STIs and PID Flashcards
For which demographics are chlamydia and gonorrhea highest?
Younger women
What are common tests for STIs? (2) Which diseases do we use each for?
NAAT: Chlamydia, gonorrhea, herpes, trichomonas, HPV
Serological test: syphilis, HepB, HepC
Gonorrhea Structure and Growth requirements
Gram (-) diplococci
Grows in Thayer-martin or chocolate media with humid/CO2 atmosphere
What is major resevoir for gonorrhea? Describe transmission rates for men and women
The major reservoir is asymptomatic carriers.
Women have 50% acquisition after single exposure to infected man. Men have 20% acquisition after single exposure
Describe laboratory diagnosis methods (3) for Gonorrhea and their effectiveness
NAAT– combination assay
Gram stain of urethral drainage– 98% sensitive for symptomatic males but
Describe structure of chlamydia and infectious route
Gram (-) bacilli
Intracellular parasite
Describe pathogenesis of chalmydia…does prior infection provide immunity?
Cellular destruction–>Host immune response–>re-infection with tissue loss
There is no immunity
What are symptoms of gonorrhea in men? In women? In neonates?
Men: Urethritis, epididymitis
Women: Cervicitis, endometritis, salpingitis, infertility
Neonates at risk for conjunctivitis
How is chlamydia diagnosed? (2)
NAAT (cotest)
Antigen detection via ELISA
What are some predominant vaginal flora? (3)
Lactobacilli (acidic pH)
Staph
Strep
Klebsiella
Where does gonorrhea typically infect in cervix? Where does chlamydia?
Gonorrhea: Prefers lower O2 of cervical canal
Chlamydia: Infects glandular cells
What are signs/symptoms of pelvic inflammatory disease? (6)
Lower abdominal pain, adnexal tenderness, cervical motion tenderness, fever, mucoprurulent cervicitis, inflammation (elevated WBC)
What are some complications of PID? (4)
Infertility–due to tubal scarring, pyosalpinx, hydrosalpinx, distal tubal occlusion
Chronic pelvic pain
Tubal-ovarian abscess
Ectopic Pregnancy
What is treatment for upper genital tract infection?
Broad spectrum antibiotics
Prevention of PID consists of _____ (3)
Screening
Treatment of asymptomatic carriers
Condom use
Epidemiology of salpingitis: who is most affected? What are predisposing factors? (3)
70% of infective salpingitis is seen in sexually active women under 25.
Predisposing factors: Lack of barrier protection, induced abortion, instrumentation of cervix
What is route of spread for infective salpingitis?
Ascending/canalicular: through cervical canal and endometrial cavity
What is gross appearance of acute infectious salpingitis? (4)
Tube swollen, adematous, congested, hyperemic
What is histological appearance of acute infective salpingitis? (2)
Pus in cervical canal
Neutrophilic infiltrate
What are courses of infective salpingitis? (3)
What are correspond sequellae? (4)
Fimbrial end stays patent–>chronic interstitial (follicular) salpingitis
Spread to ovary: tubo-ovarian abscess
Occlusion of fimbriated end: pyosalpinx/hydrosalpinx
Describe histological appearance of follicular salpingitis: (2)
Pilcae of follicle fused together
Cystic/glandular structures
Describe gross appearance of tuba-ovarian abscess
Inflamed fallopian tube and ovary is big pus-filled sac
Healing with fibrosis can form tuba-ovarian mass
What are consequences of occluded fimbriated end?
Hydrosalpinx
What is general course of PID?
Difficult to eliminate– consists of remissions/exacerbations
