Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHAR 253 Exam 2 > STI's > Flashcards

STI's Flashcards

1
Q

Define STI

A

infection passed from one person to another through sexual activity, including vaginal, oral or anal sex as well as genital skin-to-skin contact. Some STIs are spread through the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

TYpes of STI’s

A

Viral – human papilloma virus (HPV), human immunodeficiency virus (HIV), hepatitis B, herpes simplex virus (HSV)
Bacterial – chlamydia, gonorrhea, syphilis
Parasitic/fungal – trichomoniasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an STBBI?

A

= sexually transmitted and blood borne infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

RIsk FACtors STI

A

Multiple partners – concurrently or over time
Anonymous or casual sex partners
Sex without the use of barrier protection
Sex with person(s) with an STI
Previous STI
Substance use (drug, alcohol or both)
Use of medications for erectile dysfunction
History of intimate partner or sexual violence
Social environments (e.g. circuit parties, post-secondary institutions, bath houses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What populations are disproprotiantely affected?

A

Indigenous Peoples
Gay, bisexual, and other men who have sex with men (gbMSM)
Transgender people
Youth and young adults
People who use drugs
Incarcerated or previously incarcerated people
People engaged in the sale or the purchase of sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

STI Symptoms

A

Many STIs are asymptomatic
Even if no symptoms are present, the infection can still be passed toother people​
A person treated for an STI in the past can still be re-infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SK Communicable Dx Control MAnual

A

Screen using risk assessment, offer testing based on results
Individuals with ongoing risks for infection should routinely be tested for chlamydia, gonorrhea, syphilis, HIV, Hep B, Hep C
Test for one – Test for all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PHAC Guidelines

A

PHAC Sexually transmitted and blood-borne infections: Guides for health professionals:
Screening recommendations specific to STI
Offer in the course of routine care with special attention to those with risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CMAJ Guidelines

A

Screen for chlamydia and gonorrhea annually for age <30 and sexually active, more frequently if high-risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Barrier sto seeking care

A

Underestimate personal risk
Perception that STIs are not serious
Fearful of procedures
Self-conscious about genital exam
Perceived and anticipated attitudes of health care professionals and clinic staff
Stigma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

STI Reporting

A

STIs are reportable communicable disease
Under Public Health Act 1994, health care providers report to Medical Health Officer (MHO) who reports to Chief Medical Health Officer at Saskatchewan Ministry of Health
Reports available on Sask government website

Several STIs are also nationally notifiable – chlamydia, gonorrhea, syphilis, hepatitis, HIV, chancroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Partner Notification

A

Critical to prevention and control
Goal – assist individuals to inform partners about risk and honour partner’s right to make informed decisions about their health
CONFIDENTIAL
Individual, health care provider, MHO may notify partner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Barrier Protetcion

A

External condoms, internal condoms, dental dams

Decrease risk of acquiring and transmitting the majority of STIs, including HIV, HBV, chlamydia, gonorrhea

Do not provide complete protection against syphilis, HPV or HSV because lesions and asymptomatic shedding can occur in areas not covered

Spermicidal lubricated condoms containing nonoxynol-9 not recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

GOT STI

A

Treat the infection​
Abolish symptoms​
Decrease spread to sexual partners​
Decrease vertical transmission to newborns​
Reduce transmission of HIV​
Decrease probability of complications, such asinfertility, chronic pain, sepsis​

T Acquired Dirty D* Requiring Detamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SASK HEALTH

A

Sask Health provides amoxicillin, azithromycin, cefixime, doxycycline free of charge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

STI Transmisison

A

STIs are spread from person to person through:

Contact with semen, vaginal fluid or other body fluids during vaginal, anal or oral sex without a condom

Skin-to-skin contact during sexual activity

Sharing toys
Some STIs can be passed through blood transfusions and transplants

Some STIs can be transmitted vertically during pregnancy and labour

HIV can be transmitted through breast/chestfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Preganncy

