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Pathophysiology 212 > Sexually transmitted infections > Flashcards

Sexually transmitted infections Flashcards

1
Q

STIs

A
  • Reporting not accurate
  • Person-to-person transfer: oral, genitalia, urinary meatus, rectum, skin, mother to fetus
  • Increasing frequency in teenage population: often more than one type
  • Resistance is developing
  • Viral forms are not curable as yet
  • Organisms don’t survive long outside host!
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2
Q

STI Treatment

A
  • Sexual partners must be identified and treated

- Abstinence during therapy

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3
Q

Genital Warts (condylomata acuminata) & transmission

A
  • Human papillomavirus (HPV)
  • Increased incidence
    Transmission
  • Fomites
  • Mother to newborn
  • Mucosal/skin to mucosal/skin
  • Mother to newborn
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4
Q

Genital Warts Risk Factors and Progression

A

Risk Factors

  • <25 years old
  • Early first intercourse (<16 years old)
  • Increased number of partners

Progression

  • Transient or persistent
  • Incubation is 1-8 months
  • May be asysmptomatic
  • Cervical is rare
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5
Q

Genital Warts Appearance

A

External
- Soft raised fleshy lesions, or small bumps or flat rough surfaced areas on external genitalia (male & female)

Internal
- Cauliflower-shaped lesions causing discomfort, bleeding, painful intercourse

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6
Q

Genital Warts Tx.

A
  • Vaccine recently developed
  • Antimitotic agent necrosing wart tissue
  • Cryotherapy: treatment of choice (freezing)
  • Surgical excision
  • Laser vaporization
  • Electrocautery
  • Notification of partners
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7
Q

Genital Herpes

A
  • Herpes Simplex Virus (HSV) - 2
  • Incubation is 2 – 12 days
  • Neurotropic virus
  • Grows in neurons
  • Latent form moves up via peripheral nerves; dormant in dorsal root ganglia
  • Reactivates and spreads down neuron
  • Alters when replicating from dormant state
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8
Q

Genital Herpes Risk Factors

A
  • Highly contagious!
  • Spread by people unaware they have it

Risk Factors

  • Women
  • Increased sexual partners
  • Compromised immune system
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9
Q

Genital Herpes: symptoms, primary infection, triggers

A 
Symptoms
- itching, tingling, painful to touch
- Dysuria, dyspareunia 
- “Wet” vesicle eventually crusts over
Primary Infection
- h/a, malaise, muscle aches, lymphadenopathy
Recurring episodes – less severe
	Triggers
- stress, sleep loss, overexertion, other infections, prolonged coitus, menstrual distress
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10
Q

Genital Herpes Tx.

A

acyclovir

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11
Q

Candidiasis

A
  • Candida albicans
    Yeast infection/Thrush/Moniliasis
  • Present in healthy women
  • Activated when vaginal environment altered
  • 75% of women
  • Usually not transmitted sexually (not an “official” SDI)
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12
Q

Candidiasis Risk factors, manifestations, treatment

A

Risk Factors
- Decreased normal bacterial flora (antibiotics)
- Altered hormonal levels (BCPs, pregnancy)
- Decreased immune system
- Diabetes Mellitus
- HIV infection
Manifestations
- thick, white, odorless discharge
- Irritation, erythema, swelling, dysuria

Treatment: antifungal

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13
Q

Trichomoniasis & Risk factors

A 
- Trichomonas vaginalis
Transmitted via: 
- Sexual contact
- Fomites (hot tubs, swimming pools)
- Currently very prevalent
- Men harbor organism but are asymptomatic
Risk Factors - Diagnosed with other STIs
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14
Q

Trichomoniasis: Manifestations

A

Women

  • Sometimes asymptomatic
  • Frothy, malodorous green/yellow discharge
  • Erythema/edema of mucosa
  • Itching, irritation
  • Hemorrhagic cervical “strawberry spots”

