True or false.
Some STI’s can cross the placenta causing teratogenic affects on the fetus.
True
What is caused by HSV-1 and HSV-2?
Herpes Simplex Virus
What is HSV-1?
Cold sores in mouth that can be transmitted through oral sex
What is HSV-2?
Sores/lesions in genital areas transmitted sexually or through child birth
If a pregnant mother has active sores/lesions what kind of delivery do they have?
C-Section
How is HSV transmitted?
Direct contact w/ infected lesions
Transmission is greatest if?
Lesions are active
HSV can be asymptomatic bc they’re dormant from what?
Neurotropic- grows in neurons
How long can ulcers last from HSV if they pop and spread from the highly contagious virus from the liquid/pus?
Up to 6wks
The 1st occurrence of HSV is known as what?
1st outbreak
How long can the 1st outbreak last for?
Up to 12 days
Any other reoccurring outbreaks after the 1st one is called what?
Prodromal symptoms
How long can prodromal symptoms last for?
Up to 4-5 days and is less severe
What is the periods before or b/t episodes that are still infectious, but are asymptomatic?
Latency phase
What are s/s of HSV?
Painful red papules w/ small blisters of clear liquid
What are prodromal symptoms?
Itching burning, tingling, throbbing @ lesion site (legs, groin, butt)
What can happen to the fetus if a child bearing mother has HSV?
Miscarriage, PTL, IUGR
What 3 medications are used to treat HSV, not to cure it but to prevent a breakout of herpes sores or blisters?
Aciclovir, famciclovir, valaciclovir (Valtrex)
What HSV med has N/V as a side effect?
Aciclovir
What HSV med is given during pregnancy to keep the pt. in latency phase of HSV?
Valaciclovir (Valtrex)
What is caused by spirochete treponema pallidum that can infect any tissue body organ?
Syphilis
What is spirochete treponema pallidum highly susceptible to, but can survive in what for days?
Heat dry surfaces, fluids
How is syphilis transmitted?
Any break in skin and lymphatic system and through blood from sex
How long is the incubation period of syphilis?
10-90days (average 21 days)
How is congenital syphilis transferred to the fetus?
Through placental circulation (blood stream)
What stage of syphilis has little to no pain but is HIGHLY CONTAGIOUS/INFECTIOUS?
Primary stage
In primary stage of syphilis what are the s/s?
Chancre (Warning sign) and regional enlargement of lymph nodes
Where do the sores/lesions of syphilis appear at?
Genitals, rectum, mouth, and breast (@ site where contacted)
What are the s/s of early primary stage?
Macule/papule erode
What are the s/s of late primary stage?
Clean based, painless, indurated ulcer w/ smooth firm borders
When do s/s of primary stage syphilis usually resolve?
4-6wks
When does secondary stage of syphilis occur?
Usually any time after primary ends, 2wks-6mon after chancre disappears
What are s/s of secondary syphilis?
Whole body skin rash (especially palms/soles), mucous patches (highly contagious when broken), sore throat, generalized lymphadenopathy (Condylomata lata) HIGHLY INFECTIOUS
When do s/s of secondary stage syphilis resolve?
2-6wks
What stage of syphilis may not occur but if it does occur it’s usually 2+ years after initial infection and can last up to 50yrs?
Latent/Tertiary stage
Latent/Tertiary stage is not transmitted through what, but instead is transmitted through what?
Sex; Blood
In presence of HIV how is the progression of syphilis?
More rapid
Other than measuring antibody production what 2 blood lab tests are done in every pregnant woman to diagnose syphilis?
Venereal Disease Research Laboratory (VDRL) and Rapid Plasma Reagin (RPR)
What is the treatment for syphilis?
Penicillin G, single dose IM, and doxycycline, or tetracycline
What is caused by chlamydia trachomatis?
Chlamydia
Chlamydia trachomatis only reproduces w/in what?
The host cell
How is chlamydia spread?
Sexual contact or baby birth canal if vaginal
If chlamydia is not asymptomatic what are the s/s?
White, watery vaginal discharge and may/may not itch
What does chlamydia affect?
Mom and baby’s reproductive system
If chlamydia is not treated where does it go?
Upper reproductive tract causing complications of Pelvic Inflam. Disease (PID)
What can PID cause?
Endometritis
How is chlamydia diagnosed?
Gram stain discharge from endocervix or urethra and direct fluorescent antibody (DFA)
How is chlamydia treated?
Single dose of Azithromycin (Zithromax), PO meds for 7days like doxycycline for 7-14days BID
What is caused by the gram negative diplococcus Neisseria Gonorrhoeae?
Gonorrhea, the “clap”
What type of bacteria is Neisseria Gonhorrhoeae that can cause purulent exudate?
Pyogenic pus forming bacteria
How is gonorrhea transmitted?
hetero/homosexual intercourse or vaginal delivery
What are the s/s in men for gonorrhea?
Dysuria and serous, milky, purulent discharge
What are the s/s in women for gonorrhea?
Dysuria, urinary frequency, and abnormal menses
What can gonorrhea cause in men?
Epididymitis
What is epididymitis?
Painful testicles from inflam of tube at back of testicle
What can gonorrhea cause in women?
Infetility
What is the treatment for gonorrhea?
Antibiotics after swab of drip like cefttriaxone PO or PO erythromycin
What is caused by the human papillomavirus?
Genital warts
Why are women at greater risk for genital warts?
Bc have bigger mucous area
How is genital warts transmitted?
Vaginal, anal, or oral-genital contact
How long is the incubation period for genital warts?
6wks-8mon
True or false.
Genital warts are chronic, asymptomatic and incurable.
True
What type of genital wart have cauliflower shaped lesions?
Condylomata acuminata
What type of genital warts have thick hard lesions?
Keratotic warts
What type of genital warts have smooth lesions?
Papular warts
What type of genital warts have slightly raised lesions that are invisible to the naked eye?
Flat warts
How is genital warts diagnoses?
HPV DNA test and clinical appearance
How is genital warts treated?
Removal of warts, relief of s/s, health teaching to prevent reoccurrence
What type of meds are used for genital warts?
Topical agents: Podofilox, Imiquimod, Podophyllin, and trichloroacetic acid
What topical agent is contraindicated during pregnancy bc it can cause N/V, diarrhea and coma?
Podophyllin
What vaccine is given to prevent genital warts/HPV infection?
Gardasil
What procedures are done to remove the warts?
Cryotherapy, electrocautery, laser, surgical excision
What bacterial infection is often carried in the intestines and lower genital tract?
Streptococcus B-Hemolytic (Group B Strep-GBS)
How can Streptococcus B-Hemolytic be passed on to the infant?
During labor causing serious complications
How is streptococcus B-hemolytic diagnosed?
Vaginal and rectal swab ay 36-37wks gestation
If GBS is positive what is done?
Penicillin given 4hrs prior to delivery for less transmission to baby
