STIs Flashcards
STIs
Usually start as lesion on genitals or mucous membranes
-latent or sub clinical phase present
Gonorrhea
2nd most common
- highest incidence in adolescents and African Americans
- direct physical contact with host
- killed by drying, heating, or washing with antiseptic
- incubation: 3-8 days
- tubul pregnancy, chronic pelvic pain, infertility in women
Gonorrhea Male manifestations
Initial site is urethra
- symptoms develop 2-5 days
- dysuriw, profuse, purple to discharge
Female gonorrhea
Mostly asymptomatic
- vaginal discharge, dysuria, frequency of urination
- after intubation: redness and swelling, greenish yellow purulent exudate
Gonorrhea male and female manifestations
Transmission more efficient from men to women
- anorectal gonorrhea: includes soreness, itching, and discharge
- orogenital: few symptoms, gonococcal pharyngitis can develop
Gonorrhea complications
Men: prostatitis, urethral strictures, sterility
Women: PID, Bartholin’s abscess, ectopic pregnancy, infertility
Gonorrhea Dx
Men: positive finding in gram stained smear of discharge
Women: need culture to confirm
Syphilis
Mainly due to men having sex with men
- destroyed by drying, heating, washing
- incubation: 10-90 days
- spread in utero after 10 week of pregnancy
- tertiary/late stage: rare manifestations, gummy’s, CV probs, neurosyphilis
Syphilis manifestations
Chancres appear: painless insulated lesions, 10-90 days, lasting 3-8 weeks
Systemic: flu like symptoms, bilateral symmetric rash, mucous patches
Syphilis complications
Mostly in late syphilis
- gummy’s
- aneurysm
- scaring of aortic valve
- neurosyphilis
- tabes dorsal is: nerve damage
Syphilis Dx
Sexual history
PE: lesions and s/s
Dark field microscopy
Serologic testing to monitor neurosyphilis
Chlamydia
Major contributor to PID, ectopic pregnancy, infertility in women, nongonococcal urethritis in men
- most common in US
- transmitted during vaginal, anal, or oral sex
- incubation: 1-3 weeks
- silent disease
Chlamydia Male Manifestations
Urethritis: dysuria and urethral discharge
Proctitis: rectal discharge and pain during defecation
Epippdidymtis: unilateral scrotal pain, swelling, tenderness, fever
Chlamydia Female Manifestations
Cervicitis: mucopurulent discharge, hypertrophic ectopy
Urethritis: dysuria, pyuria, frequent urination
Bartholinitis: purulent exudate
Perihepatitis: abdominal pain, NV, fever, malaise, vaginal bleeding
Chlamydia diagnosis
NAAT DFA EIA Men: rule out gonorrhea Cervical/uretheral discharge less purulent, watery, and painful in chlamydia
Chlamydia care
Doxycycline
Azithromycin
Abstinence for 7 days
Genital herpes
Caused by HSV
-enters thru mucous membranes or breaks in the skin
-ascends to sensory or autonomic ganglion where it’s dormant
-HSV-1: infection above waist
-HSV-2: infects genital tract and perineum
Either strain can cause disease on mouth or genitals
Genital Herpes Primary Manifestations
Burning or tingling at site Small vesicular lesion Lesions rupture and form ulcers -fever, headache, malaise, myalgia, regional lymphadenopathy -urination may be painful Primary lesions present for 17-20 days
Recurrent genital herpes
Triggers: stress, fatigue, sunburn, menses
-prodromal symptoms of tingling, burning, itching at lesion site
-lesions heal 8-12 days
Avoid sexual activity should be avoid if lesions present
Genital herpes complications
Aseptic meningitis
Lower neuron damage: atonic bladder, impotence, constipation
Autoinoculation: lips, breasts, fingers
High risk of transmission in pregnancy: active lesion is indication for c section
HSV infection of eye
Genital herpes care
Viral isolation of tissue culture
Antibody assay for HSV viral type
Herpes care
Treat with -clovir
Genital hygiene
Loose fitting cotton underwear
Sitz bath
Genital warts
Caused by HPV, highly contagious
- incubation 3-4 months
- white to gray and pink-fleshed color
- large cauliflower masses
- itching
- bleeding defecation
Genital warts complications
Rapid growth with pregnancy
Transmitted to newborn
Linked with cervical and vulvar cancer in women
Linked with anorectal and squamous cell carcinoma of penis
