sexually transmitted diseases ch27

Question 1

Gonorrhea

Answer 1

caused by Neisseria gonorrhoeae. “the clap”

Common sites
Endocervical canal (inner portion of the cervix): most common site for women 

Urethra or rectum: most common site for men

Complications
• Pelvic inflammatory disease (PID)
• Sterility
• Disseminated infection

Clinical manifestations
Men: sudden onset of painful urination or purulent penile discharge, or both
Women: Asymptomatic; Dysuria, Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia
Disseminated gonococcal infection (DGI): Life-threatening condition causing a generalized rash and severe joint pain

Question 2

Syphilis

Answer 2

Treponema pallidum
• Infects any body tissue
• Becomes a systemic disease shortly after infection
• Maternal-fetal transmission

Primary syphilis: hard chancre (painless)
enlarged lymph nodes

Secondary syphilis: after 6 weeks, systemic manifestations
sore throat, malaise, wart like lesions

Latent syphilis
Duration: as short as 1 year or as long as a lifetime
Medical evidence of the infection; asymptomatic

Tertiary syphilis
Appearing after the latent stage
Most severe
Formation of gummas: destructive skin, bone, and soft tissue lesions
Destructive systemic manifestations

Question 3

chancroid

Answer 3

Haemophilus ducreyi (Gram-negative bacillus)
most common cause of genital ulcerations world wide
	Painful, tender, soft chancre

• Women: asymptomatic but can have dysuria, dyspareunia, vaginal discharge, pain on defecation, or rectal bleeding
• Men: unilateral, painful genital ulcers, local lymphadenopathy, inguinal buboes

Question 4

Bacterial Vaginosis

Answer 4

Gardnerella vaginalis and other anaerobes

• Gray vaginal discharge, presence of “clue” cells on wet mount
• Bacterial catalytic enzymes degrade proteins and elevate the vaginal pH to produce a fishy odor.
• Clue cells are vaginal epithelial cells covered with bacteria.

Question 5

Chlamydia

Answer 5

Chlamydia trachomatis
• Most common STI in the United States

Clinical manifestations
• Men: clear, mucous discharge or mild burning with urination

• Women: leading cause of tubal infertility; acute urethral syndrome (dysuria, urinary frequency, and presence of sterile pus in the urine); yellow mucopurulent discharge with cervicitis
• Newborn: conjunctivitis and pneumonia

Question 6

Genital Herpes

Answer 6

1. Herpes simplex virus (HSV) type 1
2. HSV type 2

• Lesions initially appear as groups of vesicles that progress to ulceration with pain, lymphadenopathy, and fever.

Clinical manifestations
• First-episode primary genital infection: no antibodies, small vesicular lesions with fever and malaise.

• Recurrent infections: mild local symptoms
• Newborn: local infection of eyes, skin, or mucous membranes to severe disseminated infection with CNS involvement

Question 7

Human Papillomavirus Infection

Answer 7

o 120 different types of HPV

• Associated with cervical dysplasia and cancer
• Test: Papanicolaou test (Pap smear)

Clinical manifestations:
• condylomata acuminata (genital warts)
• Soft, skin-colored, whitish pink–to–reddish brown benign cauliflower painless growths
• Treatment: considered cosmetic, not curative

Question 8

Trichomoniasis

Answer 8

Trichomonas vaginalis

• Urethra, vagina, and Skene and Bartholin glands

• Clinical manifestations
• Vaginal discharge (copious, frothy, malodorous, yellow-green to gray-green) and internal pruritus: most common complaints
• Dyspareunia and dysuria
• Strawberry spots

Question 9

Scabies

Answer 9

Sarcoptes scabiei

• Transmission: prolonged and close skin-to-skin contact

Classic symptom: intense pruritus •	Pediculosis Pubis