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Flashcards in STI/STD Deck (132)
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1
Q

Chain of Infection

A

Causative organism –> reservoir–>

portal of exit–>mode of transmission –> susceptible host–>mode of entry

2
Q

colonization

A

state when microorganisms are present without host interference or interaction

3
Q

Infection

A

Host interaction with an organism

4
Q

Infectious disease

A

State in which the infected host displays a decline in wellness due to the infection

5
Q

When C & S swab of a healthy person’s skin is + for a microorganism, the patient is infected? T or F

A

False

6
Q

How are STIs acquired

A

sexual contact

7
Q

Syphilis incubation period

A

10 days to 3 months

8
Q

Syphilis mode of transmission

A

Direct contact with infectious exudate (fluid)

9
Q

Is Syphilis for forever?

A

Yes. You can supress it but once you get it, you always have it.

10
Q

Is Syphilis an STD or STI?

A

Since you have it for forever it is an STD

11
Q

Syphillis is caused by what organism?

A

Spirochete Treponema pallidum

12
Q

Shyphillis medication of choice

A

Penicillin G Benzathine IM

13
Q

Primary syphilis occurs how long after initial inoculation?

A

2-3 weeks

14
Q

What happens during primary syphilis?

A

A lesion (chancre)appears at the site of infection & disapear within about 2 months if left untreated

15
Q

When does Secondary Syphilis occur?

A

when the hematogenous spread of organisms from the original chancre leads to generalized infection

16
Q

When does the rash appear during secondary syphilis & where is the rash loacted?

A

about 2-8 weeks after the chancre. Rash can be on palms of hands, soles of feet & extrmities

17
Q

What happens after the secondary stage of syphilis?

A

there is a period of latency (no s/s)

18
Q

Generalized signs of infection of syphilis?

A

lymphadenopathy, arthritis, meningitis, hair loss, fever, malaise & weight loss

19
Q

lymphadenopathy

A

abnormal enlargement of lymph nodes

20
Q

How can the latency period of syphilis be interrupted

A

by a recurrence of secondary syphilis

21
Q

Tertiary syphilis is what stage

A

the last stage in the natural progression of the disease. Some people do not exhibit s/s in this stage. dementia, stroke are most common

22
Q

Can the tertiary syphilis affect other organs?

A

Yes. this stage presents as a slow progressive inflammatory disease

23
Q

What is done to test for syphilis during the primary stage?

A

direct identification of the spirochete from the chancre lesions

24
Q

What is done to test for syphilis during the Secondary & Tertiary stage

A

Serologic tests. Venereal Disease Research Laboratory (VDRL) & Rapid plasma reagin circle card test (RPR-CT)

25
Q

When does the spirochete cross the placenta in congenital syphilis

A

After 18 weeks the spirochete cross the placenta barrier

26
Q

How is mom tested for syphilis when shes pregnant?

A

Venereal Disease Research Laboratory (VDRL) & Rapid plasma reagin circle card test (RPR-CT), or Automated reagin test (ART)

27
Q

What is the Fluorescent treponemal antibody-absorption test (FTA-ABS) used for

A

Used to verify that the syphillis screening did not represent a false-positive

28
Q

Symptoms of congenital syphilis

A

stillborn (if its a severe infection), lesions on umbilical cord, nasal passages, copper colored rash after one week of age, possible severe rhinitis, growth plate changes @ 1-3 months of age, pegged or notched teeth, eye scarring or blindness, severe neurological symptoms

29
Q

Where will a cooper rash develop on a child born with syphilis? & what else might appear?

A

Rash will be prominent over face, soles of feet & palms of hands. Bullous lesions can appear on palms & soles

30
Q

What is rhinitis?

A

inflammation or irritation of the nasal passages, resulting in runny nose, nasal congestion, & postnasal drainage

31
Q

If mom is tested + for syhilis by a VDRL, the newborn gets what at birth?

A

Penicillin

32
Q

If a patient who has syphilis is allergic to Penicillin G Benzathine, what do they get instead?

A

Doxycyline PO BID for 14 days

33
Q

Gonorrhea incubation period

A

2-7 days

34
Q

Gonorrhea mode of transmission

A

Contact with mucous membrance of infected people

35
Q

Gonorrhea symptoms in females

A

Purulent cervical discharge, asymptomatic, UTIs, vaginitis

36
Q

Gonorrhea symptoms in males

A

Purulent discharge from urethra, burning during urination, painful swollen testicles

37
Q

Gonorrhea symptoms in rectal infection

A

asymptomatic, pruritis (itching), tenesmus (involuntary straining), discharge

38
Q

Tenesmus

A

involuntary straining

39
Q

pruritis

A

itching

40
Q

Gonorrhea & Chlamydia are both bacterial or viral infections?

A

Bacterial

41
Q

Gonorrhea discharge color?

A

white

42
Q

Chlamydia discharge color?

