Sexually Transmitted Infections (STIs)

Comprehensive vocabulary flashcards covering the pathophysiology, clinical manifestations, screening guidelines, treatment protocols, and complications of sexually transmitted infections based on nursing lecture notes.

STI vs STD

STI stands for Sexually Transmitted Infection, while STD stands for Sexually Transmitted Disease (previously termed venereal disease or VD), differing in whether the active infectious invasion has progressed to clinical disease and tissue pathology.

Florida Statute 384.24

A Florida legal statute that prohibits specific conduct involving designated sexually transmitted infections, with criminal penalties that vary based on individual circumstances.

Reportable STIs in Florida

The five sexually transmitted infections legally required to be reported to health authorities in Florida: HIV, Syphilis, Gonorrhea, Chlamydia, and Chancroid.

Major STI Risk Factors

High-risk circumstances and behaviors for acquiring STIs, including having new or multiple sexual partners, age between $15$ and $24\,\text{years}$, men who have sex with men (MSM), inconsistent condom or barrier use, sexual assault, intimate partner violence, and human trafficking or sexual exploitation.

Chlamydia and Gonorrhea Screening Guidelines

Clinical guidelines recommending annual screening for all sexually active women under $25\,\text{years}$ of age, while screening for women aged $25$ and older or men is based on specific clinical risk factors and sexual practices.

Human Papillomavirus (HPV)

One of the most common viral STIs with over $200$ identified genotypes; infections are frequently asymptomatic, often clear spontaneously, and can be prevented with targeted vaccination.

Low-Risk HPV

Non-oncogenic HPV strains, predominantly types $6$ and $11$, which are responsible for the vast majority of benign genital warts.

High-Risk HPV

Oncogenic HPV genotypes, most notably types $16$ and $18$, whose persistent infection significantly elevates the risk for cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers.

Condylomata Acuminata

Genital warts caused by low-risk HPV types ($6$ and $11$), presenting as single or multiple, soft, flesh-colored or pink, typically painless verrucous lesions in genital or anal areas.

Pap Smear vs HPV Test

A Pap smear cytologically screens cervical cells for precancerous and cancerous dysplastic alterations, whereas an HPV molecular test directly detects the presence of high-risk oncogenic viral genotypes.

Colposcopy

A diagnostic procedure utilizing an illuminated magnifying instrument (colposcope) to directly visualize the cervix, vagina, or vulva and guide targeted tissue biopsies following abnormal cervical cancer screening results.

Imiquimod 5% Cream

A patient-applied topical medication prescribed for external genital warts that must be washed off after $6\text{--}10\,\text{hours}$, causes local redness or burning, and requires abstaining from sexual contact while applied to the skin.

Treponema pallidum

The spirochete bacterium responsible for causing syphilis, transmitted via direct contact with infectious lesions during sexual activity or vertically across the placenta to a fetus.

Primary Syphilis

The initial stage of syphilis defined by the appearance of a single or multiple painless chancres at the site of bacterial entry, which typically heal spontaneously within $3\text{--}6\,\text{weeks}$.

Secondary Syphilis

The systemic stage of syphilis appearing weeks to months after the primary chancre resolves, characterized by a generalized rash (frequently involving the palms and soles), mucous patches, fever, fatigue, and generalized lymphadenopathy.

Latent Syphilis

The quiescent, asymptomatic stage of syphilis during which clinical manifestations disappear, but the underlying Treponema pallidum infection remains active and detectable serologically.

Tertiary Syphilis

The destructive late stage of untreated syphilis that can emerge years after initial infection, leading to severe cardiovascular abnormalities, destructive gummatous lesions, and multi-organ damage.

Syphilis Treatment: Primary, Secondary, and Early Latent

A single intramuscular injection of Benzathine penicillin G at a dose of $2.4\,\text{million units}$.

Syphilis Treatment: Late Latent or Unknown Duration

Intramuscular Benzathine penicillin G administered at $2.4\,\text{million units}$ once weekly for $3$ consecutive weeks.

Jarisch–Herxheimer Reaction

A self-limiting, systemic inflammatory response featuring fever, chills, and headache occurring within the first $24\,\text{hours}$ of antibiotic therapy for syphilis caused by rapid spirochete lysis; it represents an expected reaction rather than a penicillin allergy.

Neurosyphilis

Central nervous system invasion by Treponema pallidum resulting in headache, cognitive deficits, altered mental status, and motor weakness, treated with intravenous aqueous crystalline penicillin G for $10\text{--}14\,\text{days}$.

Ocular and Otosyphilis

Sensory organ complications of syphilis presenting with vision loss, hearing impairment, tinnitus, and vertigo, requiring urgent diagnostic evaluation and treatment equivalent to neurosyphilis.