Men
- Harbour organisms in urethra & prostate but are almost always asymptomatic

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15
Q

Trichomoniasis complications

A
  • Human Immunodeficiency Virus (HIV)
  • Infertility, PID & premature births (women)
  • Infertility, chronic prostatitis & urethritis (men)
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16
Q

Chlamydia Trachomatis

A
  • Bacterial infection but can behave like a virus
  • Has two distinct morphologies:
    Elementary body (survives outside the cell) attaches and is ingested & activates the reticulate body (can’t survive outside the cell) which divides and forms new “elementary bodies” released when cell bursts
  • Difficult to treat!
  • Most common STI in North America
17
Q

Chlamydia: Manifestations

A 
Women
- Can be asymptomatic
- Frequency, dysuria, vaginal discharge
- Mucopurulent cervical discharge
- Cervix becomes hypertrophied, edematous, friable (falls apart easily)
Men
- urethritis, meatal erythema/tenderness, itchiness, - discharge
- Dysuria, prostatitis, epididymitis.
18
Q

Chlamydia: Complications

A 
Women
- PID (40%)
- Infertility (20%)
- Chronic pain (18%)
- Conjunctivitis 
- Damaged Fallopian tubes
- Tubal pregnancy (9%)
	Men
- Infertility
- Reiter’s syndrome: reactive arthritis, conjunctivitis, urethritis
19
Q

Gonorrhea

A
  • Neisseria gonorrhoeae
  • Transmission
  • Entry via genitals, urinary tract, eyes, oropharynx, rectum, skin
  • Neonates born to infected mothers
  • Gonorrhea conjunctivitis/blindness
  • Amniotic infection syndrome
  • Likes warm mucus membranes
  • Highest rate in adolescents & young adults
20
Q

Gonorrhea symptoms

A
  • May be asymptomatic
  • Men have more symptoms than women
    Men: urethra pain, creamy yellow/bloody discharge; rectal infections from male-to-male contact

Women: genital or urinary discharge, dysuria, dyspareunia, pelvic pain, bleeding, fever, proctitis

21
Q

Gonorrhea complications

A

Males: spread to prostate, epididymis
Females: uterine infection, salpingitis (fallopian tubes), scarring/infertility
- Pharyngitis if oral-genital contact
- Conjunctivitis

Bloodstream (bacteremia): joint, heart valves, meninges

22
Q

Syphilis (Treponema pallidum) Transmission

A

Increasing incidence as of 2001
Transmission
- Direct contact with infectious moist lesion during sexual intimacy, kissing

Mother to fetus invitro/transplacental
- Prematurity, stillbirth, congenital defects, active infection

23
Q

Syphilis: 3 stages (first stage)

A
  1. Primary Stage
    - Chancre at site of exposure (within 3 wks, but can incubate longer)
    - Buttonlike papule erodes skin
    Male: usually obvious, penis or scrotum
    Women: cervix, vagina, sometimes external
    - Often painless
    - Mild symptoms of infection
    - Heals within 3-12 weeks
24
Q

Syphilis stage 2

A
  1. Secondary Stage
    - 2-6 wks after initial chancre, lasts1 wk to 6 months
    - Rash on palms/soles
    - Fever, sore throat, malaise, stomatitis, nausea, eye inflammation, arthralgias
    - Alopecia
    - Elevated lesions on genitals: highly infectious
25
Q

Syphilis Stage 3 & 4

A 
3. Latent Phase (1-2-20 years)
Symptoms resolve but still seroreactive
1 in 3 progress to this stage
- Others have minimal symptoms or spontaneous cure
4. Tertiary Stage (can be 20 yrs after initial infection!)
Gumma lesions: 
CV: aortic valve, aortic aneurysm 
CNS (neurosyphilis): dementia, blindness
Skin/Liver/Bone
	Treatment: penicillin +

Pathophysiology 212 (18 decks)

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