IB 140 Lec 9 STI's MT II

Card Set Information

Author:
jeannette_ruiz
ID:
12670
Filename:
IB 140 Lec 9 STI's MT II
Updated:
2010-04-01 03:00:04
Tags:
IB 140 Lec 9 STI\'s MT II
Folders:

Description:
IB 140 Lec 9 STI's MT II
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user jeannette_ruiz on FreezingBlue Flashcards. What would you like to do?


  1. Sexually transmitted infections (STIs)
    • • Infections transmitted from one person to another during coitus or other genital contact
    • • Also referred to as sexually transmitted diseases (STDs)
    • • In past these infections were commonly referred to as venereal diseases, after Venus, the Goddess of Love
  2. Sexually transmitted infections (STIs) STATISTICS
    • 25% of Americans between the ages of 15 and 55 will acquire some form of STI

    • Over 15 million Americans acquire an STI each year
  3. Transition Zones for Organisms causing STI's
    • Organisms causing STIs typically require moist membranes of transition zones

    • Transition zones occur at the openings between external and internal body surfaces:
    • • Female: vulva, vagina, urethra
    • • Male: penis and urethra
    • • Both sexes: mouth, oral cavity, throat,eyes, and anus
  4. Vaginal Environment

    • Different bacteria, fungi, and protozoa are part of the normal vaginal microbial ecology and contribute to maintaining a healthy normal vaginal microbial environment
    • • Under the influence of estrogen, cells of the vaginal epithelium accumulate large amounts of
    • glycogen

    • • As these glycogen-rich cells slough off into the vaginal cavity, certain commensal bacteria
    • metabolize the glycogen to lactic acid, which makes the vaginal environment acidic

    • The acidic environment retards Candida yeast fungal overgrowth

    • • Certain antibiotics kill these beneficial bacteria which results in the vaginal environment
    • becoming basic which supports the development of Candida yeast vaginitis infections
  5. There is 6 Types of Sexually Transmitted Infections:
    • • Viral
    • • Bacterial
    • • Fungal
    • • Protozoan
    • • Lice
    • • Scabies
  6. viral
    • Human papilloma virus (genital warts)
    • Herpes simplex virus Type 2 (herpes
    genitalis)
    • Human immunodeficiency virus (HIV)
    • Hepatitis B virus
    • Hepatitis C virus
    • Molluscum contagiosum
    bacterial
    • Chlamydia trachomatis
    • Neisseria gonorrhoeae
    • Treponema pallidum (syphilis)
    • Ureaplasma urealyticum (urethritis)
    • Haemophilus ducreyi (chancroid)
    • Haemophilus vaginalis (vaginitis & urethritis)
    • Calymmatobacterium granulomatous (granuloma inguinale)
    • • Fungal:
    • Candidal albicans (monilia vaginitis)
    • • Protozoan:
    • Trichomonas vaginalis (vaginitis) see Fig 18-3
    • • Crab lice:
    • Phthirus pubis (Pediculosis pubis) (Fig 18-4)
    • • Scabies:
    • Sarcoptes scabiei
  7. Trichomonas vaginalis
    • Flagellate protozoan transmitted during coitus
    • • Vaginitis with frothy, odorous discharge that develops 4 - 28 days post exposure
    • • Vulva, cervix, urethra, and bladder may also become inflamed
    • • Most men are asymptomatic, but may develop urethritis or cystitis
    • Diagnosis by microscope (Fig 18-3)
    • Treatment with single dose of metronidazole
  8. What is Chlamydia? STATS
    • Chlamydia trachomatis is a group of small bacteria transmitted by coitus
    • Incubation period is 7 - 28 days
    • • 50% of infected men are asymptomatic
    • • 75% of infected women are asymptomatic
    • Nearly half of Chlamydia cases in women in the USA occur in adolescents ages 15-19
  9. Chlamydia can.....
    • Can cause urethritis in both men and women resulting in yellow discharge from the urethra

    • Can be transmitted to eyes of a newborn if present in vaginal canal during delivery

    • The infection can lead to conjunctivitis and pneumonia in the newborn infant

    • Newborns’ eyes are routinely treated with topical antibiotic e.g., erythromycin or silver nitrate
  10. Chlamydia in women
    • • Cervix is main site of infection in females which can cause yellow vaginal discharge
    • • The cervix, vagina, urethra, and vulva can become reddened and irritated
    • • Salpingitis (oviduct inflammation) can lead to scarring and blockage of the oviducts which can cause infertility in women
    • • Pelvic inflammatory disease can also occur in women
  11. Chlamydia diagnosis & treatment Diagnosis
    • • Urine (first stream) is collected and PCR evaluation detects genetic material from Chlamydia
    • • Culture of purulent material
    • Treatment:
    • • Azithromycin by mouth
    • • Doxycycline by mouth
  12. Gonorrhea
    • • Neisseria gonorrhoea is the gram negative, diplococcus bacteria that causes this STI
    • • Transmitted during homosexual and heterosexual coitus
    • • Thrive in moist membranes of the urogenital tract, mouth, oral cavity, anus, and eyes
    • • In USA most new cases are in 15-29 year old group
    • Incidence is especially high in two groups:
    • • Sexually active individuals under age 24
    • • Men who have sex with men (MSM)
  13. Gonorrhea in MEN
    • 70-90% of men infected with gonorrhea develop symptoms
    • Purulent discharge from the urethra
    • Redness of glans and penis
    • Urethritis: urethral inflammation
    • Prostatitis: prostate inflammation
    • Epididymiditis: epididymides inflammation
    • Orchitis: testes inflammation
  14. Gonorrhea in females
    and Complications
    75% are asymptomatic Symptomatic females develop whitish, yellowish, or greenish

    • discharge from:
    • • vagina (vaginitis)
    • • cervix (cervicitis)
    • • urethra (urethritis)
    • • bladder (cystitis)

    • Complications in females include:
    • Endometritis: uterine infection
    • Salpingitis: inflammation and infection of oviducts which can cause scarring of tissue leading to infertility because of oviduct blockage
    • Pelvic inflammatory disease: general infection of pelvic tissues
  15. Gonorrhea and Oral Sex
    • Oral sex can lead to infection of pharynx (throat) with gonococcus
  16. Gonorrhea in pregnancy
    • • If transmitted across placenta to fetus in the first trimester, there is an increased risk of miss-carriage
    • • When present in the birth canal, can infect newborns eyes on delivery
    • • Newborns’ eyes are routinely treated with topical antibiotic e.g., erythromycin or silver nitrate
  17. Gonorrhea diagnosis & treatment
    • Diagnosis
    • • Urine (first stream) is collected and PCR evaluation detects genetic material from gonococcus
    • • Culture of purulent material
    • • Swab of throat or rectum
    • Treatment:
    • • Ceftriaxone injection
    • • Doxycycline by mouth
  18. Syphilis
    Has Primary,Secondary,Latent,Tertiary,and Congenital Stages
    • • Treponema pallidum is spirocete bacterium
    • • Thrives in moist regions of body
    • • 90% of syphilis is transmitted by sex
    • • Also can be transmitted into an open sore on the skin

    • • Number of syphilis cases in USA population has increased each year between 1999-2006
    • • In 2006, 60% of the new cases in the USA were in Gay men
    • • In 1998, 5% of the new cases in the USA were in Gay men
  19. Syphilis: Primary stage
    • Chancre sore develops at site where syphilis entered the body
    • • These painless chancres are 0.5-1.0 inches in diameter, with hard edge and soft center
    • • In males occur on glans or corona of penis
    • • In females occur on vulva, cervix, or vaginal wall
    • • Oral coitus can result in sores on lips, tongue or throat
    • • Chancres appear 10 - 90 days after entrance of microbe and lasts for 1 - 5 weeks
    • • On resolution of chancre, primary stage is over
    • • Person is contagious during primary stage
  20. Syphilis: Secondary stage
    • • Develops 2-6 weeks after the primary stage
    • • Rash develops on upper body, upperextremities, and other areas of skin
    • • Rash is painless and not itchy
    • • Other symptoms include hair loss, sorethroat, swollen lymph nodes, painful joints,and poor appetite• Secondary stage goes away in
    • 2-6 weeks,but may recur over next two years
    • • Person is contagious during secondarystage
  21. Syphilis: latent stage
    • • Can last for years and person will have no or few symptoms
    • • Half of the patients who enter the latent phase, never progress on to tertiary phase
    • • People in latent stage are not contagious, except for pregnant women who can transmit to fetus
  22. Syphilis: tertiary stage
    • • Tertiary phase develops as microbe invades tissues throughout the body and develop large tumor-like(gummas) in skin, muscle,
    • intestines,liver, lungs, heart, and endocrineglands, eyes, brain, & spinal cord
    • • People in tertiary stages are not contagious, except for pregnant women who can transmit to fetus
    • • Tertiary cardiovascular syphilisdevelops 10 - 40 years after infectionresulting in infection of the heart andblood vessels which can be fatal
    • • Tertiary neurosyphilis develops 10 -20 years after infection when thecentral nervous system (brain & spinalcord) are infected; these people candevelop blindness, paralysis,dementia, psychosis, and death
  23. Syphilis: congenital
    • • Infected pregnant women in all stages of syphilis can pass syphilis on to their fetuses in the 3rd trimester of pregnancy
    • • 30% of these fetuses miscarry
    • • 70% are born with congenital syphilis andare contagious in 1st and 2nd years of life
    • • If untreated, over 20% will go on to developtertiary syphilis in 10 - 20 years
    • • Congenital syphilis includes blindness,deafness, flattening of the bridge of thenose, & notched central incisor teeth
  24. Syphilis: diagnosis & treatment
    • Diagnosis:
    • • VDRL and RPR blood tests
    • Treatment
    • :• Benzathine Penicillin G injected
    • • Tetracycline
    • • Erythromycin
  25. Human papilloma virus (HPV)
    • • Of 100 types of HPV, over 40 types aresexually transmitted
    • • Female tissues that may be infected: vulva,perineum, labia, cervix
    • • Male tissues that may be infected: prepuce,glans, coronal ridge, urethra, and scrotum
    • • 20 million Americans are infected with HPV
    • • Half of these 20 million infections are among adolescents and young adults,ages 15-24 years
    • • 20% of sexually active 14 - 18 year old females have this virus
    • • Most sexually active adults becomeinfected with HPV at some time in life
    • • Of the more than 40 types of HPV that infecthuman mucosal surfaces, most infections areasymptomatic and transient
    • • Many people who get infected with HPV will nothave any symptoms and the infection clears on itsown
    • • HOWEVER, certain oncogenic types can causecervical cancer, or less often, anogenital cancerincluding cancers of the anus, penis, and vulva
    • • Other, non-oncogenic HPV types can causegenital warts,
    • • Certain types of human papilloma virus(HPV) causes genital warts =Condyloma acuminata
    • • Soft cauliflower like warts appear 3weeks to 8 months after exposure tocertain types of HPV (e.g., HPV-6, 11,42, 43, & 44)
    • • About 1% of sexually active men andwomen in the USA have genital warts at any given time
  26. Human papilloma virus (HPV) & cervical cancer
    • • Strong association between infection with certaintypes of papilloma virus and development ofcervical cancer
    • • Of 100 types of HPV, over 40 types are sexuallytransmitted and four of the types are known to beassociated with development of cervical cancer(HPV-16, 18, 31, 45)
    • •95% of women with cervical cancer have one ormore types of HPV
    • •Association of the HPV virus and anal cancer inmen who have sex with men
  27. Human papilloma virus (HPV)diagnosis, treatment, & prevention
    • Prevention:
    • HPV vaccine recommended to be given as earlyas 9 years of age to prevent HPV, if the female is going to be a sexually active
    • teen
    • Diagnosis:
    • antibody tests for HPV types
    • Pap smear of cervix to rule out development of cancer
    • Treatment:
    • Podophyllin: antimitotic agent
    • Imiquimod: immunosuppressant
  28. HPV vaccine
    • • Quadrivalent HPV vaccine (Gardasil) for the prevention (and not treatment) of 4 different types of HPV
    • • Protects against HPV 16 & 18, whichcause 70% of cervical cancers• Protects against HPV 6 & 11, whichcause 90% of genital warts
    • Three dose vaccine recommended for females 9 - 26 years
  29. Herpes simplex Type 2 virus
    • Infection results in retention of the virus innerve fibers for life
    • •Mainly infects genital area, but can occur within oral cavity from oral sex
    • • Typically is transmitted from a person who has an active lesion, however, can be transmitted form a person who has no obvious symptoms
    • Herpes viruses can survive on toilet seats for hours and a person could potentiallyacquire the virus from these surfaces
    • • Through genital, anal, or oral contact, tinyblisters develop that change into painfulround sores in 4 - 7 days and may progressto ulcers
    • • Males: prepuce, glans, urethra, shaft
    • • Females: labia, prepuce, urethral orifice,vaginal introitus, and cervix
    • • Lesions usually resolve in 1 - 2 weeks
    • • Virus remains dormant in sensory nervefibers and intermittent
  30. HERPES diagnosis and Treatment
    • Diagnosis:
    • • PCR or culture of tissue
    • Treatment:
    • • Acyclovir by mouth can limit thefrequency and length of outbreaks
  31. Herpes 1 vs. Herpes 2
    • • Herpes simplex 1 causes “cold sores”around the mouth and infects over 90% ofadults
    • • Herpes 1 is very similar to Herpes 2 andHerpes 2 can infect humans around themouth while Herpes 1 can infect genitalia
    • • Oral sex can result in Herpes 2 infectionaround the mouth and herpes 1 infection of the genitalia
  32. Congenital herpes simplex
    • • If a Mom has active genital lesions at thetime of a vaginal delivery, the newborn canpotentially acquire herpes simplex and thiscan result in
    • infant death
    • • Women with active lesions at time of delivery are recommended to have acesarian section
    • • Newborns with herpes simplex are treated with IV acyclovir
  33. Hepatitis B & Hepatitis C
    • Hepatitis B is small, circular DNA virusin the Hepadnavirus family
    • Hepatitis C is a linear, single-stranded,RNA virus in the Flaviviridae family
    • Both of these viruses are primarilytransmitted through blood, so they canbe sexually transmitted when there isexposure to blood
  34. Human immunodeficiency virus(HIV) transmission routes
    • HIV is present in blood, semen,cervical & vaginal secretions,breast milk, saliva, and tears
    • Blood inoculation
    • Perinatal
    • • Across placenta
    • • During birth
    • • Breastfeeding
    • Sex
    • • Sores on genital or anal area from another infection
  35. Circumcision and HIV transmission
    • • Studies have demonstrated that circumcised men are 50% less likely to acquire HIV through sex
    • • Studies have demonstrated that circumcised men are less likely to acquire other sexually transmitted diseases as well
  36. HIV DIAGNOSIS
    • Diagnosis
    • • Detection of HIV antibodies in blood orsaliva
    • • Nearly all persons infected with HIV havedetectable antibodies (seroconversion)within 6 months of infection
    • • Viral RNA test can detect virus beforeantibodies emerge
  37. HIV PREVENTION
    • Prevention
    • • Condoms both for men and women
    • • Circumcised men have a 50% reductionin likelihood of acquiring HIV
    • • HIV positive women who are pregnantreceive AZT during pregnancy, labor,and delivery and the newborn receives AZT at birth
    • • Breast milk can be heated to a low temperature to eliminate the HIV
  38. HIV TREATMENT
    • Treatment
    • • Nucleoside reverse transcriptase inhibitors(NRTIs) e.g., AZT (zidovudine)
    • • Nonnucleoside reverse transcriptaseinhibitors (NNRTIs)
    • • Protease inhibitors
    • • Fusion inhibitors

What would you like to do?

Home > Flashcards > Print Preview