Congenital Syphilis

Transplacental transmission of Treponema pallidum from mother to fetus, which can lead to miscarriage, stillbirth, neonatal infection, and manifestations such as maculopapular rash, bullous lesions, desquamation, mucous patches, and rhagades.

Herpes Simplex Virus (HSV-1 and HSV-2)

Viral pathogens that infect via direct mucosal or skin-to-skin contact (even during asymptomatic viral shedding), causing genital herpes characterized by painful fluid-filled vesicles that rupture into shallow ulcers.

Primary Genital Herpes Outbreak

The initial, often most severe clinical manifestation of genital herpes, featuring painful vesicles and ulcers accompanied by systemic symptoms such as fever, myalgias, dysuria, and tender inguinal lymphadenopathy.

Suppressive Therapy for HSV

Continuous, daily oral antiviral therapy (using acyclovir, valacyclovir, or famciclovir) to decrease the frequency of recurrent genital herpes outbreaks and reduce HSV-2 transmission to susceptible partners.

Aseptic Meningitis in HSV

An uncommon viral neurologic complication of herpes simplex infection, occurring most frequently in association with primary HSV-2 genital outbreaks.

Herpetic Keratitis

A serious ocular complication of herpes simplex virus infection affecting the cornea, characteristically causing branching dendritic ulcerations and potential vision impairment.

Neonatal Herpes

Transmission of HSV to an infant primarily during passage through an infected birth canal, potentially causing localized skin, eye, and mouth (SEM) disease, central nervous system involvement, or fatal disseminated infection.

Chlamydia trachomatis

A prevalent bacterial pathogen responsible for chlamydia; it is frequently asymptomatic ('the dirty little secret') but can cause severe reproductive tract scarring and tubal injury if left untreated.

Clinical Manifestations of Chlamydia

Presentations in females include altered vaginal discharge, intermenstrual bleeding, lower abdominal pain, and dysuria; in males, symptoms include burning with urination, penile discharge, and testicular pain or swelling.

Chlamydia Treatment Regimens

Nonpregnant adults are treated with oral doxycycline $100\,\text{mg}$ twice daily for $7\,\text{days}$, whereas pregnant patients are treated with a single oral dose of azithromycin $1\,\text{g}$.

Partner Notification and Retesting for Chlamydia

The clinical standard requiring presumptive evaluation and treatment of all sexual partners from the preceding $60\,\text{days}$, complete sexual abstinence until $7\,\text{days}$ of treatment are finished, and mandatory retesting approximately $3\,\text{months}$ post-treatment.

Reactive Arthritis

A systemic autoimmune inflammatory joint complication (formerly known as Reiter syndrome) that can develop as a sequela of untreated Chlamydia trachomatis infection.

Neisseria gonorrhoeae

A Gram-negative bacterial diplococcus causing gonorrhea (colloquially called 'the clap'), which infects mucous membranes of the cervix, urethra, rectum, and pharynx and presents significant challenges due to rising antimicrobial resistance.

First-Line Treatment for Uncomplicated Gonorrhea

A single intramuscular injection of ceftriaxone $500\,\text{mg}$ ($1\,\text{g}$ for patients weighing $\ge 150\,\text{kg}$), supplemented with oral doxycycline $100\,\text{mg}$ twice daily for $7\,\text{days}$ if chlamydial coinfection has not been ruled out.

Disseminated Gonococcal Infection (DGI)

Systemic hematogenous dissemination of Neisseria gonorrhoeae from the initial mucosal site into the bloodstream, manifesting clinically as migratory polyarthralgia, tenosynovitis, skin lesions, or purulent septic arthritis.

Neonatal Gonococcal Ophthalmia

A virulent form of conjunctivitis acquired by an infant during delivery from an untreated mother, which can lead to rapid corneal ulceration, perforation, and permanent blindness if not promptly treated.

Trichomonas vaginalis

A flagellated protozoan parasite that infects the lower urogenital tract, causing trichomoniasis, with approximately $70\%\text{--}85\%$ of infected individuals exhibiting minimal or no clinical symptoms.

Strawberry Cervix (Colpitis Macularis)

A classic, visually distinctive cervical sign associated with trichomoniasis, characterized by diffuse punctate petechial mucosal hemorrhages across the exocervix.

Bacterial Vaginosis (BV)

A non-STI vaginal microbial imbalance caused by a reduction in protective Lactobacillus species and an overgrowth of anaerobic bacteria, typically presenting with a thin, homogeneous gray-white discharge and an amine 'fishy' odor.

Pelvic Inflammatory Disease (PID)

An ascending polymicrobial infection of the female upper reproductive tract (uterus, fallopian tubes, and ovaries)—commonly resulting from untreated gonorrhea or chlamydia—that causes pelvic pain, cervical motion tenderness, ectopic pregnancy, and tubal factor infertility.