A

clear

43
Q

Can Chlamydia & Gonorrhea be transmitted from mother to child at birth?

A

yes

44
Q

Chlamydia s/s in females

A

Purulent cervical discharge, asymptomatic

45
Q

Chlamydia s/s in males

A

Purulent discharge from urethra, burning during urination ,

46
Q

Complications with Chlamydia & Gonorrhea

A

PID, ectopic pregnancy, endometritis & infertility

47
Q

Causative agent of chlamydia

A

Chlamydia trachomatis

48
Q

Causative agent of gonorrhea

A

Neisseria gonorrhoeae

49
Q

Target group for preventive patient teaching about gonorrhea & chlamydia?

A

adolescent & young adult population. Usually occurs with first sexaul experience

50
Q

NAAT (Nucleic Acid Amplification test) is for what?

A

A used for chlamydia. They are for chlamydia-specific antibodies

51
Q

Antibiotics for Chlamydia

A

Azithromycin or doxycycline

52
Q

Antibiotic for Gonorrhea

A

Rocephin or Suprax Pellico pg 974

53
Q

When can a patient have sex again with chlamydia/gonorrhea?

A

No sex until treated & cured

54
Q

When are women tested again for Chlamydia?

A

3-4 months afterward

55
Q

Vaginits

A

Inflammation of vaginal epithelium

56
Q

S/S of vaginits

A

itching, reddish irritation, white, cheese-like discharge clinging to epithelium,

57
Q

Lactobacillus

A

healthy bacteria that live in vagina. They maintain normal vaginal ph

58
Q

What decrease lactonacilus?

A

Antibiotics, oral contraceptives, menopause, spermicides, diabetes

59
Q

Is vaginits an STD or STI?

A

neither. It can coexist with STI’s but not considered an STI by itself

60
Q

Vaginits is caused by

A

Candida albicans, Trichomonas, Bacterial Vaginosis (BV)

61
Q

Candidiasis incubation period

A

variable

62
Q

Candidiasis s/s

A

cottage-cheese like discharge, odorless, burning inflammation, pruritis, increased symptoms before or during menstrual cycle

63
Q

Candidiasis treatment

A

Diflucan (Fluconazole) 150mg x1, Clotrimazole or miconazole vaginal cream 3-7 day treatment

64
Q

Diflucan (Fluconazole) 150mg x1, Clotrimazole or miconazole vaginal cream 3-7 day treatment is used for?

A

Candidiasis

65
Q

Trichomoniasis incubation period

A

4-20 days

66
Q

Trichomoniasis s/s

A

may be asymptomatic, itching, inflammation, bubbly gray or yellow discharge,strawberry spot on vaginal wall

67
Q

Trichomoniasis treatment

A

Metrodiazole (Flagyl) 2 Gm PO single dose or Metrodiazole (Flagyl) 500 mg BID for 7 days

68
Q

Trichomonas vaginalis is a

A

flagellated protozoan

69
Q

What kind of membrance does a trichimonasis have & what shape is the organism?

A

undulating membrance with a pyriform shape

70
Q

How is a patient tested for trichimonasis

A

microscopic detection

71
Q

trichimonasis causative organism

A

Trichomonas vaginalis

72
Q

Trichimonasis transmission

A

almost exclusively sexually transmitted

73
Q

Where is Trichomoniasis found in women?

A

Vagina, urethra & paraurethral glands

74
Q

Where is Trichomoniasis found in men?

A

urethra

75
Q

Bacterial Vaginosis (BV) mode of transmission

A

controversial whether sexually transmitted

76
Q

BV s/s

A

fishy odor (positive whiff test), grayish or milky discharge

77
Q

How is BV diagnosed

A

by positive clue cells on wet mount

78
Q

BV causative agent

A

overgrowth of anaerobic bacteria & Garnerella vaginalis with an absence of lactobacilli

79
Q

BV risk factors

A

douching after menses, smoking, multiple sex partners, other STIs

80
Q

BV treatment

A

Flagly 500mg BID for 7 days or Clindamycin (Cleocin) cream or 300mg TID for 7 days, Augmentin 500mg TID for 7 days. If pregnant: Flagly 250mg TID for 7 days

81
Q

Flagly, Clindamycin (Cleocin) & Augmentin are used to treat?

A

BV

82
Q

Is BV and STI or STD?

A

BV is not considered an STI exclusively but is associated with sexual activity

83
Q

Special instructions when taking flagly

A

avoid alcohol during and for 24 hrs after treatment to prevent significant GI upset

84
Q

BV complications

A

premature labor, endometritis, PID, recurrant UTIs

85
Q

Herpes causative agent

A

Herpes simplex virus (HSV) type 1 & 2

86
Q

Herpes mode of transmission

A

baginal, oral or anal sex. Transmitted by open sores or skin surface covered with HSV

87
Q

Herpes incubation period

A

2-12 days

88
Q

Herpes patient profile

A

age 14-49 yrs old. 1 out of 6 people in the US

89
Q

Testing for Herpes

A

Culture sores or if there are no symptoms, a blood test is taken for IgG antibodies

90
Q

Herpes treatment

A

Acyclovir. taken daily to supress infection or Famciclovir, Valacycovir

THINK: meds ending in “vir” =viral infection

91
Q

Acyclovir

A

antiviral medication

92
Q

Herpes teaching

A

no sex during outbreak, use a condom everytime

93
Q

untreated herpes in babies leads to

A

permanent CNS damage, mental retardation, or death

94
Q

HSV-1 transmission

A

transmitted to the genitalia by oral sex or self-inoculation (touching a cold sore then touching the genital area

95
Q

Sexually transmitted infections in the US per year. (highest to lowest)

A

Chlamydia, Herpes, HIV

96
Q

HIV transmission

A

blood-borne, sexually , thru breast milk

97
Q

what precautions do you use with an HIV patient?

A

Standard precautions

98
Q

Does HIV carry its own RNA or DNA?

A

RNA

99
Q

retrovirus

A

viruses that carry their genetic material in the form of RNA rather than DNA. HIV is a retrovirus

100
Q

HIV pathophysiology

A

HIV binds to T-cell (CD4+ cell), RNA is released into cell, reverse transcription converts RNA to DNA, Viral DNA enters T-cell’s nucleus & inserts itself into T-cell DNA, T-cell makes copies of HIV components and are released from the cell

101
Q

HIV tests

A

Antibody test: emzyme immunoassay (EIA) test, Western blot test, Viral load tests

102
Q

Stage 1) Primary HIV infection

A

intense viral replication, window period occurs (HIV infected patients can test negative on the HIV antibody blood test. (Thats why you have to get tested more than once if you think you might have HIV)

103
Q

Stage 2) HIV asymptomatic

A

by about 6 months, the rate of viral infection reaches a lower but relatively steady state

104
Q

Stage 3) HIV symptomatic

A

of t-cells gradually falls

105
Q

Stage 4)AIDS

A

T-cell level drops below 200 cells/mm3

106
Q

A persons stage of HIV infection is based on what?

A

Based on symptoms AND T-cell levels

107
Q

Viral load tests measure

A

HIV RNA levels

108
Q

IF you have HIV antibodies are you immune?

A

No. HIV antibodies do not indicate immunity

109
Q

Kaposi’s sarcoma

A

HIV-related malignancy. Leasions on skin

110
Q

Wasting syndrome

A

wasting of whole body. Manifestation of HIV

111
Q

Manifestations of HIV (Common infections with HIV)

A

TB, PCP, loss of appetite, oral & esophageal candidiasis, chronic diarrhea, t-cell lymphomas, HIV encephalopathy, CMV, Immune reconstitution inflammatory syndrome (IRIS)

112
Q

HIV encephalopathy

A

progressive decline in cognative, behavioral & motor functions

113
Q

HIV Gynecologic manifestations occur how often?

A

often. recurrent vaginal candidiasis or BV may be first sign of HIV

114
Q

HIV Treatment is based on what?

A

s/s, viral load test, T-cell counts, & willingness of participation

115
Q

Effective antiretroviral regimens contain at least ____ virologically active meds from at least ____ classes

A

three, two. That way Dr. can figure out effects

116
Q

What is most important when on treatment for HIV

A

Strict adherence to the regimen is vital

117
Q

What is considered when doing HIV treatment?

A

side effects & drug resistance

118
Q

Pneumocystic Pneumonia (PCP) in HIV patients is treated with

A

TMP-SMZ (Bactrim, Septra)

119
Q

Cytomegalovirus (CMV)

A

fluffy-yellow-white retinal leasions. Manifestation of HIV

120
Q

Cytomegalovirus (CMV) is treated with

A

various antiviral agents

121
Q

Kaposi’s sarcoma treatment successful?

A

No one treatment has been shown to increase survival

122
Q

Mycrobacterium avium complex (MAC) treated with

A

clarithromycin(biaxin) or azithromycin (Zithromax)

123
Q

condylomata

A

genital warts

124
Q

what stains of HPV cause genital warts?

A

HPV 6 & 11

125
Q

Which strains affect the cerfix

A

HPV 16, 18, 31,33 &45

126
Q

How do we detect HPV?

A

pap smear

127
Q

What does HPV effect?

A

cervix

128
Q

When is the HPV vaccine recommend for males & females

A

before onset of sexual activity Ages 9-26 yrs old

129
Q

Treatment of HPV

A

Topical agents:Trichloroacetic acid, podophyllin, chemotherapeutic agents; Injections: interferons; electrocautery (used with large areas)

130
Q

HPV transmission

A

sexual intercourse, can be transmited by skin to skin

131
Q

HPV vaccine for girls protects against how many strains?

A

4

132
Q

Males are vaccinated with quadrivalent HPV to prevent what

A

genital warts