STDs

Question 1

STI vs STD

Answer 1

STI: infections from sexual contact and microorganisms, most readily cured
STD: conditions that cannot be readily cured

Question 2

viral STD/Is

Answer 2

HPV

herpes simplex virus 1 & 2

Question 3

bacterial STD/I

Answer 3

vaginosis
epididymitis
chlamydia
gonorrhea
syphilis
pelvic inflammatory disease

Question 4

parasites STD/Is

Answer 4

trichomoniasis

pediculosis pubis

Question 5

HPV

Answer 5

most prevalent
high risk (16,18,31,33,45,52,58) vs low risk (usually warts) 6,11
s/s: most asymptmatic vs genital warts (16/18)

Question 6

HPV TX

Answer 6

prevention: vaccine
.5% podophyllotoxin solution/gel appliced twice daily for 3 days followed by 4 days w/out 
imiquimod 5% cream
cryotherapy
liquid nitrogen

Question 7

herpes simplex virus types

Answer 7

orofacial: pain/burning>papule>vesicle
genital: pain/fever/malaise>vesicles
primary: painful, erythema/vesicles/lmphadenopathy
secondary&recurring: not as painful/extensive
neonatal: encephalitis/blindness/high-mortality

Question 8

chlamydia

Answer 8

caused by chlamydia trachomatis
high rate at birth transmission (causes pneumonia/conjuncitivits)
most common and usually ofund w/ gonorrhea
in columnar epithelial cells

Question 9

chlamydia s/s

Answer 9

usually asymptomatic

males: dysuria/yellow urethral drainage
females: vaginal discharge, abn vaginal bleeding, dysuria, painful intercourse

Question 10

chalmydia complications

Answer 10

women: pelvic inflam disease, infertility ectopic pregnancy
men: reiter syndrome (conjuncitivitis/urethritis/arthritis)
neonate: conjunctivitis

Question 11

chlamydia DX & TX

Answer 11

urine, vaginal/urethra swabs

TX: azithromycin or doxycycline

Question 12

gonorrhea

Answer 12

can also attach to sperm

Question 13

gonorrhea s/s

Answer 13

can be asymp

males: dysuria, purulent penile discharge, can more to prostate/epididiymis
females: dysuria, purulent vaginal discharge, painful intercourse, can move to fallopian tubes (infertility)

Question 14

gonorrhea can

Answer 14

invade bloodstream and become systematic

Question 15

gonorrhea DX & TX

Answer 15

nucleic acid amplified swab, urine, swabs

all partners treated, IM ceftriaxone and PO azithromycin

Question 16

syphilis

Answer 16

treponema pallidium
spirochets rapidly disseminate systemically to blood& lymphatics
incubation about 3 weeks
w/out treatment: primary, secondary, latent, tertiay stages > death
can be transmitted across placenta
during incubation spirochetes penetrate CNS = inflammatory response

Question 17

syphilis primary s/s

Answer 17

lesion or chancre (painless)
reginal lymphadenopathy
lesions disappears around 3 months w/ or w/out treatment and may go unnoticed

Question 18

syphilis secondary s/s

Answer 18

alopecia
fever
arthralgia
lymphadenopathy
rash (soles of feet/hands of palms)

Question 19

syphilis tertiary s/s

Answer 19

damage of arterial lining & nervous system 
impacts brain, meninges, spinal cord
multiple organ lesions (gummas)
aortic aneurysm
meningitis
confusion
visual disturbances
hearing loss

Question 20

syphilis DX and TX

Answer 20

VDRL, RPR, treponema pallidum antibody IgG

TX: all partners, IM penicilin (or cephalosporin & erythromycin)

Question 21

syphilis congenital

Answer 21

late abortion/stillbirth

infantile: rash/osteochonritis, periositis, liver/lung fibrosis
childhood: interstitial keratisis, hutchinson teeth, eighth nerve deafness

Question 22

trichomoniasis

Answer 22

increased risk for devloping HIV

usually w/ other STIs

Question 23

tichomoniasis s/s

Answer 23

usually asym
female: vulvar itching, burning, soreness, redness, frothy white, gray-green/yellow discharge, musty/fish smelling discharge, dysuria, dysparenuia
strawberry cervix: cervical petechia/friable cervix
males: purulent discharge, dysuria, testicular pain, lower ab pain

Question 24

trichomoniasis DX & TX

Answer 24

microscopy, pH testing

oral metronidazole

Question 25

pediculosis pubis

Answer 25

pthirus pubis
crabs/pubic lice
lives outside body (ectoparasite)
female lays 3-6 eggs daily 
nits (eggs) attach to hair shafts or clothing fibers

Question 26

pediculosis pubis s/s

Answer 26

pruritus
excoriation from itching
maculae ceruleae: bluish-gray macule on skin from louse bite

Question 27

pediculosis pubis DX & TX

Answer 27

microscope
permethrin (1%) lotion, second treatment 9 days after first to kill new nits, all clothing/linen washed in hot water, if can’t be washed: throw away/freezer for 2 weeks

Question 28

pelvic inflammatory disease

Answer 28

infection ascends thru uterus to Fallopian tubes & ovary

Question 29

PID s/s

Answer 29

inflammation causes: 
pain in lower ab/back/cervix
purulent drainage
fever
increased WBC
increased C-reactive protein

Question 30

PID DX & TX

Answer 30

gyn exam > cervical motion tenderness

TX for gonorrhea & chlamydia