Lecture 19 - Sexually Transmitted Infections

Many STI/STDs are _____ and are not associated w significant long term health consequences if treated.

All it takes to acquire one is to have _____ of any kind. Many infections are ____ and have no signs of disease

By strict definition, STDs refers to _____ infection with sexually transmitted organism.

curable; sex; asymptomatic; symptomatic

The most frequently reported bacterial STI in the US is _____ caused by chlamydia trachomatis. It transmits via vaginal, rectal, and oral _____ as well as transmission to ___ during delivery.

In most casues, this STI is ______ called a silent infection so ___ is an important tool to prevent spread.

It infects the genital ___ in both men and women. The most common site of infection for women is the ____. The most common site for infection for men is the ______. Other sites for both sexes include the epitheelial cells of the conjuctiva, rectum, and _____.

chlamydia; sex; newborns; asymptomatic; screening; epithelium; cervix; urethra; throat

_____ is an STI that is caused by Neisseria gonorrhea. Transmission routes include vaginal, rectal, and oral ____, and from mom to newborn during _____. 

Infection is usually asymptomatic in ____ and symptomatic in _____ with symptoms appearing within two weeks after infection. 

The most common site of infection for women is the ______. 

The most common site of infection for men is the _____

Other sites for both sexes include the epitheelial cells of the conjuctiva, rectum, and _____.

Untreated gonorrhea can spread to the ______ leading to disseminated gonococcal infection (DGI). This causes issues at the _____ and leads to multiple skin _____.

gonorrhea; sex; delivery; women; men; cervix; urethra; throat; bloodstream; joints; lesions

Bacterial infection of the urethra in men is called ________ and can be caused from symptomatic infection of chlamydia or gonorrhea. 

They can be classified as:

1. Gonoccal urethritis in which penile discharge appears purulent and ____

2. Non-gonococcal urethritis in which the penile discharge is cloudy or ____. It is most commonly caused by ______. 

Signs of urethritis include ____ (inc frequency of urinating), pain with urination called ______, and painful ejaculation. 

urethritis; milky; clear; chlamydia; polyuria; dysuria

Symptomatic chlamydia and gonorrhea in women is when there is appearance of symptoms within the first ___ weeks after infection.

This can lead to ______ which is the infection of the cervix. This leads to _____ endocervical discharge and the cervix ___ easily with probing. 

A small percentage also have infection of the uretha called ____ which can lead to polyuria and ____ (pain with urination). 

In pregnant women, this increases the risk of ____ delivery and premature rupture of membranes. 

Infants born vaginally to infected mothers are at risk for ______ (both chlamydia and gonorrhea) or penumonia which is mainly caused by _______.

two; cervicitis; mucopurulent; bleeds; urethritis; dysuria; preterm; conjuctivitis; chlamydia

The cure for chlamydia and gonorrhea are ____ but it may not reverse organ damage if the treatment is late.

Untreated chlamydia/gonorrhea increases the risk of _____ inflammatory disease in women. This leads to chronic pelvic pain nad increased risk of _____ pregnancy and infertility. 

**check to see if need to know meds)

antibiotics; pelvic; ectopic

The gold standard for screening/diagnosing chlamydia and gonorrhea is using the Nucleic Acid ____ test (NAAT) which detects bacterial _____.

In women, this can be self-collected via vaginal ____ or it can be done by health professional who collects ______ samples.

In men, the sample is collected using the first 20mL of _____ produced during micturition. 

amplification; DNA; swabs; endocervical; urine

The STI caused by Treponema pallidum is called ______. Transmissioin occurs during _____ contact with the infectious lesion during vaginal, anal, and oral sex. This bacteria can also cross the ____ during pregnancy leading to a fetal infection. 

To diagnose:

1. Use a microscope to look at the lesion _____ which is not common

2. Use _____ tests for the presence of antibodies against syphylis or elevated levels of antibodies that are elevated due to multiple types of infection.

The treatment of choice for all stages of syphilis is _____ but may not reverse organ damage if given too late.

syphilis; direct; placenta; exudate; serological; penicillin

The stages of syphilis occur as follows:

1. The primary stage in which there is a localized _____

2. The secondary stage in which there is ____ illness

3. The latent stage in which there is an infection but _____ which can remain that way for up to 2 years. 

4. Tertiary syphilis in which there is severe medical problems due to long-term _____

5. ____ syphiliss which can occur at any time during course of infection. This leads to meningitis, vision/___ loss, dementia, and loss of ____ coordination (tabes dorsalis).

sore; systemic; asymptomatic; exposure; neuro; hearing; motor

Primary syphilis manifests as primary ____ or open sore/ulcer at the site of infection. These are usually ______, round, and firm.

It usually ____ on its own but is very _____.

chancre; painless; disappears; contagious

Secondary syphilis usually develops 1-2 months after development of the ____. It is a _____ infection meaning it has effects all over the body. 

Skin ____ are commonly found on palms, bottom of feet, and trunk of body. The patient may also have ____, mucous patches, genital ___-like lesions, fatigue, and swollen ____ nodes. 

