Pathophysiology Chapter 34
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inflammation of the urethra
Inflammation of the cervix
Inflammation of the uterine tubes
Define Pelvic inflammatory disease (PID)
Results when acute salpingitis spreads into the pelvis
What is the effect of Local Inflammatory STIs?
Cause urethritis, salpingitis, PID
What are the two classes of local inflammatory STIs?
What is the treatment for Local Inflammatory STIs?
What is the Etiology of Gonococcal Infection?
- Inflammation of epithelial tissue by organism Neisseria gonorrhoeae
- -->Gram-negative Diplococcus
What is the transmission of Gonococcal Infection?
Direct contact with infectious mucous membranes from infected person
What is the pathogenesis of Gonococcal Infection?
- Gonococcus attaches to and penetrates columnar epithelium
- -Bacteria enter the submucosal connective tissue and initiate immune responses
- -Mast cells, neutrophils, and plasma cells are the most involved in the immune response
- Direct extension of infection occurs through lymphatic system
- Once spread, localized infection occurs
- -Causes formation of cysts and abscesses
- -Purulent exudate damages tissue
- -Fibrous tissue replaces inflamed tissue
What are the clinical manifestations of Gonococcal infection in Women?
- Usually asymptomatic
- Vaginal discharge
- Normal or Abnormal bleeding
- Affects urethra, Bartholin & skene glands, anus, cervix
What are the clinical manifestations of Gonococcal infection in Men?
- Purulent urethral discharge
- Redness and swelling at infection site
- Untreated-->infection may produce abscesses in both sexes
What is the pathogenesis of Nongonococcal Infections?
- Caused by Chlamydia trachomatis
- Acts on columnar epithelium
- Spread by extension to oviducts
- Results in pelvic inflammatory disease
- Transmission during birth may result in ophthalmia neonatorum
What is the treatment for gonorrhea?
What is the treatment for chlamydia?
What are the STIs with Systemic Involvement?
- Lymphogranuloma venereum
- Genital Herpes
What is the Etiology of Syphilis?
- Systemic infection of vascular system
- Caused by Treponema pallidum
- Acquired when organism penetrates intact mucous membrane or abraded skin during sexual contact
- Incubation phase: goes thru body, invades other organs
- Transmission of fetus may occur transplacentally
What is the pathogenesis of Syphilis?
- Causes changes in vascular system
- Inflammatory response in tissue
- Terminal arterioles and small arteries become obliterated and no longer functional
- Long-term inflammation of vascular tissue results in fibrosis leading to necrosis
What are the five phases of Syphilis?
- Incubation Period
- Primary Phase
- Secondary Phase
- Latent Phase
- Late Phase
What is the incubation period?
What is the Primary Phase?
- Formation of chancre
- -->Painless, ulcerative lesion that arises at original spirochete portal of entry
- Resolve spontaneously within 3-6 weeks
What is the Secondary stage?
- Characterized by:
- Low-grade fever
- Sore Throat
- Mucosal or cutaneous rash
What is the Latent Phase?
- No symptoms are present
- May experience infectious mucocutaneous lesions
- May last >40 years
What is the Late phase?
- Manifestations depend on area of arterial lesion and extent of circulatory insufficiency
- Cardiovascular system-aortic insufficiency
- Nervous system-shuffling walk, paralysis, blindness
How do you diagnose Syphilis?
- Serologic screening test
- Darkfield examination of tissue and exudates
- Direct fluorescent antibody tests
How do you treat Syphilis?
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