A

STIs can negatively affect fertility and pregnancy, and can also be harmful for babies

Chlamydia = preterm birth, conjunctivitis and pneumonia in newborn

Gonorrhea = endometritis and pelvic sepsis, ophthalmia neonatorum and systemic infection in newborn

Syphilis = systemic symptoms, fetal loss

Pregnant people should be tested early in pregnancy and again in third trimester if ongoing risk andtreated before giving birth to decrease therisk of problems during pregnancy anddelivery, and resulting complications for thebaby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

STI SX

A

Many STIs are asymptomatic, but may present as syndrome/symptom

Syndromes: cervicitis, epididymitis, pelvic inflammatory disease, proctitis, urethritis, vaginitis, anogenital ulcers

May be caused by an STI, another infection, or have a non-infectious cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vulvovaginal Candidiasis

A

Candidia Albicans

Pruritis, white,clumpy discharge

FLuconazole 150 mg posingle dose

Topical azole antifungals
clotrimazole, miconazole, terconazole

Not necessary to tx partners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Trichomoniasis

A

Trichomoniasis Vaginalis

Pruritis

Odour

Off, white or yellow frothy discharge

Metronidiazole 2 g single dose or 500 mf BID f7d

Treat sexual partners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bacterial Vaginosis

A

Mycoplasma and GArdnerella Vaginalis

Fishy odour

Grey or milky, thin, copious discharge

Metronidazole 500 mg po BID x 7 days or 2 g PO x single dose

Metronidazole 0.75%
5 g PV x 5 days (x 10 days plus twice weekly x 4-6 months if recurrent)

Clindamycin 2% 5 g PV x 7 days

Not necessary to treat asymptomatic patients unless undergoing procedure or high risk pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Angogentical Ulcers

A

Herpes simplex virus
Lymphogranuloma venereum (CT L1, L2, L3)
Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anogenital Warts

A

HPV types 6 and 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CHlamydia

A

Etiology: Chlamydia trachomatis

Most common nationally reportable STI in Canada
May be under-detected because majority of people with infection are asymptomatic
Empiric treatment may be given without lab testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Chlamydia SX

A

dysuria → painful to pee
urethritis = inflammation of urethra → dysuria, dyspareunia
cervicitis = inflammation of cervix → abnormal bleeding, abnormal discharge, dyspareunia
proctitis = inflammation of lining of rectum → pain, diarrhea, bleeding, discharge
conjunctivitis → excessive tearing, discharge, inflammation, swelling or redness of eye

Clinical presentation reflects site of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Chlamydia SX Genders

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Chlamydia Complications

A
28
Q

Chlamydia TX

A
29
Q

Doxycycline Counselling

A

Take with food
Taking with iron or calcium may decrease absorption
Photosensitivity

30
Q

Azithromycin Counselling

A

GI upset - prophylactic antiemetics

31
Q

CHalamydia Counselling

A

Counselling: abstain from sexual activity without barrier protection until treatment of person and partners is complete (7 days after one dose therapy, end of multiple dose therapy) and symptoms have resolved –> preferably abstinence

32
Q

Follow Up Chlamydia

A

Test of cure (TOC) recommended when symptoms persist, compliance is suboptimal, preferred treatment not used, prepubertal, pregnancy

Repeat screening recommended 3 months post-treatment due to risk of reinfection

SK – TOC 3-4 weeks following positive. Repeat testing in all individuals6 months post as re-infection risk high.​

33
Q

LGV

A

Etiology: Chlamydia trachomatis genotypes L1, L2, L3 which are more invasive than non-LGV genotypes

Relatively rare, some outbreaks reported in Canada

Preferentially affect the lymph tissue

Divided into three stages: primary, secondary, tertiary

34
Q

LGV SX

A
35
Q

LGV TX

A
36
Q

Gonorhhea ETyiology

A

Etiology: Neisseria gonorrhoeae

Second most common nationally reportable STI in Canada
Frequently asymptomatic
When left untreated, infections become chronic
Reinfections common
High rates of concomitant infection with chlamydia → treat for both

