STD's + HIV/AID's Flashcards
what are the 4 big harmful, often irreversible and costly complications related to STDs?
-cancer
-fetal and perinatal issues
-reproductive health issues
-transmission of HIV
What are the 5 modes of transmission?
-anal
-genital
-oral
-blood
-IV drug use
what are 5 ways to prevent STIs?
-education about transmission
-abstinence
-mutual monogamy
-condoms
-inform about rapid spread in other countries
What is the only STD not reportable to the CDC?
herpes
_____ is the most common STI, there are 40 different types and 200 related viruses.
HPV - Human Papilloma Virus
Gardasil-9 is the vaccine for HPV, BUT is only prevents ____ out of the 40 different HPV types.
9
What is the test that women can have done to test of HPV?
pap smear
these cells can turn into cancer
no test for men
If HPV goes undiagnosed/ untreated what are the 3 complications that can arise?
-genital warts
-respiratory papillomatosis (rare)
-cancer of genital areas + oropharynx
HPV results in a small lump or ________ on the genitals.
swelling
Which type of HPV genital warts have a cauliflower appearance that are raised and rough, which can be skin colored, pink or hyper-pigmented.
Condylomata Acuminata
What are the 3 diagnostic tests for HPV?
-pap smear (women)
-swab (men)
-Lab HPV test
What are the 5 treatment options for genital warts?
-excision
-electrocautery
-laser
-cryotherapy
-topical ointments
Scabies are very contagious, it can spread ______ to ________. These mites burrow leaving marks that look like pencil marks, and lay eggs into the skin, these eggs mature in ____ days.
skin to skin; 21
What are the 2 most common symptoms of having scabies?
intense itching and a skin rash that looks like pimples
What are the 4 medications commonly used for scabies?
-Permethrin (Elimite)
-Ivermectin
-Sulfur creams
-Benadryl for itches
Which scabies medication gets applied from the neck down, and then washed off the next day, and can be reapplied in 7 days if tunnels and burrows w/ eggs are still there?
Permethrin (Elimite)
Which scabies medication is oral and not approved by the FDA?
Ivermectin
Which medication is an OTC treatment for scabies? and you use a 2.5% for infants and a 10% concentration for adults?
Sulfur Creams
What are the 3 decontamination methods for scabies?
-wash in HOT water and dry on the hottest setting in the dryer
-dry cleaning
-seal clothes, linens etc. in plastic bags for AT LEAST 72 hours
It is important to cut nails short and vacuum thoroughly, scabies can’t survive more than __-__ days off of human skin.
2-3
Crabs “pubic lice” are tiny 6 legged parasitic insects that affect genital and other areas but NOT the ______.
Scalp
What is happening when you have crabs to cause the moderate to severe itching?
the pubic lice bury their heads into the pubic hair shafts to feed on small amounts of blood and they excrete a substance that causes the itching
do pubic lice “crabs” and scabies have the same treatment?
yes
What are the 4 medications for head or body lice?
Permethrin
Pyrethrin
Malathion
Lindane
What is the bacteria that causes syphilis?
Treponema Pallidum
What are the 4 stages of Syphilis?
primary
secondary
latent
tertiary
How long do you have to treat Syphilis in its primary stage before it progresses to more than open sores?
3-6 weeks
What are the 2 tests used to diagnose syphilis?
(VDRL)- venereal disease research laboratory
(RPR)- rapid plasma regain
An IM injection of what, will cure syphilis in a person who has had it less than a year?
penicillin (antibiotic)
What does the secondary stage of syphilis look like?
-Rough, red, reddish/brown, spots on palms and soles
-firm, round, painless sores on the genitals, anus or mouth
-or a body rash
In the primary stage of syphilis, a chancre ______ is the hallmark sign and may appear 10-90 days after exposure, and without treatment it’ll disappear in 2-8 weeks.
lesion
True or false?
If a baby has congenital syphilis, it can still receive the penicillin shot to get rid of the bacteria, but will still have neurosyphilis (nerve damage) because that is irreversible.
TRUE
True or false? In the secondary stage of syphilis, the patient can still receive a penicillin shot and avoid neurosyphilis and nerve damage.
true
How many years after the primary stage of syphilis does the latent stage occur?