Symptoms usually ____ on their own but are very ____ when present. 

Condylomata lata lesioin (wart-like are contagious and contain _____.

chancre; systemic; rashes; fever; wart; lymph; disappear; contagious; spirochetes

Tertiary syphilis is rare and is no longer considered ____. This stage develops in individuals who do not receive ____ for primary/secondary syphilis. 

It occurs 10 to ___ years after initial infection.

Manifestations include:

1. _____ (acronym) symptoms and abnormalities

2. Infection of ____ and spinal cord

3. Presence of _____ or tissue destruction by the bacteria

4. Can be fatal

contagious; treatment; 30; CV; brain; gummas

_____ syphilis is found in newborns who are delivered to women who have untreated syphilis. Up to 40% are stillborn or die from infection ____ after birth.

Louisiana requires:

1. Screening at the _____ prenatal visit and during the ___ trimester for ALL women

2. For high risk women, screening is required at the first prenatal visit, 3rd trimester, AND at ____.

3. Treatment includes _____

congenital; shortly; first; third; delivery; penicillin

Human papilloma virus (HPV) is treat via ___ to skin contact, vaginal/oral/anal sex, and via hand to ___ contact.

In most people the infection is ______ and clears within the first 2 years but in about 10%, the infection is persistent.

There are 100 types of HPV which are classified as high or low risk based on the risk of developing cervical _____. Some manifest as genital warts.

HPV 6 and 11 cause the formation of genital ____ but have a ___ risk for cervical cancer.

HPV 16 and 18 have a ____ risk of developing cervical cancer.

skin; genital; asymptomatic; cancer; warts; low; high

HPV 6 and 11 produce genital warts that are non-cancerous and are often ____. They have predilection (preference) for _____ (area around anus/genital) skin.

The warts are ___ to touch and appear flesh colored with a flat or _______ like appearance.

These are considered _____ so condoms help to reduce the risk of transmission but are not perfect.

A patient can be diagnosed via a ______ confirmation or by performing a ____.

Treatment includes cryotherapy, laser therapy, chemical ____and an immune enhancer; however these warts can ____ after treatment.

painless; anogenital; soft; cauliflower; contagious; visual; biopsy; removal; reappear

HPV 16 and 18 lead to cervical or other types of _____ which can take years to develop.

Screening is available for cervical cancer in the form of a ____ test. There are ____ rates in black/Hispanic women. Early signs/symptoms include irregular vaginal _____, pelvic pain, and watery or ___ vaginal discharge

Oropharyngeal cancer has ____ screening available. SIgns and symptoms include persistent ___ throat and dry cough, and changes in _____.

cancers; PAP; higher; bleeding; pink; no; sore; voice

The HPV vaccine is called ____ -9. It prevents infection of HPV 6,11,16,18 and 5 other types of HPV that are ___ risk for cervical cancer.

The CDC recommmends vaccination at around ___ to 12 yrs old.

It has the biggest benefit when given ____ become sexually active. It does not ____ the virus if the vaccine is given after the person is infected with HPV.

gardasil; high; 11; before; elimiinate

Genital herpes is called the herpes ____ virus I and II. It is transmitted via oral/vaginal/anal ____ and transmission to newborn during ____ delivery. Most people with HSV are ______. 

HSV I is the cause of most ____ or labial infections. Most people with this infection contacted it from non-sexual contact with ____ early in childhood. 

HSV II is the cause of most ____ infections. There is been increasing incidence of this one especially in young ____. This is often due to ____ transmission of HSV-1 to genitals. 

Diagnostic procedures include a physical exam or a viral ____ from a lesion.

simplex; sex; vaginal; asymptomatic; oral; saliva; genital; women; oral; culture

Treatment and preventions for genital herpes includes:

1. An _____ therapy like acyclovir.

2. An _____ therapy in which the med is taken at onset of outbreak which shortens/reduces severity of outbreak.

3. A _____ therapy which reduces the number of recurrences and viral ____

4. The use of ____ and suppressive antiviral meds for infected partner can decrease risk of spreading infection

HSV is most contagious during _____ lesion but can spread when no lesions are present such as asymptomatic viral shedding.

antiviral; intermittent; suppressive; shedding; condoms; active

_____ HSV infections are HSV infections that are transmitted to newborn during vaginal delivery.

This leads to skin, eye, and ____ disease which can spread to the _____ (acronym) and other organs. 

You want to treat with parenteral ____ therapy.

This is reportable in Louisiana. 

To prevent this from occurring, the mother with an active infection can have antiviral treatment during ____ pregnancy. The partner can also use a ____ if they have a history of HSV. Women with active genital herpes at the time of delivery should have the baby delivered via ______ section. 

neonatal; mouth; CNS; antiviral; late; condom; cesarean

Louisiana has the ____ highest rate in congenital syphilis.

What is the STI that has been becoming antibiotic resistent?

7th; gonorrhea