sexually transmitted infections

Question 1

Chlamydia

Answer 1

C. trachomatis
most common STI
gram-negative bacterium

can lead to ectopic pregnancy
pelvic inflammatory disease and infertility

screen sexually active women

treatment:
azithromycin

Question 2

Neisseria gonorrhoeae

Answer 2

N. gonorrhoeae
second most common uti
highest rates among women age 15 to 19

screen in women who are at higher risk

can cause
cervicitis
pelvic inflammatory disease

disseminated gonococcal disease:

Arhritis +/- dermatitis
migrating polyarthralgia
tensosynovitis

gram stain of ureth

urethral discharge is highly sensitive and specific

treatment:

ceftriaxone
azithromycin

Question 3

Herpes simplex virus

Answer 3

most common genital ulcer

painful lesions, vesicles that become ulcers
extensive
painful

antiviral therapy can reduce the severity and duration of symptoms
counselling, education

daily therapy with acyclovir, famcyclovir or valacyclovir reduces rates of transmission

Question 4

Syphillis

Answer 4

Treponema Pallidum infection

painless genital ulcer
heal in 3 to 6 weeks

secondary syphillis:
generalized macular / papular rash
trunk, palms and soles

can be latent

Cardiovascular — Cardiovascular syphilis classically involves the ascending thoracic aorta resulting in a dilated aorta and aortic valve regurgitation.

Neuro:

General paresis -dementia

The most frequent symptoms of tabes dorsalis are sensory ataxia and lancinating pains

treat with penicillin

Question 5

HPV

Answer 5

Genital warts
most commonly caused by HPV
human papilloma virus

typically painless

80% of patients will clear the infection spontaneously
treatment does not prevent transmission

associated with

Cervical cancer
Virtually all cases of cervical cancer are attributable to HPV infection

Anal cancer
HPV types 16 and 18 cause nearly 90 percent of anal cancers and precancerous anal lesions

Oropharyngeal cancer
HPV infection plays a role in the pathogenesis of squamous cell carcinomas of the head and neck

Females — Vaccination with 9-valent, quadrivalent, or bivalent HPV vaccine provides a direct benefit to female recipients by safely protecting against cancers that can result from persistent HPV infection