Reproductive System

What are STIs?

infections transmitted through sexual contact (oral, vaginal, anal)

Pathogens of STIs

mother to child(pregnancy or childbirth) or blood contact(HIV, syphillis)

Which STIs are reportable to the CDC?

Chlamydia, gonorrhea, and syphilis.

Curable STIs

chlamydia, gonorrhea

Lifelong STIs

herpes, hpv

Factors contributing to Increased STIs

drug use, poverty, stigma, unstable housing

Bacterial STIs (treatment)

simple course of antibiotcs

Prevention

abstain from sexual activity until bacteria eradicated, safe sex, treat sexual partners

Cause of Chlamydia

Chlamydia trachomatis (bacteria, intracellular parasite-like = requires a host)

Most commonly reported STI

chlamydia

Transmission of chlamydia

sexual contact, mother → child

What can chlamydia cause in neonates?

neonatal conjunctivitis → blindness

Chlamydia/Gonorrhea hallmark

Often asymptomatic (“silent STI”) ~ mainly syph

Clinical features of Chlamydia

dysuria, penile, vaginal, rectal discharge, testicular tenderness, rectal pain, dyspareunia,

what is dyspareunia

painful intercourse

Gonorrhea cause

Neisseria gonorrhoeae + drug resistant strains

what does gonorrhea affect?

infects epithelia of mouth, anus, vagina, pharynx, conjunctiva

transmission of gonorrhea

mother to child, sexual contact (bacterium die os body quickly)

Who is more likely to show symptoms of gonorrhea

men

Symptoms of Gonorrhea

dysuria, urinary urgency, penile, vaginal, rectal discharge(white, yellow, grenn “the drip”)

Syphilis cause

Treponema pallidum (spirochete), wants warm moist environment

transmission of syphillis

skin, mucous membrane contact w chancres

Primary syphilis symptoms

Painless chancre at infection site (often unnoticed)

Secondary Syphilis (contagious)

generalized nonpruritic(not itchy), brown red rash, malaise fever, patchy hair loss, lymphadenopathy

Latent syphilis

asymptomatic following secondary syphilis

early latency(syphilis) infections

can spread to eyes, brain, nervous system, heart, blood vessels, skin, bones(affected but unaware)

Tertiary Syphilis characterisitcs

formation of gummas(granulomatous growths in organs), ocular syphilis(vision changes, blidness), neurosyphilis, cardiovascular syphilis

Timing of tertiary syph?

10-30 days after infection

timing of primary syphilis

2-3 weeks after infection

what id used to treat syphilis

antibiotics ~ penicillin

Viral STIs

infections caused by viruses (condylomata to HIV)

Genital herpes (HSV) cause

herpes simplex virus

HSV-1

usually above waist, cold sores, can infect genitals via oral-genital contact (can spread with or without visible lesions)

HSV-2

usually below waist, responsible for ~70 of genital herpes causes (can spread with or without visible lesions)

Transmission of HSV

direct skin-skin, oral-genital contact, mother-child(pregnancy/childbirth)

Pregnancy risks of HSV

spontaneous abortion, neonatal encephalitis, or brain damage

Which STI has major antibiotic resistance issues?

gonorrhea

Frothy, green discharge is most associated with

trichomoniasis

Which infection causes painful vesicles?

HSV

Which STI can lead to cervical cancer?

HPV

Undescended testes is called

cryptorchidism

Primary gential herpes symptoms

2-20 days after exposure

painful vesicular lesions, malaise, low grade fever, high viral shedding(transmission increase)

lesions on penis, labia, clitoris, vagona, cervix

latent HSV

virus become dormant in nerve root (asymptomatic)

recurrent HSV

reactivation of virus, lesions <10 days

trigger; stress, menstruation, illness

Condylomata Acuminata(anogenital warts/HPV) cause

HPV 6 & 11

high risks = 16 & 18 → cervical, penile, anal cancer

Transmission of Condylomata Acuminata(anogenital warts/HPV)

sexual contact, skin to skin, mother to child during child birth (asymptomatic) no cure

Vaccine for HPV (age 11-12)

Gardasil

Trichomoniasis cause

Trichomonas vaginalis (protozoa)

Trichomoniasis hallmark symptom (women)

Frothy, odorous discharge, strawberry cervix(petechia)

resides in vagina

Trichomoniasis hallmark symptom (men)

usually in urethra + asymptomatic

Transmission of Trichomoniasis

sexual contact, prolonger moisture exposure(bathing suits, protective garments)

Epispadias

Urethra opens on top of urethral meatus

males → dorsal surface

women→ clit or abdomen

Hypospadias(Male)

urethra opens on underside of penis instead of tip

Hypospadias(Women~rarely affects)

urethra opens on anterior vaginal wall

What can hypospadias lead to?

gender ambiguity→wrong surgical gender assignment if genetic testing not done

prevalence of hypospadias(most common)

1 in 200 babies

When do most testes descend (without treatment)

9 months

Painful menstruation

dysmenorrhea

Primary Amenorrhea

no menstruation by 16

Secondary Amenorrhea

Menstruation stops after starting

Cause of Secondary Amenorrhea

stress, sudden weight loss or reduced body fat(eating disorder, athletes), anemia

Pathophysiology of dysmenorrhea

excess prostaglandins-→ strong uterine contractions, uterine ischemia increase(intermittent abdominal pain) → nausea, vomiting, diarrhea

Premenstrual syndrome

group of physical and emotional symptoms occurring before menstruation

Clinical manifestions PMS(emotional)

Irritability, depression, mood swings, fatigue

Clinical manifestions PMS(physical)

headaches, abdominal bloating, join pain, weight gain, breast tenderness

Clinical manifestions PMS(other)

changes in bowel patterns, sleep disturbances

Premenstrual Dysphoric syndrome

severe form of PMS→ severe depression, tension and irritability→interferes w/ daily activity.

A newborn develops conjunctivitis shortly after birth. Which STI is most likely responsible?

chlamydia

Which symptom is MOST characteristic of gonorrhea?

thick green/yellow discharge

A patient with HSV asks when it is safe to have sex. What is the best response?

avoid during active lesions

What is the most serious complication of untreated tertiary syphilis?

neurological damage

Which STI is MOST likely to be asymptomatic in men?

trichomoniasis

A nurse is teaching a patient diagnosed with gonorrhea. Which statement shows understanding?

“I should avoid sex until treatment is complete.”

A pregnant patient has active genital herpes lesions at delivery. What is the priority intervention?

Cesarean section