10-30 years after; this is where damage to internal organ damage occurs
________ are infiltrative tumors of the skin, bones and liver that are precancerous that occur due to latent stage syphilis?
Gummas
-Gumma’s
-difficulty coordinating movement
-paralysis + parenthesis
-numbness + tremors
-gradual blindness (ocular syphilis)
-dementia
-Aortitis
-Aneurysms
-Aortic regurgitation
-meningovascular/ degenerative changes
-shooting pains
-abnormal reflexes
-psychosis
(neurosyphilis)
This is all damage that can occur in the _______ + ________ stages of syphilis.
latent and tertiary
Congenital syphilis includes oto and ocular syphilis. These babies can’t be cured but they can get Penicillin G IM _________ units/kg for 10 days to get rid of the bacteria.
50,000
What are the signs and symptoms of Gonorrhea in WOMEN? (6)
-malodorous thin + watery discharge OR thick white/ yellow/ green discharge
-irritation/ discharge from anus
-abnormal vaginal bleeding
-low ABD or pelvis tenderness
-pain/ burning when urinating
-sometimes nausea
What are the signs and symptoms of Gonorrhea in MEN? (4)
-thick white/ yellow/ green discharge
-testicle + prostate inflammation
-irritation/ discharge from anus
-itch/ pain/ burning while urinating
_______ + _________ are 2 STDs that are tested for together because they present with the same signs and symptoms.
Gonorrhea and Chlamydia
What is the incubation period of gonorrhea?
1-14 days
What are the 3 diagnostics for gonorrhea?
-swabs
-urine
-culture
undiagnosed gonorrhea causes pain, _________, ________ ________, and PID (pelvic inflammatory disease)
infertility, ectopic pregnancies
What kind of medication is used to treat gonorrhea?
ANTIBIOTICS
-penicillin
-cefixime
-ceftriaxone
-azithromycin
-ciprofloxacin
-doxycycline
Lymphogranuloma Trachomatis Venereum AKA __________, affects the lymph nodes, genitals and rectal area.
chlamydia
There are 3 stages of chlamydia, in the first stage it is very easy to go unnoticed due to _______ being the only sign.
discharge
In the 2nd stage of chlamydia (1-6 weeks) there are many signs and symptoms including: (5)
-lymphatic involvement
-fever
-enlarged spleen + liver
-rash
-headache
-pain when urinating
-cloudy urine
-watery + crusty discharge
In the 3rd stage of chlamydia, there is rectal pain, constipation, genital discharge. What 2 things can occur long term?
bowel rupture and abscesses
Chlamydia is a bacterial infection that can cause infertility and PID. What can it cause to a fetus?
blindness
Which STD can be a “silent infection” and show no signs or symptoms?
chlamydia
Which antibiotics are used to treat chlamydia?
tetracyclines
-amoxicillin
-azithromycin
-doxycycline
-erythromycin
-levofloxacin
Which 2 STDs are tested for together because they are often found together as an infection?
Gonorrhea (Neisseria gonorrhoeae (GC))
and Chlamydia (Chlamydia trachomatis (CT))
What are the 2 ways Gonorrhea and Chlamydia are transmitted?
through sex (oral, anal, vaginal) and from mother to baby
-Urethra
-Oropharynx
-rectum
-epididymis (men)
-cervix
-uterus
-fallopian tubes
These are the following places that Gonorrhea and/ or Chlamydia can infect men and women.
IF either of these goes untreated in women, what are the 4 complications that could follow?
-PID
-scarring of fallopian tubes =
-infertility or
-ectopic pregnancy
if left untreated, it can also cause disseminated infections in other body/ organ systems and contribute to transmission of HIV
Herpes Simplex Virus 1 (HSV1) sits near the trigeminal ganglion, this results in cold sores/ fever blisters around the _______, transmitted through oral contact.
mouth
Herpes Simplex Virus 2 (HSV2) sits near the sacral ganglion, this results in sores/ blisters in the ________ _______ or _______, transmitted through sex.
genital area or rectum
HSV1 + HSV2 can lay latent in the nervous system, and it is common for patients to not have any symptoms or have too mild to notice symptoms like fever + myalgia. Even though there may be no symptoms can they still recur and be spread?
YES
there is no cure for herpes (1 or 2) but there is treatment, what 3 medications are used to treat this virus?
-Acyclovir
-Famciclovir
-Valacyclovir
Even though herpes stays in the body indefinitely, the number of outbreaks tends to _________ over the years.
decrease
Herpes blisters contain fluid that is contagious, that’s how it spreads. If it gets spread to the eyes, what are 2 possible complications?
-blindness
-hepatic encephalopathy
If a pregnant women has herpes lesions/ outbreak present at birth can she have a vaginal delivery?
no, she will have a C-section
if there is no present outbreak she can have a vaginal birth
The Epstein Barr Virus (EBV) is part of the herpes virus. This is the same group of viruses that causes the cold sores, genital herpes, chicken pox and _________.
shingles
What 6 autoimmune diseases is Epstein Barr Virus (EBV) correlated to?
-chronic fatigue
-lupus
-MS
-fibromyalgia
-Hashimoto’s
-Grave’s Disease
Hepatitis B + C are both spread through contact with percutaneous or mucous membrane exposure to ________ or _______ _______ that contains blood.
blood; body fluids
TRUE OR FALSE?
Hep. B has NO cure.
Hep. C does have a cure.
true.
There is HIV-1 and HIV-2, unless otherwise noted HIV is referring to HIV-1. HIV is damaging the persons body by destroying which blood cells, that are crucial in the body being able to fight disease?
CD4 cells and T cells
(WBCs)
What do early signs of an HIV infection look like?
-fever
-flu-like symptoms
-elevated/ hyperactive B cells
the body is trying to fight off the virus
What does the beginning stages of HIV developing into AIDS look like?
-fever
-generalized lymphadenopathy (edema of the lymph nodes)
-Kaposi Sarcoma (this is cancer that forms in the lining of blood vessels and lymph nodes)
AIDS is the end stage of HIV, Kaposi Sarcoma is the beginning stages of AIDS. After that how long does a person usually have to live?
usually die within a year
What are some examples of Complementary Alternative Medication (CAM) that is used along side the pain regimen and other treatment?
-massage therapy
-yoga
-herbal and dietary supplements
can breastfeeding transfer HIV to the baby?
YES - the mother can not breastfeed
the baby will be on medication for 10 weeks after birth
what is the diagnostic test used to detect HIV plasma EARLY ON?
RNA (ribonucleic acid)
what 2 diagnostic tests are used for HIV in the later stages?
-western blot test
-immunofluorescence assay (IFA)
what is the antigen and antibodies (immunoglobulins) that are tested/ looked at to diagnose HIV?
-P24
-IgM
-IgG
(HAART) _________ _________ ____________ _________ is often called the “drug cocktail,” this available and most reactive within the first year of contraction.
Highly Active Anti-Retroviral Treatment
(this drug cocktail “packs up the HIV and hides it away in the body”)
what is a normal CD4 count?
500-1500
Acute Retroviral Syndrome (ARS) is the initial stage of an _____ infection. ARS is characterized by what 4 S+S?
HIV
-fever
-malaise
-skin rash
-lymphadenopathy (swelling of lymph nodes)
A patient who has HIV and has a CD4 count below 200 and/ or has an OI is automatically diagnosed with ______.
AIDS
These are some OI’s just to be familiar with related to HIV that could cause AIDS.
-Candidiasis (thrush)
-Invasive cervical cancer (HPV)
-encephalopathy
-HSV
-Kaposi Sarcoma (CD4 can be >350)
- TB
-pneumonia
-wasting syndrome (through weakened skin integrity)
wasting syndrome is a significant weight loss due to multiple reasons associated with HIV
-loss of appetite
-poor nutrient absorption
-increased metabolism
OI’s
S+S
-weight loss
-fever
-diarrhea
-weakness
________ is usually seen is HIV patients with a CD4 count between 500-200, and can be treated with an antifungal like fluconazole (Diflucan), it is important to note that this drug can cause __________ __________.
candidiasis (thrush); cardiac issues
what are the signs and symptoms of oral or vaginal thrush?
steroid inhalers can also cause thrush
-thick white discharge
-vaginal burning/ itching/ irritation
-loss of appetite
-difficulty swallowing
-pain in mouth/ throat
-white patches in mouth, tongue, throat and/ or gums
Bactrim is an antibiotic given for UTI’s but it can also cause thrush. When giving this medication why do we need to be monitoring BUN and Creatinine?
if they are elevated we want to hold the Bactrim so we don’t cause kidney issues
Kaposi Sarcoma are cancerous lesions due to HIV. It starts in the lining of the lymph nodes and blood vessels. what does it look like in the earliest stages?
red/ purple/ brown lesions, on the skin and mouth, that eventually turn into bumps
Doxorubicin is an antibiotic that can turn your urine, tears, sweat, a harmless _____ color.
red
To treat Kaposi Sarcoma, chemo and radiation are used to _____ the lesions. Antiretroviral’s are used to increase ____ counts (they should already be taking these). Surgery and cryotherapy may also be done.
shrink; CD4;
CMV (Cytomegalovirus) is an OI, transmitted through salvia, semen, blood and other bodily fluids. In a patient with HIV, CMV can cause infections in the _____ and ____ tract.
eyes and GI tract
what are 4 S+S of CMV?
-sore throat
-swollen glands
-fatigue
-fever
Mycobacterium Avium Complex (MAC) is a bacteria found naturally in the environment in places like the soil water + dust. This bacteria is extremely harmful to patients with HIV and a CD4 count of <50. It can infect the lungs, intestines and in some cases become disseminated, which means…….
it has spread to the blood stream, which means it’s spread to other parts throughout the body
this could be life threatening
can (MAC) Mycobacterium Avium Complex spread from person to person?
no
S+S of MAC are very similar to TB, what are those signs and symptoms?
-Night sweats
-ABD pain
-Fever
-Fatigue
-Diarrhea
clarithromycin
Azithromycin
clarithromycin
ethambutol
rifabutin
rifampin
These medications are used to treat which OI?
Mycobacterium Avium Complex (MAC)
What are the signs and symptoms of TB?
CD4 count <200 = at risk
-night sweats
-fever/ chills
-loss of appetite/ weight loss
-hemoptysis (coughing up blood/ bloody sputum)
-fatigue
-pain in the chest or back
TB is mainly found in the lungs. what kind of precautions and what kind of room will a TB patient be placed in?
-droplet precautions
-negative pressure room
providers/ nurses need N95’s
If you suspect a patient has TB, why is it important to ask if they have been out of the country recently?
because people in other countries are vaccinated against TB
Isoniazid, Rifampin (Rifadin, Rimactane) – turns saliva, urine, tears, RED!!!
Ethambutol (Myambutol)
Pyrazinamide.
Drug resistance use for 20 months:
Bedaquiline (Sirturo),
Linezolid (Zyvox)
These drugs are used to treat what OI?
TB
what are the signs and symptoms of Trichomonas vaginalis aka “Trich”?
-itching/ burning/ redness of the genitals
-discomfort w/ urination
-thin, white/ clear/ yellow/ green discharge w/ an unusual odor
A pregnant woman with Trichomonas vaginalis aka “Trich” is at risk of what?
delivering early w/ a low birth weight
one dose of metronidazole (Flagyl)or tinidazole (Tinactin) can cure which STD?
Trichomonas vaginalis aka “Trich”
When a patient is receiving PREP medication for HIV, the most important thing to educate them on is what?
DO NOT STOP TAKING THE MEDICATION NO MATTER WHAT!!!!
HIV will replicate faster/ viral load will increase
TRUE OR FALSE?
ARV’s for HIV/AIDS don’t cure the virus they only suppress it, even to undetectable levels sometimes, so they are able to live longer and healthier.
true
patients w/ HIV can still transmit the virus, even if on medication, so they must continuously take the medication and use __________ w/ sex.
condoms/ protection
also don’t share toothbrushes
HIV/ AIDS encephalitis, AKA _____ _______ _______. This is when the virus crosses the blood brain barrier. Manifestations include
1.
2.
3.
4.
5.
AIDS dementia complex
- CNS decline
- mental changes
-depression
-memory loss
-profound weakness
Policies will vary based on facility, BUT if you get stuck by a needle what should you do?
- pinch and bleed
2.wash hands - incident report/ ED
4.PREP meds
5.tested 6 months later
if someone tests positive for HIV antibodies, they are considered HIV seropositive and should be offered ____.
PREP
(PEP) post exposure prophylaxis, should be completed as a __ day course.
28
