STI's Flashcards

1
Q

which 4 common STI’s are curable?

A

syphilis
gonorrhoea
chlamydia
trichomoniasis

  • all bacterial
  • trichomoniasis - parasitic
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2
Q

which 4 common STI’s are incurable (virus’)

A

hepatitis B
herpes simplex
HIV
HPV

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3
Q

how are STI’s classified?

A

into bacterial, parasitic and viral

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4
Q

what are different treatment modalities used to treat STI’s?

A

bacterial and parasitic STI’s
- treated with single-dose antibiotics

virus
- antiviral agents can modulate disease but no cure

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5
Q

why are STI’s relevant to dentists?

A
  • can present oral manifestations
  • can refer for treatment
  • STI’s can be transmitted via saliva, blood and/or direct contact
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6
Q

give principle risk factors for STI’s

A
  • unprotected sex
  • oral sex
  • multiple partners
  • previous STI
  • alcohol/drug misuse
  • young individuals
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7
Q

describe Syphilis, the aetiology and mode of transmission (2)

A

caused by bacteria
- treponema palilidum
= spirochete organism - corkscrew shape

pathogenesis
- sexual transmission
- vertical - mother to child

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8
Q

describe the 4 stages of Syphilis with the pathology

A
  1. Primary
    = 10-90 days after exposure
    - chancre - painless ulcer on the genitals
    - lymphadenopathy - localised, painless enlarged lymph nodes
  2. 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
  3. Latent Phase
    - asymptomatic
    - 25% secondary recurs, 90% within a year
    = infectious
    - non-infectious after 1 year
  4. Tertiary
    - Neurosyphilis
    - Cardiovascular
    - **Benign Tertiary/Gummatous **
    - occur in 1/3 untreated patients, after 5+yrs
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9
Q

describe 3 components of Neurosyphilis

A

meningovascular neurosyphilis

general paresis

tabes dorsalis

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10
Q

what comes under meningovascular neurosyphilis? (4)

A

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

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11
Q

what is general paresis? describe 10 symptoms

A

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
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12
Q

describe Tabes Dorsalis

A
  • peripheral nerves are involved
  • lighting pains
  • ataxia - loss of proprioception
  • argyll robinson pupil
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13
Q

describe argyll robinson pupil

A

bilateral small pupils

  • eyes don’t react to light
  • eyes react to near objects, accommodate to distance like normal
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14
Q

how does tertiary syphilis affect the cardiovascular?

A
  • 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
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15
Q

what is Benign Tertiary/Gummatous Syphilis?

A

formation of nodular lesions in bone, skin and mucous membranes of upper airway and mouth

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16
Q

how is Syphilis investigated?

A
  • detection via microscopy or PCR
  • serology
  • VDRL test - blood test for non-specific IgG or IgM = quantitative
  • TPPA - specific anti-t.pallidum antibodies = qualitative
17
Q

describe chlamydia trachomatis - the symptoms.

A

50% cases = asymptomatic
- sore throat
- pharyngitis
- tonsillitis

18
Q

describe Gonorrhoea, the aetiology

A

sexual transmission

19
Q

why are antibiotics difficult with gonorrhea?

A

there is a resistant strain

20
Q

describe the clinical and pathological features of Gonorrhoea

A
  • gonococcal pharyngitis
  • sore throat with red exudates
21
Q

describe Pelvic Inflam Disease, the aetiology and pathogenesis

A

an ascending infection of the vulva/vagina with spread to other areas of the female genital system

aetiology - occurs from gonorrhoea and chlamydia

22
Q

Describe the clinical and pathological features of Pelvic Inflammatory Disease. give 2 risks

A
  • pelvic pain
  • adnexal tenderness - lower abdominal tenderness
  • fever
  • vaginal discharge

acute inflammation
chronic = scarring over the fallopian tube

  • infertility risks
  • ectotopic pregnancy risk
23
Q

describe HPV, the aetiology and pathogenesis

A

aetiology
- oral and maxillofacial transmission

pathogenesis
- most infections clear themselves

24
Q

Describe the clinical and pathological features of HPV

A
  • condyloma acuminatum - genital warts
  • squamous papillomas
  • verruca vulgaris
25
why is HPV type 16 and 18 important?
can lead to cervical and head and neck cancers
26
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
27
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
28
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
29
how long do herpes infections last?
lifelong
30
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
31
Describe the clinical features of Herpes Simplex Virus 2
painful ulcers and blisters
32
is there a link between HSV-2 and HIV?
HSV-2 infection increases the risk of acquiring and transmitting HIV