37
Q

Gonorhhea SX

A
38
Q

Gonorhhea Complications

A
39
Q

Gonorhhea TX (Not Specifc)

A

Treat gonococcal infections with combination therapy →improve efficacy and potentially delay resistance
Therapy depends on site of infection and probability of resistance
Recommended combination includes a third-generation cephalosporin with either azithromycin or doxycycline

40
Q

Gonorhhea TX

A
41
Q

Gonorhhea Counselling

A

Penicillin allergy
Cross-sensitivity between penicillins and second- or third-generation cephalosporins is low.

Resistance is a concern – encourage adherence, treating all partners, other sexual health education

Azithromycin can be taken with food to minimize nausea (vomit within 1 hour, repeat dose) or anti-emetics

Abstain from sexual activity without barrier protection until treatment of person and partners is complete (7 days after one dose therapy, end of multiple dose therapy) and symptoms have resolved

42
Q

Gonorhhea FOllow Up

A

Test of cure (TOC) cultures recommended within a week for all positive sites or NAAT 2-3 weeks after treatment completed

Repeat screening recommended 6 months post-treatment

SK – follow up TOC cultures 4-5 days following treatment incertain circumstances.

NAAT not recommended but if needed, atleast 4 weeks following positive. Repeat testing in all individuals6 months post as re-infection risk high

43
Q

Syphillis

A

Etiology: Treponema pallidum

Third most common nationally notifiable STI in Canada
Rates of infection increasing rapidly

Transmission via contact with chancres

Untreated syphilis has many complications

Universal screening recommended in pregnancy

HIV → more rapid progression to neurosyphilis and more aggressive and atypical signs of infection

44
Q

Syphillis Sx

A

Neurosphyllis is not tertiary syphillis

45
Q

Congenital Sx syphilis

A
46
Q

Syphillis Testing

A

National comitte SSTBI –> screening in all sexually active persons with multiple sexual partners or upon the patients request

New or multiple partners regardless sof risk factors
Screen every 3-6 months in people with risk factors

In patient at high risk, should be the norm to test high risk individuals. The norm should be that you “opt-out” rather than “opt-in”

47
Q

Syphillis TX

A
48
Q

Syphillis Counselling

A

Abstain from sexual contact until the lesions are completely healed and it has been 7 days since they received their final dose of treatment

Condoms should be advised and encouraged for all sexual encounters

PHAC: Advise all people with potentially infectious lesions such as chancres, condylomata lata and/or rash of secondary syphilis to abstain from sexual contact until symptoms have resolved and for 7 days after treatment

49
Q

Syphillis Follow Up

A

No test of cure – treatment response based on clinical picture (symptom resolution) and nontreponemal test (NTT) titre change (ie: four-fold change at 6 months)

50
Q

What is the Jarisch-Herxheimer RXn?

A

Acute febrile reaction accompanied by headache, myalgia, chills and rigors

Occurs within 1st 24 hours after initiation of any syphilis therapy

NOT an allergic reaction, but rather reaction to therapy
Manage with antipyretics (NSAID), but not proven to prevent reaction

May induce early labour or cause fetal distress in pregnancy

51
Q

HPV

A

HPV is everywhere –over 200 types have been identified
Most common STI in the world
At least 40 types of HPV known to infect mucosa of the anogenital tract and oropharynx
Majority of infections are self-limited, asymptomatic, unrecognized
Infection with multiple types possible

52
Q

HPV types

A

Infection with low-risk types (6, 11) associated with low/no cancer risk but may lead to anogenital warts, cervical lesions, and rare conditions such as recurrent respiratory papillomatosis

