Unit 19 Flashcards
how do stds spread
genitals, mouth, rectum, skin, placenta
viral/recurring stds
herpes, warts, aids
bact/elimanted stds
syph, clap, gonorhea, chancroid
high risk practice
multi partners, unsafe/high risk sex practice drug abuse medically underserved prior stds non compliant std tx
low risk or no risk practice
monogomy
abstinence
genital herpes
recurrent, systemic, viral infc
what virus causes gential herpes
herpes simplex type 2
what virus causes cold sores
herpes simplex type 1
what type of microbe is herpes
neurotropic
neurotropic microbes
attack host cells ganglia
how does herpes spread
contact with shedding leisions or vaginal sec
incubation herpes
2-10 days
when do mnfts appear in herpes
3-7 days post contact with apperance of lesions
mnfts of herpes lesions
pain, burning at site (internal in women)
systemic mnfts of herpes
fever, m ache
when may a herpes virus become subclinical
if virus is latent
major problem with herpes
reoccurence
tx for herpes
no cure, symptom tx, anti viral for flare ups
which hpv strains have inc incidence in warts
6,11
characteristics of warts
beningn, neoplastic growth. short stock lesion with multi heads
incubation for warts
1-2 mo
cure for wart
no
tx for warts
removal topical drugs sx cryosx monitor for ca vaccine to prevent hpv?
what types of topical drugs are used in warts
cytotoxic or antimyotic
what strains of hpv may cause ca
16 and 18
name of syph bact
treponema pallidum
how does syph spread
contact with leasions and across placenta at 16 wks gest
incuation syph
10-90 days
how does syph spread
microbe divides and spreads systemically
comp of syph
blindness, paralysis, hd, death
1 stage of syph
bact introduced. painless chancre (ulcrative bleeding) reginal lympahdenopathy
how long does it take for a painless chancre in 1st stage syph to heal
3-12 weeks
2nd stage of syph
appearance of further lesions
when does 2nd stage syph begin
6-8 weeks post infc
mnfts of 2nd stage syph
macupapular rashes (white, pimple like) on palms and soles
white patches on mucous membs and tongue
flat papules
generalized and progressed lymphadenopathy
fever and malaise
latencyup to 50 yrs
when does 3rd stage of syph occur
1-35 years after primary infc
what happens in the 3rd stage of syph
irreversiable damage to bone, joints, cvs, ns,
what is important to remember about 3rd stage syph
we can eradicate syph bact but disease process is permanent. infc is systemic
tx for syph
long acting penicillin
why do we use long acting penicillin in syph
bact is spirochete shape - these bact have inc generation time of approx 30h. we need abx to last in system for duration of this time
bact name for clap
chlamyida trachomatis
characteristics of clap
gram -, tiny, hard to detect bacteria
what percent of clap is asymptomiatic
50
mnfts clap in male
white or clear urethral discharge
mild dysuria rt pain in urethra
testicular pain within scrotum rt inflm of epididymis
mnfts of clap in female
mucopurulent vaginal dc plus cervical mucous
dysuria
bleeding
pelvic pain + PID
tx for clap
abx, doxycycline. azithromycin
bact name for gonorrhea
neisseria gonnorrhea
incubation of gono
3-8 days
mnfts of gono in female
purulent, vaginal dc
dysuria, genital irritation, late pelvic pain rt PID
mnfts of gono in male
urethral dc, dysuria
systemic mnfts of gono (m and f)
bacteremia
pharygneal infc rt oral sex
conjunctivitis rt contaminated hands touching eyes
arthritis dermatits syndrome/ septic arthritis
mnfts of arthritis dermatis
swollen,painful joints
tx gono
1st line: abx (cephalosporins) 2nd line: inc dose plus add another class of antibiotics
AIDS
infc rt HIV
incubation of HIV
varying
what does hiv target
IR and T helper cells
what happens when IR is targetted
inc immunesuppression -> opport infc, CA
2 forms of HIV
HIV 1 and HIV 2
how does HIV spread
sex, cont blood, maternal (in utero, LDR, lactation)
what is the risk of HIV for HCP1
0.3%
what does HIV infection by needle stick injury depend on
viral load of blood
depth and location of injury
3 phases of HIV infc
primary inf
latent
overt AIDS
primary infc
weeks-mo. introd + replication
window period
time req for dx test to detect microbe
what do we look for in the window period of HIV
looking for inc Ab in blood in response to Ag
how long may the window period be
up to 3 mo
what occurs in the primary infc
seroconversion
high viral load and dec cd4 count
seroconversion
formation of ab in blood
what is the relationship between viral load and CD4 count
inversely porportional to eachother
what classifies AIDS
cd4 count that falls below a certain number and stays down OR 2 infcs and/or Ca
latent periods AIDS
asymptomatic
lymphatic tissue damage
recurrent resp infc rt dec IR
fatigue
when does overt aids occur
about 10 years after infc
what is targetted in overt aids
th cells, macrophages, b cells
what happens in overt aids
destrosy IR -> dec IR and defenses-> inc new infc + latent pathogens
affects various organs
dx for aids
clinical progression ELISA western blot assay PCR CD4 count P24 Ag test NAT
what does ELISA measure
measures abs via ez linked reaction. measures ab against whole virus
western blot assay
measures virus spec ag. test with inc specifity
PCR
biochemical tests not typically done. Measures virus
CD4
measures number of t helper cells. (inc viral load - dec CD4)
P24 ag test
measures protein within viral vore. appears in serum of infctd individual.
NAT
nucleic acid testing. replaces PCR, detects virus by looking at its nucleic acid content
best early test for AIDS
p24 ag test
number one dx for AIDS
elisa
top 3 mfnts for aids
resp (TB/pnumonia) -> drug resistant TB
GI
NS (dementia, encephalopathy) -> extensive damage rt infc and toxins
why does oppurtunistic ca occur 2
malignant cells multiply because IR cannot control them -> neoplasia -> CA
genetic mutation rt virus interruption to host cells
why does opportunistic infc occur
IR compromise and anatomic damage to IR
which oppurtunistic cas are most common in HIV
Kaposi sarcoma
NHL
cervical ca
kaposi sarcoma
cutaneous lesions visible on skin, mouth, lymph nodes. endothelial origin
tx AIDS/HIV
slow progression to AID
antiretrovirals
