Flashcards in Sexually Transmitted Diseases Deck (34):
1
Describe the common etiologies of STD 's
Who is at risk in particular?
• Most STD are viral or Bacterial (but protozoa, fungal, ectoparasites are all possible aetiologies
• Viral (recurring)
o Genitalia herpes, warts, aids
• Bacterial (exterminated)
o Syphilis, chlamydia infect
o Gonorrhea, chancroid
• Men vs Women
o Men: lesions more often external, more detectable
o Women: internal lesion, less detectable, larger surface area and probability of infection via sexual contact
2
What are the risks for STD's
• Multiple sex partners
• Unsafe/high risk sex practices
• Drug abuse
• Medically under served communities
• Prior STD’s
• Non compliant STD Tx
3
What is the difference between Type 1 and Type two Herpes
• Type II describes herpes simplex STD, Type I refers to basic cold sores. Both caused by same virus, but different strain
4
What cells or tissue does herpes prefer?
Virus is neurotropic microbe (prefers neurons)
5
How is the Herpes Virus Spread?
• Spread via contact with lesions (breaks or bursts) or secretions (mucous membrane active secretion e.g. cervix)
o Lesions include fluid and microbes described as a “shedding lesion”
6
What is the timeline for Herpes progression?
o 2-10 incubation
o Manifests 3-7days post contact
o However, can remain latent and subclinical
7
Describe the MNFTS and Tx of Herpes
• Manifestations
o Burning at site
o Painful vesicles
o Fever/muscle ache
• Tx
o No cure
o Recurrence major issue
o Antivirals for flare ups
8
What causes genital Warts?
Caused by HPV (Human papillomavirus)
Strains 6 and 11
9
Why is someone with genital warts also at risk for Cancer?
What specifically causes Ca in this case?
If person has one strain of HPV they are at risk (similar sexual risk behaviours) for other meaning treatment for genital warts needs to include monitoring for CA.
CA caused by strains 16 and 18
10
Describe Genital Warts in general terms.
Presentation, Location, incubation, Cure
• Normally causes multiple benign growths
o Cauliflower shaped (i.e. stalk and irregular top)
• Genital or anorectal are common areas
• 1-2 months incubation
• no cure
11
Describe Tx for Genital Warts
o Remove warts
• Topical meds sx or cryotherapy
• Topical includes antimitotic or cytotoxic drugs
o Monitor for CA
o Vaccine Available (covers 4 key strains)
• Gardasil- requires 3 shots, good for 5 years
12
What is the etiology of Syphillis
•Bacterial infection – Treponema Pallidum
(Part of spirocheter group known for spiral shape)
13
What are the complications of Syphillis if allowed to progress?
Why is it silly for this to happen?
Blindness, paralysis, heart disease and death
It's preventable and Treatable and will take time to progress to systemic infection that causes these complications
14
Syphillis timeline varies greatly.
Describe common incubation period and Stage one of the Disease
o 10-90 days incubation possible
o Stage 1
• Develops in weeks and clears up 3-12 weeks. Leads patient to believe it’s has gone.
