the actual virus.

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15
Q

What types of perscription drugs will one take for genital warts?

A

Antimytotic, which inhibits mitosis, or cell division. Cytotoxic, which prevents replication or growth of cells.

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16
Q

What is syphilis?

A

Syphilis is a serious bacterial STD caused by the bacteria Treponema pallidum. It is spread via contact with lesions. It can also cross the placenta. It occurs over three stages.

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17
Q

What is the incubation time of syphilis?

A

10 - 90 days

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18
Q

What are compications of syphilis?

A

Blindness, paralysis. Heart disease, and Death.

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19
Q

What are the characteristics of primary stage syphilis?

A

Painless chancre at exposure sites. Heals in 2 - 3 weeks. Regional lymphadenopathy.

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20
Q

What are the characteristics of secondary stage syphilis?

A

Second stage occurs 6 - 8 weeks post infection and lasts for up to 6 months. Maculopapular rash on palms and soles. Patches on mucous membranes. Flat papules. Generalized lymphadenopathy. Fever. Malaise. The infection then enters a laten period.

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21
Q

What are the characteristics of third stage syphilis?

A

Occure 1 - 35 years after untreated primary infection. Irreversible damage to bone, joints, CVS, and Nervous system.

22
Q

What is treatment for syphilis?

A

Long-acting penicillin.

23
Q

Why long-acting penicillin the drug of choice for syphillis?

A

Long-acting penicillin is required because syphyillis bacteria are known as spirochetes, which are flexible and sprirally. They have a long generation time (30 hrs). Thus, there is a need for drugs to be present for a longer period of time.

24
Q

What is lymphadenopathy?

A

Refers to lymph nodes which are abnormal is size, number or consistency.

25
Q

What is Chlamydial infection?

A

Chlamydial infection is a bacterial infection cause by Chlamydia trachomatis. It is a very simple bacteria, which makes isolation and detection difficult. It is a gram negative microorganisim which mean it resides intracellular. Chlamydia has a 7-21 day incubation period. In many cases it is asymptomatic.

26
Q

What are the manifestations of chlamydia in males?

A

White of clear discharge. Mild dysuria. Testicular pain. Could be bleeding.

27
Q

What are the manifestations of chlamydia in females?

A

Mucopurulent vaginal discharge. Dysuria. Bleeding. Pelvic paid (PID).

28
Q

How is chlamydia treated?

A

Antibiotics. Doxycycline or Azithromycin.

29
Q

What is Gonorrhea?

A

Gonorrhea is a bacterial STD caused by Neisseria gonorrhoeae. It has an incubation period of 3 - 8 days. It is a gram negative bacteria (intracellular) which has a diplococcus shape (pairs). It causes local and systemic manifestations.

30
Q

What are the manifestations of gonorrhea in females?

A

Purulent vaginal discharge. Dysuria. Genital irritation. Late pelvic pain.

31
Q

What are the manifestations of gonorrhea in males?

A

Urethral discharge. Dysuria.

32
Q

What are the systemic manifestations of gonorrhea?

A

Bacteremia (Septicemia). Pharyngeal Infection and Conjunctivitis. Arthritis-demititis syndrome.

33
Q

What is arthritis-demititis syndrome? What STD does in sometime manifest during?

A

It is a serious complication in gonorrhea. It in characterized by septic arthritis and dermititis. The septic arthritis develops because bacteria enter the joints and cause an infection. The dermititis arises from inflammation in the skin, and lesions appear.

34
Q

What is the treatment for gonorrhea?

A 
1st line: Cephalosporins (group of Abx, which are beoming resistant)
2nd line: Increased dose of Cephalosporins + another class of Abx.
35
Q

What is Acquired Immunodeficiency Syndrome (AIDS)?

A

AIDS is a retrovirus caused by human immunodeficiency virus (HIV). It targets the immune system causing sytemic immmunosuppression. This results in an increase in opportunistic infections and higher levels of cancer. There is no cure.

