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Practice topics Exam 1 > STD > Flashcards

STD Flashcards

1
Q

Reportable disease means what

A

required by statute to be reported to public health authorities
most STDs are reportable

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2
Q

Local health departments do what

A

local tracing once something has been reported

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3
Q

Sexually transmitted vs. transmissible

A 
transmitted = it has been transmitted
transmissible = it is transmissible (can be transmitted)
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4
Q

STD vs. STI

A 
STD = symptomatic
STI = asymptomatic
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5
Q

Features of STDs

A 
Diverse biological types
Can be bacterial or viral
Most bacteria are hard to culture
Humans = natural host
Few STDs are vaccine prevented 
Antimicrobial resistant!
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6
Q

Important characteristics of STDs

A

production of ulcers of the genital tract epithelium

increased HIV risk

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7
Q

Bacterial STDs - major bacteria

A

chlamydia trachomatis
neisseria gonorrhoreae
treponema pallidum

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8
Q

Chlamydia

A

most prevalent in US

Damage to women reproductive organs - salpingitis (infertility), blindness of child

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9
Q

Chlamydia enters host how

A

through minor abrasions in mucosal surface

drug needs to be able to get into the affected cell (need to get through the membrane)

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10
Q

Chlamydia - description

A

Energy parasite - takes up a lot of energy

Various infections - genital, eye, lymph node

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11
Q

Chlamydia - treatment

A

Sensitive only to antibiotics that enter the infected cells!

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12
Q

Clinical syndromes and complications caused by chlamydia - men

A

Urethritis, epididymitis, proctitis, conjunctivitis

systemic spread, Reiters

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13
Q

Clinical syndromes and complications caused by chlamydia - women

A

Urethritis, cervicitis, bartholinitis, salpingitis, conjunctivitis
Ectopic pregnancy, infertility!!, systemic spread, perihepatitis arthritis dermatitis

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14
Q

Clinical syndromes and complications caused by chlamydia - neonates

A

conjunctivitis

interstitial pneumonitis

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15
Q

Chlamydia treatment

A

Cell wall inhibiting antibiotics are NOT useful - antimicrobial agent has to penetrate inside the tissue to be effective!
Doxycycline, azithromycin
Tetracycline - but be careful of teeth stain (not in pregnant or children)
Alternative therapy can be quinolones

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16
Q

Gonorrhea (the clap) is what

A

A sexually transmitted non ulcerative inflammatory disease of mucosal epithelium (genitals, eyes, mouth, rectum, urethra)

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17
Q

Gonorrhea is caused by what organism

A

gram negative diplococcus (gonoccocus)

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18
Q

Gonorrhea can disseminate to form what

A

skin lesions and arthritis

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19
Q

Gonorrhea - sequelae includes what

A

dissemination to upper reproductive tract in F- salpingitis, tubo-ovarian abscess, peritonitis
Epididytimis in M
Neonates born via birth canal may develop blinding conjunctivitis

20
Q

Pathogenesis with gonorrhea - tranmission

A

Direct mucosal contact
Primary infection sites - female cervical epithelium, male urethra, oro pharynx, rectum
Secondary - autoinoculation of eyes with fingers
Infection of infant conjunctiva during vaginal delivery

21
Q

Pathogenesis with gonorrhea - Dissemination

A

1% cases spread to blood stream
Can lead to arthralgia, septic arthritis is most common
Skin rash on trunk, arms, palms, and soles

22
Q

Pathogenesis with gonorrhea - what type of transmission is most effective

A

male to female

23
Q

Pathogenesis with gonorrhea - female vs. male

A

female infection more likely to be asymptomatic compared to males

24
Q

Gonorrhea - features in male

A

Urethritis - usually painful with pus present
Dysuria and frequent micturation
Infection can inclue epididymitis with scrotal swelling
Sympt 2-5 days after infection but can take as long as 30 days

25
Q

Gonorrhea - features in females

A

Dysuria, lower pelvic pain, vaginal discharge
Primary infection in cervix - often asymptomatic
20% develop endometritis - upper tract invasion and damage
Primary infection in eye due to vaginal delivery of infected mother - bilateral, adults is unilateral
If primary site is oral cavity or rectum, symptoms are mild

