9- STI Flashcards
(49 cards)
The immediate goal of screening for STI’s is to
identify and treat infected people before they develop complications, and to identify, test and treat their partners to prevent transmission and reinfections
T. pallidum is what kind of bacteria, and how is it detected?
order spirochaetales, cannot be seen by direct microscopy, needs darkfield microscopy (has rotary motion with flexing movement which are considered sufficiently characteristic to be diagnostic
transmission of T pallidum is via
direct contact with an infectious lesion (primary chancre, mucous patches, condyloma lata) during sex, it readily crosses the placenta, not through blood transfusions bc it cannot survive longer than 24-48 hours under storage conditions
which syphilis stages are considered contagious
those with early latent syphilis
which type of syphilis has serological evidence but no symptoms
latent syphilis
early syphilis includes
primary and secondary syphilis (occur weeks to months after initial infection), and early latent syphilis (which is an asymptomatic infection that was acquired within the previous 12 months)
when do pts enter late latent syphilis , and does it have symptoms
when pts are untreated during the early syphilis stages
no this stage is asymptomatic
what is teritary syphilis
when pts are not treated for early syphilis and they develop major complications
when do events due to late syphilis occur
they can occur anytime from 1-30 years after primary infection and can involve a variety of different tissues
when can pts get neurosyphilis
any time during the course of the infection
pathology of a chancre
the lesion starts 21 days after initial infection; it begins as a papule (painless) at the site of inoculation, then ulcerates, 1-2 cm in size with a raised indurated margin
T/F chancres heal spontaneously within 3-6 weeks without treatment
T (note that as the chancre disappears, the infections disseminates)
what % of people develop secondary syphilis
25%
T/F the acute manifestations of syphilis resolve spontaneously, except in cases of severe cutaneous ulceration called lues maligna
T
common findings in secondary syphilis
- rash (maculo-papular also on palms and soles)
- lymphadenopathy
- condyloma lata (in moist regions where a previous chancre was)
alopecia type in secondary syphilis
moth eaten alopecia (is reversible with treatment)
T/F most pts with ocular syphilis develop diminished visual acuity, secondary to posterior uveitis
T (other manifestations are retinal necrosis, and optic neuritis)
note that involvement of the eye should be considered manifestation of neurosyphilis
most common clincal manifestations of late syphilis
- aortitis (CV syphilis)
- gummatous syphilis (granulomatous, nodular lesions in skin and bone)
- CNS involvement (general paresis, and tabes dorsalis)
who gets tertiary syphilis
pts with late syphilis who have symptomatic manifestations involving the cardiovascular system or gummatous disease
why do you need to know the difference between early and late latent syphilis
to know the risk of transmission; pts with late latent dx are not infectious, but pts with early latent dx are
- pregnant women with late latent syphilis can transmit T. pallidum to their fetus for upto 4 years
T/F like all herpes virus strains, HSV has a latent state followed by viral reactivation and recurrent local disease
T
T/F perinatal transmission of HSV can lead to significant fetal morbidity and mortality
T
define primary HSV
the infection in a pt without preexisting antibodies to HSV1 or HSV2
define non primary HSV
getting genital HSV1 in a pts with pre existing antibodies to HSV2 or the acquisition of genital HSV2 ina pt with pre existing abs to HSV1