36
Q

What is a retrovirus?

A

A retrovirus is a virus whose RNA codes for DNA, which is then inserted into some part of the host’s DNA. The virus comes with its own special enzyme called reverse transcriptase, which facilitates this insertion.

37
Q

What cells does HIV destroy?

A

T-Helper cells.

38
Q

What is the cause and transmission methods of HIV?

A

There are two different strands of HIV (I and 2). It is transmitted through sexual contact, typically through semen (major resivour), and blood. It can also be transmitted maternally in utero, labour and delivery and lactation.

39
Q

What is the occupational risk of health workers to contract HIV? How does transmission typically occur in a health care context? What does it depend on?

A

0.3 % risk to health care workers. Transmission typically occurs via needle stick injury. It depends on the site of injury, the depth, and the viral load in the contaminated resivour.

40
Q

What are the three pathophysiological phases of HIV/AIDS?

A

Primary Infection. Latent Period. Overt AIDS.

41
Q

What are the characteristics of primary infection of HIV?

A

Primay infection takes week to months to occur. There is a window period as antibodies are gradually formed and take time before they can be detected. The process of forming antibodies is called seroconversion. There is an inversely proportional relationship between a high viral load and a low CD4 count.

42
Q

What are the characteristics of latent period phase of HIV?

A

Patients are often asymptomatic, but damage is occuring. Lymphatic tissues are being damaged, and the patient experiences recurrent respiratory infections. There is also a lot of fatigue.

43
Q

What are the characteristics of the overt AIDS phase of AIDS?

A

This typically occurs after approx 10 years. The virus targets the t-helper cells, particularly the CD4 receptors. Macrophages, and B-cells are also affected and there is a problem with antibody production. It destroys the immune system leading to decrease immunity and defenses. This results in more new infections and latent pathogens activate. The damage is substantial and many organs are affected.

44
Q

What is a CD4?

A

Cluster Differenciation Surface Receptor 4. CD4 is a glycoprotein found on the surface of immune cells, such as T-helper cells. HIV leads to a progessive reduction in the number of T-helper cells expressing CD4. They are used to assess the immune system of a patient with HIV. They are not a test for HIV.

45
Q

How is diagnosis of HIV made?

A

Clinical progression. ELISA. Western blot assay. PCR. CD4 counts and viral loads.

46
Q

What is PCR when discussing diagnosis of HIV?

A

Polymerase Chain Reaction. This is an expensive, time consuming diagnostic which is usually used in research labs. It is a process of measuring the genetic RNA of the virus

47
Q

What is an ELISA test when discussing diagnosis of HIV?

A

Enzyme Linked Immunosorbant Assay is a test that uses antibodies and color change to identify a substance.

48
Q

If the ELISA test is positive, what secondary test will be conducted in diagnosing HIV?

A

The Western blot assay. It will measure Antibodies against a particular antigen on a virus.

49
Q

What is a new test that is available for HIV? What is it testing for?

A

P24 Antigen test. This test measures a viral protein found in the core of the HIV virus. It is released into the patients blood during the primary phase of infection and allows for early detection.

50
Q

What are the manifestations of HIV?

A

There are many. The presence of opportunistic infections because of the bodies reduced defenses, particularily respiratory infections such as TB (drug resistance) and Pneumonia (quick/recurrent). GI manifestations. Nervous System (dementia, encephalopathy). Opportunistic Cancers (Kaposi’s sarcoma, non-Hodgkin’s, Cervical)

51
Q

What is the treatment for HIV/AIDS?

A

There is no cure. Patients will be put on a regiment of antivirals, known as a coctail of drugs.

52
Q

When does the HIV virus become AIDS?

A

According to the CDC - When the CD4 count decreases below the threshold of 200 and have at leas 1 - 2 opportunistic diseases.
According to the WHO - Once the patient has gone through 20 opportunistic infections they are diagnosed with AIDS.

Kydd - Pathophysiology 2 (22 decks)

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