STI's Flashcards
which 4 common STI’s are curable?
syphilis
gonorrhoea
chlamydia
trichomoniasis
- all bacterial
- trichomoniasis - parasitic
which 4 common STI’s are incurable (virus’)
hepatitis B
herpes simplex
HIV
HPV
how are STI’s classified?
into bacterial, parasitic and viral
what are different treatment modalities used to treat STI’s?
bacterial and parasitic STI’s
- treated with single-dose antibiotics
virus
- antiviral agents can modulate disease but no cure
why are STI’s relevant to dentists?
- can present oral manifestations
- can refer for treatment
- STI’s can be transmitted via saliva, blood and/or direct contact
give principle risk factors for STI’s
- unprotected sex
- oral sex
- multiple partners
- previous STI
- alcohol/drug misuse
- young individuals
describe Syphilis, the aetiology and mode of transmission (2)
caused by bacteria
- treponema palilidum
= spirochete organism - corkscrew shape
pathogenesis
- sexual transmission
- vertical - mother to child
describe the 4 stages of Syphilis with the pathology
- Primary
= 10-90 days after exposure
- chancre - painless ulcer on the genitals
- lymphadenopathy - localised, painless enlarged lymph nodes - Secondary
= 2 weeks-6 months
- painless rash of skin/mucosa, palms, soles of feet
- condylomata lata - bumpy lesions in moist areas of the skin
- mild neurosyphilis - headaches - Latent Phase
- asymptomatic
- 25% secondary recurs, 90% within a year
= infectious
- non-infectious after 1 year - Tertiary
- Neurosyphilis
- Cardiovascular
- **Benign Tertiary/Gummatous **
- occur in 1/3 untreated patients, after 5+yrs
describe 3 components of Neurosyphilis
meningovascular neurosyphilis
general paresis
tabes dorsalis
what comes under meningovascular neurosyphilis? (4)
chronic meningitis
- invades membrane and fluid surrounding the brain
obliterative vascular inflammation
- occlude vessels supplying the brain
= Heubner Arteritis
stroke-like symptoms
- small/medium CNS arteries are inflamed
cerebral gummas
- lesions in the meninges
- extend into the parenchyma
what is general paresis? describe 10 symptoms
treponema palilidum invades the brain
- mem loss
- personality change
- depression
- mania
- psychosis
- dysarthria - speech issues
- tremor
- argyll robertson pupil
- mood alterations
- ends in severe dementia
describe Tabes Dorsalis
- peripheral nerves are involved
- lighting pains
- ataxia - loss of proprioception
- argyll robinson pupil
describe argyll robinson pupil
bilateral small pupils
- eyes don’t react to light
- eyes react to near objects, accommodate to distance like normal
how does tertiary syphilis affect the cardiovascular?
- mainly affects the aorta
- aneurysm proximal aorta
- aortic valve insufficiency
- coronary artery disease
- aorta becomes inflammed
- vaso vasorum (vessles to the aorta) become occluded
- proximal aorta wall = scarred
= loss of elasticity - narrow coronary artery ostia = myocardial ischaemia
what is Benign Tertiary/Gummatous Syphilis?
formation of nodular lesions in bone, skin and mucous membranes of upper airway and mouth
how is Syphilis investigated?
- detection via microscopy or PCR
- serology
- VDRL test - blood test for non-specific IgG or IgM = quantitative
- TPPA - specific anti-t.pallidum antibodies = qualitative
describe chlamydia trachomatis - the symptoms.
50% cases = asymptomatic
- sore throat
- pharyngitis
- tonsillitis
describe Gonorrhoea, the aetiology
sexual transmission
why are antibiotics difficult with gonorrhea?
there is a resistant strain
describe the clinical and pathological features of Gonorrhoea
- gonococcal pharyngitis
- sore throat with red exudates
describe Pelvic Inflam Disease, the aetiology and pathogenesis
an ascending infection of the vulva/vagina with spread to other areas of the female genital system
aetiology - occurs from gonorrhoea and chlamydia
Describe the clinical and pathological features of Pelvic Inflammatory Disease. give 2 risks
- pelvic pain
- adnexal tenderness - lower abdominal tenderness
- fever
- vaginal discharge
acute inflammation
chronic = scarring over the fallopian tube
- infertility risks
- ectotopic pregnancy risk
describe HPV, the aetiology and pathogenesis
aetiology
- oral and maxillofacial transmission
pathogenesis
- most infections clear themselves
Describe the clinical and pathological features of HPV
- condyloma acuminatum - genital warts
- squamous papillomas
- verruca vulgaris
why is HPV type 16 and 18 important?
can lead to cervical and head and neck cancers
describe the progression and treatment (4) of HPV.
- most infectious when warts are visible
- condoms do not eliminate the viral transmission
treatment
- cryotherapy
- podophylltoxin creams
- immune modulation
- surgical excision
state the low risk HPV subtypes and the high risk.
low risk
= HPV 6 and 11
- unlikely to cause pre-malignant change
high risk
= HPV 16 and 18
- unlikely to cause visible warts
describe Herpes Simplex Virus, the aetiology and pathogenesis
HSV-1 type 1
HSV-2 type 2
aetiology of HSV-1
- oral to oral contact - cause cold sores and genital herpes
aetiology of HSV-2
- sexually transmitted - genital herpes
how long do herpes infections last?
lifelong
Describe the clinical features of Herpes Simplex Virus 1. Is it eliminated?
cervical lymphadenopathy - lymph node enlargement
cold sores - recurrent herpes labialis
symptoms go within 2 weeks
not eliminated
- stays latent in trigeminal ganglion
- reactivates spontaneously
Describe the clinical features of Herpes Simplex Virus 2
painful ulcers and blisters
is there a link between HSV-2 and HIV?
HSV-2 infection increases the risk of acquiring and transmitting HIV