• Painless chancre (small oval vesicles)
• Located at site of exposure
• Regional lymphadenopathy
15
Describe Stage 2 of Syphillis
o Stage 2
• Normally develops 6-8 weeks post infection and can last up to 6 months
• Maculopapular rash on palms and soles
• Patches on mucous membranes
• Flat papules
• Generalized lymphadenopathy
• Fever/malaise
• Eventually enters latent peiod
16
Describe Stage 3 of Syphillis
o Stage 3
• 1-35 years after untreated primary infections
• Irreversible damage to joints, bone, CVS and NS
17
What is the Tx for Syphillis
• Tx
o Long acting penicillin
• R/t long generation time
18
Describe Chlamydia
(Etiology, incubation, character)
• Caused by Chlamydia Trachomatis
o Tiny simple gram-Neg bacteria- difficult to isolate
• 7-21 days incubation
• Asymptomatic in most cases
• Obligate intracellular (i.e. must be inside cells)
19
Describe male vs female symptoms of chlamydia
Male
• White / clear discharge
• mild dysuria
• Testicular Pain
Female
• Mucopurulent vaginal discharge
• Dysuria
• Bleeding
• Pelvic pain (PID)
20
Tx for Chlamydia
• Doxycycline or azithromycin
Abx
21
Describe Gonorrhea
(Etiology, incubation and character)
• Caused by Gram-neg Bacteria Neisseria gonorrhea
o Short diplocauces
• 3-8days incubation
• Local progresses to systemic
22
Describe the Different Symptoms of Gonorrhea - Male vs Female
Female
• Purulent vaginal discharge
• Dysuria, genital irritation, late pelvic pain
Male
• Urethral discharge, dysuria
23
Describe symptoms of systemic Gonorrhea
Systemic (Both M and F)
• Bacteremia (AKA Septecemia)
• Pharyngeal infect, conjunctivitis (related to touching eyes)
• Arthritis-dermitis syndrome
o Infm of joints after bacterial invasion (called septic arthritis)
o Microbe can also cause dermal infections
24
Describe the Tx of Gonorrhea
• 1rst line – cephalosporins
• 2nd line- Inc dose and provide a second Abx
(Resistance is requiring inc in dosage)
25
Describe HIV
o Human immunodeficiency virus (HIV)
o Targets immune system
o INc immune suppression -> opportunistic infections, CA (how?)
o No cure
o Chronic, progressive
o HIV → AIDS
o Retroviruses (RNA synthesizes DNA and insert into host cell)
26
Describe reservoir and mode of transmission
o Et and Transmission HIV-1 and HIV-2
Reservoirs semen, blood, saliva
Transmission
• Sexual
• Contaminated blood
• Maternal (in utero, labor & delivery, lactation)
• Occupational (health workers) ~0.3% risk
o Needle stick most common (location, viral load)
27
Describe Phase 1 of HIV
o Weeks to months (incubation varies a lot)
o Window period & seroconversion)
• WP refers to time taken for enough Ab to be detected by a test (3 months) (time taken post contact to get results)
• Seroconversion- process by which AB are formed
o High viral load and Dec CD4 count
• CD4 are receptors on t helper cells
• T helper cells being destroyed
• Measure CD4 protein content (through test as a High viral load causes T cell number to be low
28
Describe the latent period of HIV
o Asymptomatic (years)
• Sub clinically damage is still occurring
o Lymphatic tissue damage
o Recurrent respiratory infections (compromised defenses)
o Fatigue
29
Describe phase 3 of HIV
o Within ~10yrs (new MNGMT means longer period)
o Targets T helper cells (CD4)
oAlso macrophages and B cells
o Destroys immune system -> dec immunity and defenses -> inc new infections and via latent pathogens
o Various organs affected
30
Describe 4 diagnostic for HIV Dx
• ELISA (old school test)
o Enzyme linked immunosorbant assay
o Enzymatic rx test for AB against virus ( 3months required)
• Western blot assay
o Measure Abs against specific Ag related to HIV
• PCR (Polymerase chain reaction)
o Complex, used in research laboratories
o Measuring viral RNA
• NEWER
1) P24-Ag (viral protein found in HIV)
• This protein is released to blood by virus, allows early detection
2) NAT (Nucleic acid test)
• Test CD4 and viral loads
31
MNFTS of HIV
• Many
• Opportunistic infections
• Respiratory (TB and Pneumonia)
• GI (infections)
• NS (dementia, encephalopathy)
o Encephalopathy is general term for diseases in brain not only liver issue we were talking about
• CA (Nothing to destroy abnormal cells, + CA related to viral infections that in turn cause CA)
32
What CA 's are associated with HIV
o Kaposi’s sarcoma (why sarcoma?)
• Endothelial cells of blood vessels
• Lesions go beyond vessel (skin, mouth, nodes)
o Non Hodgkin’s lymphoma
o Cervical
33
Tx for HIV
• No cure
• Antiviral Drugs (control proliferation)
o Cocktail combinations
o Different drugs target different step in virus reproduction
o Use several drugs, but side effects are an issue
o Referred to as retro antivirals
34