Lecture 15: STI's A

Question 1

Incidence

Answer 1

Estimated number of people that are newly infected during a specific time period

Question 2

Prevalence

Answer 2

Estimated number of people in a population with the disease

Question 3

Rate

Answer 3

A measure of the frequency of an event compared with the number of persons at risk for an event

Question 4

Describe the burden of sexually transmitted infections

Answer 4

15-24 year olds, most common is HPV

Question 5

What are the three factors that determine the rate of spread of an STI?

Answer 5

Rate of exposure to suscpetible people

Efficiency of transmission per exposure

Duration of infectivity of those infected

Question 6

Describe some ways an STI can spread from person to person

Answer 6

-Sex
-Oral-genital contact or in other non-sesxual ways
-IV drugs
-Congenital transmission

Question 7

Which gender is more geneticcally prone to STI’s ?

Answer 7

Women

Question 8

Describe some harm reduction strategies for preventing STI acquisition

Answer 8

Abstinence, practising safe sex, monogamous relationship, reduce number of sexual partners, vaccinatio n

Question 9

Name 3 bacterial STIs

Answer 9

-Treponema pallidum
-Chlamydia trachomatis
-Neisseria gonorrhea

Question 10

Name 3 viral STIs

Answer 10

HIV, HPV, HSV

Question 11

Name a parasitic STI

Answer 11

Trichomonas vaginalis

Question 12

Which disease is refererred to as the “great imitator” and what is it caused by?

Answer 12

Syphilis, treponema pallidum

Question 13

Where are we seeing a large outbreak of syphilis?

Answer 13

Old age homes and MSM

Question 14

Describe the pathogenetis of syphilis

Answer 14

Infection with T. Pallidum, primary syphillus, secondary syphilis, latent syphilis, then either no further complications of tertiary syphilis

Question 15

Primary Syphilis

Answer 15

-Abrasions in dermis or mucuous membrane; manifests as cancre at SOI
-Cancre typically non-purulent and painless

Question 16

Which locations is the syphilis chancre in men compared to women?

Answer 16

Women: labia or cervix, inconspicious and can be easily missed
Men: on penis usually, but could be in oral cavity, anus, or rectum

Question 17

Secondary syphilis

Answer 17

Hours: syphilis dissemination into tissues
Symptoms: non-specific with sore throat, muscle aches, malaise, weight loss
Desseminated rash

Question 18

Disseminated secondary syphilis rash

Answer 18

On the palms and soles of your feet, frequently found in secondary syphilis

Question 19

What disease can secondary syphilis also manifest as?

Answer 19

Hepatitus, and lead to glomerulonephritis-immunoglobin antigen complexes that can lead to kidney damage

Question 20

Tertiary Syphilis

Answer 20

20-40 years after initial infection, rare in post-antibiotic period

May lead to: Cardiovascular, neurological disease manifestations and death

CNS: personality changes, emotionaly instability, memory impairment, hallucinations

Question 21

Treatment for syphilis?

Answer 21

Penicilin

Question 22

How do we diagnose syphilis?

Answer 22

Treat: Syphilis specific antibodies (treponemal tests IgG, IgM) and test for non-syphilis proteins (RPR- rapid plasma reagen VDRL)

Question 23

RPR is used for __________
Treponemal tests ________

Answer 23

Monitor therapy response, diagnosis

Question 24

Chlamydia trachnomatis

Answer 24

Bacterial STI, caused by intracellular bacteria: chlyamydia trachomatis (CT)

Higher rate in females than males, rates likely underreported

Question 25

What is the leading cause of bacterial genital infections in developing countries?

Answer 25

C. trachomatis

Question 26

Majority of chlamydia is...

Answer 26

asymptomatic

Question 27

Trachoma

Answer 27

-Caused by C. trachomatis serovars A, B, Ba, and C -It is an ocular infection that can lead to blindness if untreated, often spread through direct contact or contaminated surfaces.

Question 28

Lymphogranuloma Venereum (LGV)

Answer 28

-Caused by serovars L1, L2, and L3 -A sexually transmitted infection that affects lymph nodes and can lead to ulcers and inflammation in the genital area.

Question 29

Genital Infection

Answer 29

-Caused by serovars D-K, most commonly E, F, and D -These are the most common sexually transmitted C. trachomatis infections, leading to conditions like urethritis, cervicitis, and pelvic inflammatory disease.

Question 30

Incubation period for chlamydia?

Answer 30

1-3 weeks

Question 31

What disease is commonly comorbid with chlamydia?

Answer 31

Neisseria gonorrhoea; also increases your risk for acquisition of other STIS like HIV

Question 32

Which cells does chlamydia infect?

Answer 32

Columnar epithelial cells, increeasing the risk in young females beucase the cells extend further into the ectocervix. Cells recruit neutrophils to the region and lead to inflammatory response

Question 33

What can chlamydia lead to?

Answer 33

Ectopic pregnancies, women with PID can develop perihepatitis

Question 34

Describe the presentation of chlamydia in men?

Answer 34

-Itchy penis -Pain when peeing -Discharge -Pain or swelling in balls -Half of men have no symptoms

Question 35

Describe the presentation of chlamydia in women?

Answer 35

-Burning when peeing -Bleeding between periods -Increases in pain in intercourse or menstruatin -Abdominal or lower back pain -Fever and chills

Question 36

Describe the presentation of chlamydia in men and women?

Answer 36

Discharge, redness, painful BMs, itchiness

Question 37

Describe lab detection of chlamydia?

Answer 37

Swabs, insert 3-5mm into urethra, cannot send semen or purulent discharge Avoid cotton swabs. use Dacron or rayon (specific) Also test for Neeisseria gonorrhea Can collect from endocervix or cervic Send swabs for PCR of CT and NG

Question 38

Neisseria Gonorrhoea

Answer 38

Gram negative diplocooi Pathogenic Only host for organism is humans

Question 39

Where does a N.gonorrhoea infection take place in the body?

Answer 39

Infects the mucous membranes in the body (genital tract, rectum, pharynx, eyes)

Question 40

Describe pathogenesis of N.gonorrhoeae in women

Answer 40

Mucuous membrane of reproductvei tracr, cervix, fallopian tubes etc.. In men it travels along seminal vesicle, prostate and then urethral structures which impair male fertility

Question 41

Explain why there is a risk of infertility and ectopic pregnancy with gonorrhea

Answer 41

Pelvic inflammatory disease that can lead to internal abscesses, directly damaging the fallopian tubes

Question 42

(T/F) ejaculation must happen for gonorrhea to be transmitted?

Answer 42

False

Question 43

Describe the symptoms of gonorrhea

Answer 43

Complications from this infection can include variosus systems. -Colourful discharge -Pain -Burning when peeing -swelling -Swollen glands

Question 44

Desseminated gonococcal infection

Answer 44

Arthritis, endocarditis, meningitis

Question 45

How do people often present with gonorrhea?

Answer 45

Asymptomatic in 10% men, and 50% of women are also asymptomatic Cases resolve after a few weeks, but you should always seek treatment

Question 46

What is the current line of treatment and what phenomenon has followed gonorrhea?

Answer 46

Increasing resistance, now we use ceftiaxone and azithromycin (as of 2015)

Question 47

How do we diagnose N.Gonorrhea?

Answer 47

Sample anterior region of urethra 2cm and rotate, remove mucous plugging the cervix, Dacron and Rayon swabs Send for PCR and culture