Card Set Information
wk 11/12 std lecture
What are the chief complaints of a person w/ an STD?
itching, burning, dysuria, pain
What is a VDRL?
VDRL= Veneral Disease Research Lab
-blood test for syphillis, flourescent treponemal antibody test
What is a gram stain used for?
: urethral in males and cervical in females
Gram negative diploc = GC (ghonnerea). The exclusion of GC= chlymadia
-enzyme-like immunoassay and direct flourescent antibody tests
Define Genetial Herpes
-acute, recurring, incurable viral disease
: classis cold sore caused from heat, sun, or fever, often referred to as "fever blisters"
: genetal herpes
what are the s/sx of HSV?
-initial and recurrent outbreaks w/ the same symptoms
-burning sensation of skin or prickly like pins/needles
-small itchy or painful red bumps
-bumps become fluid filled vesicles, painful
-fluid goes from clear to thick and yellow in a few days, they break open w/ very painful sores
-females may be more painful (due to warm, moist areas)
What is the course of genital herpes?
-blisters crust over and crusts fall off in 10 days
-may have swollen lymph glands in groin and other areas
-50% fever, muscle aches, HA. Most women have vaginal discharge
-30% males have sores inside urethra causing painful urination
-firs infection may be mild and go unnoticed until reoccurance, or be severe
Discuss reoccurence in regards to HSV
-may be q 2 wks to 6 mo.
-usually less severe. May accompany local trauma (i.e. menses, infection, other STDs, anxiety, stress, poor nutrition
-outbreaks may become fewer over the years but HSV is incurable.
-anything over 4 outbreaks/year is considered severe and treated w/ continuout prophylactic meds all year
What are the complications of HSV?
-spread from initail site by hands, mouth, and can go to other open sores or the eyes causing infection/blindness
-can go to fingers/fingernails= Herpatic Whitlow - a former occupational hazard when med staff didn't wear gloves, esp. when working in mouth (dentists and anesthesiologist
Discuss pregnant women and HSV
-should inform MD if they have HSV.
-if HSV in inactive phase the pt can deliver vaginally, or CS needed to prevent spread to newborn
-babies of active mother have a 25-40% chance of becoming infected, and 60% of infected babies die
How is HSV transmitted?
-during viral shedding (type I and type II)
-just before and during the active outbreak via direct contact genital to genital or mouth to genital
-virus enters through small cracks/abrasions in skin but virus can also survive outside the body in warm moist environ for a short period of time
-chlorine kills the virus-you can't get it from swimming pools
What is the Tx for HSV?
-virus lies dormant in nerve ganglia until body becomes stressed then it comes out again
we treat the symptoms:
-astringent compresses (i.e. Burrow's soak for cooling and pain relief)
-and meds to decr. severity, promote healing and decr. frequency of outbreaks
What are the ANTIVIRAL meds for Herpes?
*Acyclovir (Zovirax or Avirax)
-used orally 7-10 days
-used orally 7-10 days
: start w/in first 48hr of sx
-used orally 7-10 days
: GI distress, HA, dizziness
Discuss Tx for HSV
-avoid touching active blisters and avoid sexual activity
-used condoms at all times
-Use cold compresses to reliefve symptoms, avoid hot bc it incr. inflammation
-wear ventilated clothing, dry blisters w/ powder, corn starch, cool hair dryer
What is considered the "classic STD?"
Discuss Syphillis: cause and incidence
: Treponema pallidum spirochete (slender, spiral shape)
: fewer cases d/t use of PCN and better public health educ.
Discuss the PRIMARY phase of Syphilis
-chancre (pronounced "shank-are") at site of inoculation in genitals, about 3wks after exposure
- 1st small papule w/in 3-7 days then it breaks down into characteristic painless, indurated, smooth, weeping lesion
-if no Tx chancre disappears in 6wks and organism disseminates throughout bloodstream, leading to secondary phase
Discuss SECONDARY Syphilis
-6wks to 6mo after primary syphilis
: malaise, low-grade fever, HA, muscle-ache/pain and sore throat
-grneralized rash involves papules to squamous papules and pustules
Discuss the LATENT STAGES of Syp
: first year after infection
: more than a year duration after infection. Noninfectous except to fetus of pregnant woman.
Tertiary or Late (can cause extreme damage in body systems):
highly variable s/sx, period for 4-20 years
: benign lesions, skin and mucous memb., bones, aortitis (inflammation of aorta), aneurysms (from weakened vessels), and neurosyphilis (affects whole nervous system and pt can become psychotic)
How is Syphilis diagnosed?
-incubating Syphilis can NOT be detected w/ lab tests
-primary can be Dx by microscope identification (spirochetes from oozing canchre looked at under microscope and diagnosed)
: VDRL blood test
-FTA-ABS (flourescent treponemal antibody absorbtion)
-RPR (rapid plasma reagin-detects 2 types of antibodies)
-tests can give false neg/false pos even after pt had adequate tx, retreatment may be only choice
What is the Tx for Syphilis?
: SAFE SEX!
Secondary: early Tx, prevntion of complications
: treat complications, notify partners
*Syphilis is completely curable by using PCN AB (but remember it doesn't provide immunity, you can get the disease again)
-Gm neg. diplococcus, transmitted by sexual contact or in an to a neonate via an infected birth canal
-initail symptoms 3-10 days after contact or non-symptomatic
What are the s/sx of GC in MALES?
-penile discharge, profuse yellow-green, clear or scant
-GC is referred to as the "drip"
-rectal bleeding, pain w/ defication, pharyngitis (sore throat from incocculation in oral area)
most common- urethra then spread to prostate, seminal vesicles and epididymis
What are the s/sx of GC in FEMALES?
-change in vaginal discharge, odorus
-urinary frequency, dysuria
-anal itch, irritation, bleeding
-pain w/ defication
: cervix or urethra and spreads up causing PID, endometritis, salpinfitis, pelvis peritonitis
What is the Tx for GC?
-must be seen by MD
-prob w/ incr. resistant strains
: ceftriaxone (Rocephin) AB of choice- want to mix w/ lidocaine if you give it IM-painful shot, one dose of Rocephin can cure GC
-C. trachomatis most common transmitted bacteria
: 4 million infected annually
- invades columnar epithelial tissues in reproductive tract w/ manifestations similar to GC
-incubation 1-3 wks or months/years
-many w/o sx, (usually picked up on pap screening)
What are the sx for MALES with Chlamydia
-frequency of urination
-mucoid discharge (more h2o, less copious than GC)
: epididymitis, prostatitis, infertility, Reiter's syndroms (arthrytis)
What are the sx for WOMEN with chlymadia
- mucopurulent cervicitis, change in vaginal discharge
-soreness of infected area
: salpingitis, PID, ectopic preg and infertility
: azithromycin (Zithromax) or doxycycline
: treat partner
Pelvic Inflammatory Disease:
-process involves one or more pelvic structures
-most common in fallopian tubes = leading cause of infertility
- acute PID-complex lower genital tract organism that migrates to endocervix through endometrail cavity and fallopian tubes
-PID can lead to
: endometritis, peritonitis, salpingitis, oophoritis, parametritis, adhesions, strictures that can lead to a bowel obstruction.
PID most often caused by STD- GC, chlymadia, mycoplasma
What is the Tx for PID?
-analgesia, sitz baths, heat on lower back/abdomen, bedrest in semi-fowlers
-AB as ordered
-laproscopic or abdominal laparotomy to remove abscesses, masses
: meticulous perineal hygiene, treat partners for STDs, provide counseling and educ. about infertility, ectopic preg, chronic pain