26
Q

Gonorrhea - treatment

A

Drug resistance inc (penicillin, tetracycline, azythromycin, cipro)
Travel history and sex hx are important
Most people also have chlamydia so antibiotics for both can be given together

27
Q

Gonorrhea - drug therapy

A

for uncomplicated primary in adults - broad spectrum sephalosporins or wuinolones - ceftriaxone, cefixime, ciprofloxacin, ofloxacin, levofloxacin
For neonates with bacterial conjunctivits - silver nitrate or antibacterial eye drops (ceftriaxone)

28
Q

Chlamydia and Gonorrhea Prevention

A

NO vaccine available
Antimicrobial prophylaxis is not practical
Avoid exposure, safe sexual practice!!!
CDC recommends testing for all 25 or younger if sexually active, older women with multiple sex partners, preganant women

29
Q

Genital herpes - herpes simplex virus - lesion progression from

A 
macules 
papules
vesicles
pustules
ulcers
30
Q

Genital herpes - herpes simplex virus - what s/s

A

often fever, inguinal adenopathy, malaise

symptoms are more severe in women

31
Q

Genital herpes herpes simplex virus - lesion duration is

A

about 3 weeks

32
Q

Genital herpes - herpes simplex virus common lesion sites

A

vulva, cervix
peritoneum
penis, thighs
buttocks

33
Q

Genital herpes - herpes simplex virus - recurrent lesions

A

3-5 discreet lesions
vulvar irritation
prodrome - tingling, pain
heal within 7 to 10 days

34
Q

Genital herpes - herpes simplex virus - Other issues

A

Viral meningitis/encephalitis
Bells palsy
Herpetic keratitis

35
Q

Genital herpes treatments - herpes infections last how long

A

lifelong!
antivirals inhibit lytic replication in epithelial cells but do not clear the latent infection in neurons
viral shedding can occur in the absence of lesions (infectious)

36
Q

Genital herpes - herpes simplex virus - primary infection - treatment

A

oral acyclovir treatment

Valcyclovir, gancyclovir

37
Q

Genital herpes - herpes simplex virus - frequent recurrences -

A

long term oral acyclovir treatment to suprress herpes outbreaks

38
Q

Genital herpes - neonatal herpes infection description

A

Highest risk is infants born to mothers experiencing primary infection
rarely asymptomatic
often lethal

39
Q

Genital herpes - neonatal herpes infection and herpes simplex virus - disease localized to skin, eyes, mouth

A

Not lethal
present at 10-11 days following birth
recurrences in first 6 months
30% untreated more serious consequences - blindness, microcephaly, spastic quadriplegia

40
Q

Genital herpes - neonatal herpes infection Encephalitis +/- skin lesions

A

1/3 of neonate infections
symptoms - seizures, lethargy, irritability, tremors, poor feeding, temp instability, bulging fontanel
50% mortality if untreated
survivors often have impairments

41
Q

Genital herpes - neonatal herpes infection - disseminated infection

A

can go to visceral organs and skin
symptoms - irritable, seizure, resp distress, jaundics, bleeding diathesis, shock
80% mortality rate in untreated, 23% with tx
complications = hsv pneumonia, disseminated intravascular coagulation

42
Q

Genital herpes - neonatal herpes infection - prevention

A

physical exam for lesions
caesarian sections
health care provider precautions in neonatal wards

43
Q

Genital herpes - neonatal herpes infection - treatment

A

IV adminstration of acyclovir or similar antivirals for all neonate herpes cases

44
Q

Genitral warts (human papillomavirus - HPV) - description

A

Hyperkeratotic, firm, exophytic papules
1mm-2 cm diameter
Symp - itching, pain, burning - 75% asymptomatic
Divided into low and high risk groups

45
Q

Genitral warts (human papillomavirus - HPV) - Genital warts - treatment

A

cryotherapy

CO2 laser

46
Q

Genitral warts (human papillomavirus - HPV) - prevention

A

gardasil vaccine - recommendation is universal vaccination for girls between ages of 11 and 12

Practice topics Exam 1 (15 decks)

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