Persistent infection with oncogenic, high-risk types (16, 18) may lead to cancer – cervical, oropharyngeal, cancer of vulva, vagina, penis, anus

Virtually all cases of cervical cancer are attributable to HPV
Can lead to cancer

53
Q

HPV SX

A
54
Q

Tx Anogenital Warts

A
55
Q

HPV TX counselling

A

Avoid contact with healthy skin
Refrain from sexual activity while undergoing treatment
Skin reactions: itching, tenderness, erythema, ulceration

Pain reduction – lidocaine/prilocaine, injectable lidocaine

56
Q

HPV VAccination

A

Gardasil 9 – HPV types 6, 11, 16, 18, PLUS 31, 33, 45, 52, 58
Cervarix – HPV types 16 and 18

57
Q

Gardasil 9

A

Approved for Individuals aged 9-45 years
IM injection (deltoid preferred)

Dose:
>15 years old: 0.5 ml x 3 doses – 0, 2, 6 months
9-14 yo: 0.5 ml x 2 doses – 0, 6 months (5-13 months)
Immunocompromised (no matter age): 3 dose series

97% vaccine efficacy for preventing CIN (cervical intraepithelial neoplasia, abnormal cervical cells) or more severe disease in HPV naïve 16-26 yos

Adverse effects: local injection site reaction, headache (7-20%), fever (2-10%), nausea, dizziness, fatigue, diarrhea, oropharyngeal pain, upper abdominal pain

58
Q

Sk Coverage Gardasil-9 Criteria

A

Females and males in Grade 6
Those that did not receive vaccine in Grade 6 until they are 26 years old
Immunocompromised females and males aged 9-26 years

59
Q

HSV

A

Etiology: herpes simplex virus type 1 and 2

HSV-1 is primarily associated with ORAL infection but may cause genital herpes
refer to Herpes Labialis management (guidelines on medSask)

HSV-2 is primarily associated with genital infection but may also present orally as a result of oro-genital transmission (rare)

60
Q

HSV Transmisison

A

Transmitted by unprotected sex and via delivery of baby
Higher risk with open sores, also asymptomatic viral shedding

Common in adolescents and adults, women > men – but true incidence is not known since not reported

Virus establishes itself intracellularly within host cell ganglia for life

Genital herpes increases the risk of acquisition of HIV twofold

61
Q

HSV Sx

A
62
Q

Gential Herpes TX

A

Acyclovir 200mg PO five times per day for 5-10 days
OR
Famciclovir 250mg PO TID for 5 days
OR
Valacyclovir 1000mg PO BID for 10 days

Topicals not effective
Pregnancy
Acyclovir200 mg PO qid for 5-10 days

Severe: IV acyclovir 5mg/kg infused over 60 minutes every 8 hours, convert to oral therapy once significantly improved

63
Q

Genital Herpes Recurrent TX

A

Valacyclovir500 mg PO bid OR 1 g PO daily for 3 days
OR
Famciclovir125 mg PO bid for 5 days
OR
Acyclovir200 mg PO 5 times/day for 5 days
800 mg PO TID x 2 days also shows efficacy

64
Q

Neonatal Herpes

A

Occurs when baby is delivered through an infected vagina
Initial symptoms ~4 weeks of age
Results in generalized systemic infection involving liver, other organs, CNS and skin
Mortality in nearly 60% of cases, 70% will experience severe or fatal complications

Acyclovir45–60 mg/kg/day IV in three equal 8-hourly infusions, each over 60 minutes for 14 to 21 days

65
Q

HSV Counselling

A

Antivirals will decrease severity and duration of symptoms, but not prevent recurrences

Use as early as possible (preferably fewer than 6h) and until lesions are healed
Abstain from sexual contact during symptomatic episodes until lesions are completely healed

Always use a condom as asymptomatic viral shedding can occur

May not eliminate risk of transmission when lesions not limited to genital area

Lifelong infection – encourage patient to seek support

PHAR 253 Exam 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions