STI Flashcards by Ellie Kready

how is hpv transmitted

Intimate skin to
skin contact; Vaginal, Anal,
Oral sex

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clinical signs hpv

Wart-like growths in
perineal area
* Body can clear most
infections within two years,
some infections persist

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maternal/fetal effects of hpv

Lesions grow more rapidly during
pregnancy (affects vaginal birth)
* #1 cause of cervical, vaginal, penile,
oropharyngeal cancers
* Rarely transmitted through the placenta

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plan of care hpv

Plan of Care:
* No cure
* Vaccinate
* Can be spread
without active lesions
* Regular Pap smears
* Trichloroacetic acid
* Laser or surgical removal
Vaccine:
* Gardasil 9
* Children 11-12: 2 vaccines 6-
12 months apart; if less than
5 months apart, will require
3rd shot
* If 15 or older, 3 doses
of vaccine over 6 months
* Women up to age 26 and
men up to 21

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how is herpes transmitted

Direct contact
with person shedding the virus

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clinical signs herpes

Primary outbreak: malaise,
muscle aches, headache,
painful lesions
* Subsequent outbreaks are
less severe with shorter
duration

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maternal/fetla effects herpes

PTB (Preterm birth)
* Dermatological scarring
* Microcephaly
* Encephalitis
* Vaginal birth is
contraindicated with an
active outbreak
* Neonatal sepsis/death

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herpes plan of care

Abstain from sexual contact
during outbreak
* No cure
* Acyclovir, valacyclovir,
famciclovir to improve
quality of life
Pregnancy:
* Suppressive therapy starting
at 36 weeks gestation
through delivery

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hiv clinical signs

Progressive disease
which results in AIDS
* Fever, rash,
pharyngitis, myalgia
* Opportunistic
infections mean the
person has AIDS

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hiv maternal/fetal effects

Spread through
childbirth and
breastfeeding
* PTB
* IUGR
* Perinatal mortality-
higher if woman is
untreated

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plan of care hiv

Antiretroviral therapy
(zidovudine)
* Assess viral load q 3 months
* Scheduled cesarean (if viral load >
1,000)

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goals of therapy hiv

Decrease viral load
* Restore the body’s
ability to fight
pathogens
* Improve quality of
life
* Reduce morbidity
and mortality

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is chlamydia bacteria or viral

bacterial

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how is clamydia transmitted

vaginal
anal
oral sex

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clinical signs chlamydia

Most are
asymptomatic
* Mucopurulent
discharge
* Dysuria
* Dysfunctional
uterine bleeding

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maternal/fetal effects chlamydia

Salpingitis
* Endometritis
* PID, infertility
* Ectopic pregnancy
* PROM, PTB
* Opthalmia neonatorum
* Neonatal pneumonia

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chlamydia plan of care

Azithromycin 1 gm PO x 1 dose OR doxyclycline 100
mg PO x 7 days
* Treat partners
* Abstain for 7 days after completion of treatment
* Test of Cure three weeks later if pregnant or
symptoms persist

is gonorrhea bacteria or viral

bacterial

how is gonorrhea transmitted

vaginal, Anal, or Oral
sex; and from maternal to newborn

clinical signs of gonorrhea

Commonly asymptomatic
* Vaginal discharge
* Abnormal vaginal bleeding
* Dysuria
* Co-exists with chlamydia

maternal/ fetal effects of gonorrhea

PID, infertility
* PROM
* Disseminated infection
* Opthalmia neonatorum
* Chorioamnionitis
* Postpartum endometritis

plam of care gonorrhea

Ceftriaxone 250 mg IM x 1 dose
* Azithromycin 1 gm PO x 1 dose
* Add doxyclycline if also positive for chlamydia

is syphilis bacterial or viral

bactera

how is syphillis transmitted

vaginal and oral sex

clinical signs of syphilis

Primary: painless chancre (round, ulcerated lesion with raised edges) * Secondary: flu-like, sore throat, weight loss, rash on trunk, palms, and soles * Latency: asymptomatic, + serology * Tertiary: life-threatening heart and neurological disease

maternal/fetal effects of syphilis

Death if untreated * Congenital Syphilis * PTB * Fetal Death * Pericarditis * Jaundice * Anemia

plan of care syph

Plan of Care: * Penicillin G IM or IV: treatment of choice, specific regimen and duration depends on length of infection * Kills bacteria and precent further damage, but does not reverse damage * Re-evaluate at 6 and 12 months after treatment

mothers should not kiss their baby with a cold sore since they will be transmitting...

hsv

how is bacterial vaginosis transmitted

Not sexually transmitted (linked to new sex partner and/or multiple sex partners)

clinical signs of bacterial vaginosis

Change in normal flora: lactobacilli in the vagina are replaced with anaerobic bacteria * Thin white or grey discharge * “Fishy” odor * Vaginal pH 4.5

maternal/fetal effects bacterial vaginosis

PTB * LBW * Chorioamnionitis * Postpartum endometritis * PID

plan of care bacterial vaginosis

Metronidazole 500 mg PO bid x 7 days * OR * Gel, 0.75%, one full applicator, intravaginally, once a day x 5 days

clinical signs of yeast infections

Pruritus * Irritation * Tick, white, cottage cheese like discharge * Dyspareunia * Vaginal soreness * Erythema

maternal/fetal effects of yeast infection

Increased incidence in pregnancy * Newborn thrush

plan of care yeast infection

Micronazole cream or suppository * Clotrimazole PO or cream * Terconazole cream or suppository * Fluconazole 150 mg PO x 1 * These agents may weaken latex condoms * Cotton underwear * Avoid tight pants

what is trichomoniasis

parasite

how is trichomoniasis transmitted

Penis to Vagina and/or Vagina to Vagina

clinical sigsn trichomoniasis

Frothy grey or yellow/green discharge * Foul odor * Erythema, pruritus and edema of external genitalia * Dysuria * Dyspareunia * Vaginal pH >4.5

maternal/fetal effects trichomoniasis

Increased risk of HIV transmission * PTB * PROM * LBW infants

plan of care trichomoniasis

Metronidazole 2 GM po x 1 dose * Avoid alcohol while taking metronidazole * Treat partner