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Repro / GU > SM_202b: Reproductive Impact of STIs > Flashcards

SM_202b: Reproductive Impact of STIs Flashcards

1
Q

Sexually active w/ swollen, painful joints and sore throat is likely ____

A

Sexually active w/ swollen, painful joints and sore throat is likely gonorrhea

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2
Q

Number of new cases: ____ > ____ > ____

A

Number of new cases: HPV > chlamydia > HIV

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3
Q

Describe epidemiology of STIs

A

Epidemiology of STIs

  • Half occur in young people: screen sexually active young women and men 15-24 for STIs annually)
  • Women are disproportionately impacted by STIs
  • African Americans
  • Men who have sex with men account for 3/4 of all primary and secondary syphillis cases
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4
Q

Components of the disease transmission tetrahedron of STIs are ____, ____, ____, and ____

A

Components of the disease transmission tetrahedron of STIs are pathogen, vector (sexual behavior), environment, and host

  • Rate of spread = efficiency of transmission * rate of partner change * duration of infectiousness
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5
Q

Prevalence of STIs ____ with the number of lifetime sexual partners especially if ____

A

Prevalence of STIs increases with the number of lifetime sexual partners especially if concurrent

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6
Q

___ have the shortest duration of shedding in an infected but untreated person

A

Non-latent infections (syphillis, chlamydia, etc) have the shortest duration of shedding in an infected but untreated person

  • HSV and HIV are latent infections
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7
Q

Percentage of HIV-infected persons engaging in continuum of care ____ as they go father down the continuum

A

Percentage of HIV-infected persons engaging in continuum of care decreases as they go father down the continuum

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8
Q

Risk of sexual transmission of STDs per episode of unprotected heterosexual intercourse is highest in ____

A

Risk of sexual transmission of STDs per episode of unprotected heterosexual intercourse is highest in women

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9
Q

Neisseria gonorrhea has ____

A

Neisseria gonorrhea has pili

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10
Q

HIV has ____ ligands

A

HIV has CD4 ligands

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11
Q

A 15 yo girl is more susceptible to acquisition of chlamydia than a 55 yo woman because ____, ____, and ____

A

A 15 yo girl is more susceptible to acquisition of chlamydia than a 55 yo woman because

  • 15 yo has more exposed cervical columnar cells
  • 55 yo has more robust mucosal immune response
  • 15 yo is less likely to use a condom
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12
Q

Describe sexual transmission of HIV-1

A

Sexual transmission of HIV-1

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13
Q

STI pathogens have different efficiency of transmission due to a variety of factors such as ____ and ____

A

STI pathogens have different efficiency of transmission due to a variety of factors such as duration of infectivity and phenotypic and genetic variants

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14
Q

____ partially explains differences in HIV acquisition by type of sexual contact

A

Disproportionate sharing of body fluids partially explains differences in HIV acquisition by type of sexual contact

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15
Q

____ is the race / ethnicity with greatest rate of STIs

A

African American is the race / ethnicity with greatest rate of STIs

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16
Q

Human ____ influence HIV infection and disease

A

Human genes influence HIV infection and disease

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17
Q

____ intercourse is associated with the highest risk of HIV transmission

A

Receptive anal intercourse is associated with the highest risk of HIV transmission

  • Larger pathogen load in semen is deposited over a larger surface area (rectum) with more target cells (monocytes and macrophages in the sub-epithelium): explains higher risk for MSM
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18
Q

____ is the act with the greatest risk of HIV acquisition

A

Blood transfusion is the act with the greatest risk of HIV acquisition

19
Q

Recent trauma is associated with ____ HIV risk

A

Recent trauma is associated with increased HIV risk

20
Q

HIV prevalence is highest at ____ income

A

HIV prevalence is highest at lowest income

21
Q

Describe approaches for prevention of HIV

A

Approaches for prevention of HIV

  • Behavior change initiatives (abstinence, monogamy, condoms) are not really effective
  • Test and treat efforts (PreP, PeP, microbicides, and circumcision) are more effective
22
Q

