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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
Q

Gonorrhea and chlamydia can produce ____, ____, ____, ____, and ____

A

Gonorrhea and chlamydia can produce acute ascending infection, pain, infertility, ectopic pregnancy, and death

26
Q

HBV can produce ____ and ____

A

HBV can produce acute and chronic illness and death

27
Q

Describe effects of passing STIs to fetuses / neonates

A

Passing STIs to fetuses / neonates

  • Congenital abnormalities (syphilis)
  • Diminished growth (syphilis)
  • Fetal death (syphilis)
  • Neonatal morbidity (syphilis, gonorrhea, chlamydia, HIV)
28
Q

Perinatal transmission of STIs can be ____ or ____

A

Perinatal transmission of STIs can be transplacental or transvaginal

29
Q

Describe approaches to reduce perinatal transmission of STIs

A

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
Q

___, ___, ___, and ___ are transmitted transplacentally

A

HIV, syphilis, Zika, and HSV are transmitted transplacentally

31
Q

____, ____, ____, and ____ are transmitted transvaginally

A

HIV, chlamydia, HSV, and HBV are transmitted transvaginally

32
Q

____ and ____ are transmitted via breastfeeding

A

HIV and HBV are transmitted via breastfeeding

33
Q

Describe fetal and neonatal disease caused by STIs

A

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
Q

Describe approaches to prevent perinatal transmission of STIs

A

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
Q

Most perinatal transmission of HIV is ____

A

Most perinatal transmission of HIV is at birth

36
Q

Describe factors affecting mother to child transmission of HIV

A

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
Q

Risk of perinatal HIV transmission is directly related to ____ of mother

A

Risk of perinatal HIV transmission is directly related to viral load of mother

38
Q

Risk of perinatal HIV transmission is highest in the ____ mode of delivery

A

Risk of perinatal HIV transmission is highest in the vaginal mode of delivery

(next is emergent c-section)

39
Q

____ can reduce the risk of perinatal HIV transmission even if given at time of delivery or after birth

A

Antiviral therapy can reduce the risk of perinatal HIV transmission even if given at time of delivery or after birth

40
Q

Describe strategy to prevent perinatal HIV transmission

A

Preventing perinatal HIV transmission

41
Q

Chlamydia is primarily transmitted at ____

A

Chlamydia is primarily transmitted at birth (and intrapartum)

42
Q

Chlamydia is transmitted ____

A

Chlamydia is transmitted transvaginally

43
Q

Describe outcomes of perinatal transmission of chlamydia

A

Perinatal transmission of chlamydia outcomes

  • Ectopic pregnancy
  • Chronic pain
  • Infertility
  • Maternal death
  • Congenital infection (conjunctivitis, pneumonia)

Repro / GU (46 decks)

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