Describe the impact of STIs on reproductive health of women

A

Impact of STIs on reproductive health of women

  • Maternak acquisition -> maternal disease
  • Fetal acquisition -> fetal disease
  • Neonatal acquisition -> neonatal disease

(perinatal transmission)

23
Q

STIs can cause ____, ____, and ____

A

STIs can cause acute and chronic illness, death, and fetal / neonatal effects

24
Q

HPV produces ____

A

HPV produces a chronic infection causing genital warts, dysplasia, and cervical / vaginal / vulvar cancer

25
Gonorrhea and chlamydia can produce \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_
Gonorrhea and chlamydia can produce acute ascending infection, pain, infertility, ectopic pregnancy, and death
26
HBV can produce ____ and \_\_\_\_
HBV can produce acute and chronic illness and death
27
Describe effects of passing STIs to fetuses / neonates
Passing STIs to fetuses / neonates * Congenital abnormalities (syphilis) * Diminished growth (syphilis) * Fetal death (syphilis) * Neonatal morbidity (syphilis, gonorrhea, chlamydia, HIV)
28
Perinatal transmission of STIs can be ____ or \_\_\_\_
Perinatal transmission of STIs can be transplacental or transvaginal
29
Describe approaches to reduce perinatal transmission of STIs
Approaches to reduce perinatal transmission of STIs * Maternal: reduce pathogen load, upregulate immune response, treat infection * Obstetrical: different route of delivery, preventing rupture of membranes * Fetal: preventing prematurity, peri-exposure prophylaxis
30
\_\_\_, \_\_\_, \_\_\_, and ___ are transmitted transplacentally
HIV, syphilis, Zika, and HSV are transmitted transplacentally
31
\_\_\_\_, \_\_\_\_, \_\_\_\_, and ____ are transmitted transvaginally
HIV, chlamydia, HSV, and HBV are transmitted transvaginally
32
\_\_\_\_ and ____ are transmitted via breastfeeding
HIV and HBV are transmitted via breastfeeding
33
Describe fetal and neonatal disease caused by STIs
Fetal and neonatal disease caused by STIs * Fetal: fetal infection, spontaneous abortion, congenital anomalies, premature birth, growth restriction, fetal death / stillbirth * Neonatal: congenital infection, death
34
Describe approaches to prevent perinatal transmission of STIs
Approaches to prevent perinatal transmission of STIs * Maternal acquisition: primary prevention (vaccinate, safer sex, treat male partner) * Maternal disease: maternal screening, maternal treatment, obstetrical interventions * Fetal acquisition: prenatal diagnosis, pregnancy interruption, fetal treatment * Neonatal acquisition: vaccination, screening, treatment
35
Most perinatal transmission of HIV is \_\_\_\_
Most perinatal transmission of HIV is at birth
36
Describe factors affecting mother to child transmission of HIV
Mother to child transmission of HIV * Maternal: viral load, antiretroviral therapy, seroconversion * Placental: chorioamniotis, abruption * Obstetrical: route of delivery, duration of membrane rupture * Fetal: gestational age, post-exposure prophylaxis, breastfeeding
37
Risk of perinatal HIV transmission is directly related to ____ of mother
Risk of perinatal HIV transmission is directly related to viral load of mother
38
Risk of perinatal HIV transmission is highest in the ____ mode of delivery
Risk of perinatal HIV transmission is highest in the vaginal mode of delivery (next is emergent c-section)
39
\_\_\_\_ can reduce the risk of perinatal HIV transmission even if given at time of delivery or after birth
Antiviral therapy can reduce the risk of perinatal HIV transmission even if given at time of delivery or after birth
40
Describe strategy to prevent perinatal HIV transmission
Preventing perinatal HIV transmission
41
Chlamydia is primarily transmitted at \_\_\_\_
Chlamydia is primarily transmitted at birth (and intrapartum)
42
Chlamydia is transmitted \_\_\_\_
Chlamydia is transmitted transvaginally
43
Describe outcomes of perinatal transmission of chlamydia
Perinatal transmission of chlamydia outcomes * Ectopic pregnancy * Chronic pain * Infertility * Maternal death * Congenital infection (conjunctivitis, pneumonia)

Repro / GU (46 decks)

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