DOSEASES

(Morning drop, Clap, Jack)

Gonorrhea

CA Gonorrhea

•Neisseria Gonorrheae, gram (+)

IP Gonorrhea

•IP: 3-7 days

  Females: usually asymptomatic or minimal urethral discharge w/ lower abdominal pain

Gonorrhea
(Morning drop, Clap, Jack)

   - sterility or ectopic pregnancy

Gonorrhea
(Morning drop, Clap, Jack)

  Male: Mucopurulent discharge, Painful urination

Gonorrhea
(Morning drop, Clap, Jack)

  - decreased sperm count

Gonorrhea
(Morning drop, Clap, Jack)

Gonorrhea
(—————)

(Morning drop, Clap, Jack)

Gonorrhea

Diagnostic

•Gram stain and culture of cervical secretions on Thayer Martin VCN medium

Gonorrhea

Management

Management:  single dose only

•Ceftriaxone (Rocephin) 125 mg IM

•Ofloxacin (Floxin) 400 mg orally

•Treat concurrently with Doxycycline or Azithromycin for 50% infected w/ Clamydia

Gonorrhea

Complications:

PID, ectopic pregnancy and infertility, peritonitis, perihepatitis, Ophthalmia neonatorum, sepsis and arthritis

Syphilis

CA

•Treponema Pallidum, a spirochete

•a spirochete

Treponema Pallidum

IP Syphilis

•IP: 10-90 days

S/sx:Syphilis

S/sx:

Primary (3-6 wks after contact)

•nontender lymphadenopathy and chancre

•most infectious

•resolves 4-6 wks

Secondary

•systemic; generalized macular papular rash including palms and soles and painless wartlike lesions in vulva or scrotum (condylomata lata)

•lymphadenopathy

Tertiary

•6-40 years

•neurosyphilis/permanent damage

•gumma (necrotic granulomatous lesions)

•aortic aneurysm

•

painless chancre

Primary (SYphilis)

generalized rash

Secondary (SYphilis)

gumma

Tertiary (SYphilis)

Diagnostics SYphilis

•Dark-field examination of  lesion- 1^st and 2^nd stage

•Non9specific VDRL

Management SYphilis

•Primary and secondary - Pen G

•Tertiary - IV Pen G

Herpes Genitalis

Cause:

•HSV 2

Herpes Genitalis

•S/sx:

•Painful sexual intercourse,

•Painful vesicles (cervix, vagina, perineum, glans penis)

Herpes Genitalis

Diagnostic:

•Viral culture

•Pap smear (shows cellular changes)

•Tzanck smear (scraping of ulcer for staining)

•(shows cellular changes)

Pap smear

•(scraping of ulcer for staining)

Tzanck smear

Herpes Genitalis

Mgmt

  Anti viral - acyclovir (zovirax)

Herpes Genitalis

Complications:

•Meningitis

•Neonatal infection (vaginal birth)

Genital Warts,

Condyloma Acuminatum

Genital Warts CA

•HPV type 6 & 11, papilloma virus

Genital Warts

•Signs and symptoms:

•Single or multiple soft, fleshy painless growth of the vulva, vagina, cervix, urethra, or anal area,

•Vaginal bleeding, discharge, odor

•Dyspareunia

Genital Warts

Diagnostics:

•Pap smear-shows cellular changes (koilocytosis)

•Acetic acid swabbing (will whiten lesion)

•Pap smear-shows cellular changes (____)

koilocytosis

Acetic acid swabbing (———)

•(will whiten lesion)

Genital Warts

Mgmt:

  Laser treatment

Genital Warts

CX:

•Neoplasia

•Neonatal laryngeal papillomatosis (vaginal birth)

Moniliasis

Candidiasis

Candidiasis, Moniliasis
CA

•Candida Albicans, Yeast or fungus

Candidiasis, Moniliasis

Signs and Symptoms

Cheesy white discharge,

Extreme itchiness

Candidiasis, Moniliasis

Diagnostics:

•KOH (wet smear indicate positive result)

Candidiasis, Moniliasis

Management:

•Imidazole, Monistat, Diflucan

Candidiasis, Moniliasis

Complication:

•Oral thrush to baby (vaginal birth)

a member of the retrovirus family)

lentivirus

causes acquired immunodeficiency syndrome (AIDS)

Human immunodeficiency virus (HIV)

a lentivirus (a member of the retrovirus family)

Human immunodeficiency virus (HIV)

Two types of HIV

First to be discovered

Termed as both LAV and HLTV-III

More virulent and more infective

Cause of majority of HIV infections

Has lower ineffectivity

Has poor capacity of transmission

HIV First to be discovered

Termed as both

LAV and HLTV-III

More virulent and more infective

LAV and HLTV-III

Cause of majority of HIV infections

LAV and HLTV-III

HIV Infection

Mode of  Transmission

Blood transfusion

Perinatal transmission

Unsafe sex

Contaminated needles

Timeline of HIV infection

HIV

Signs and Symptoms

Starts 2-4weeks after exposure.

Most individuals (80 to 90%) develop an influenza.

Duration of symptoms varies, averaging 28 days and usually lasting at least a week.

Can vary between two weeks and 20 years.

Chronic HIV Infection

HIV is active within lymph nodes

Chronic HIV Infection

Lymph nodes are swollen

Chronic HIV Infection

Individuals in this stage is still infectious

Chronic HIV Infection

Early initiation of antiretroviral therapy significantly improves survival

Chronic HIV Infection

Progressive failure of the immune system

Acquired Immunodeficiency Syndrome

Last and fatal stage of HIV Infection

Acquired Immunodeficiency Syndrome

CD4+ T cell numbers decline below a critical level of 200 cells per µL

Acquired Immunodeficiency Syndrome

Opportunistic Infections are at greatest

Acquired Immunodeficiency Syndrome

HIV SIgns and Symptoms

Unexplained moderate or sudden weight loss

Recurring respiratory tract infections

Prostatitis

Skin rashes

Oral ulcerations

HIV

Diagnostic Procedures

ELISA

Western Blot

Highly Active Antiretroviral Therapy (HAART)

Nucleoside analogue reverse transcriptase inhibitors (NRTIs)

Protease Inhibitors (PIs)

Initial test for HIV/AIDS

ELISA

ELISA

(enzyme-linked immunosorbent assay) 

Confirmation test for HIV/AIDS.

Western Blot

Also an antibody detection test.

Western Blot

Determines the size of the antigens in the test kit binding to the antibodies

Western Blot

(The number of viral bands is the basis of the result.)

Western Blot

Involves drug combinations

Highly Active Antiretroviral Therapy (HAART)

Consist of at least three drugs belonging

types or classes of antiretroviral drugs.

Highly Active Antiretroviral Therapy (HAART)

Combinations and the order in which drugs are given influence effectiveness.

Highly Active Antiretroviral Therapy (HAART)

Interferes with DNA chain

Nucleoside analogue reverse transcriptase inhibitors

(NRTIs)

Zidovudine (AZT, Retrovir)

Nucleoside analogue reverse transcriptase inhibitors

(NRTIs)

Didanosine (ddl, Videx)

Nucleoside analogue reverse transcriptase inhibitors

(NRTIs)

Abacavir sulfate (Ziagen)

Nucleoside analogue reverse transcriptase inhibitors

(NRTIs)

Side effects:Nucleoside analogue reverse transcriptase inhibitors

- lactic acidosis,

- hepatomegaly,

- peripheral neuropathy,

- rash

Examples:Nucleoside analogue reverse transcriptase inhibitors

Zidovudine (AZT, Retrovir)
Didanosine (ddl, Videx)

Abacavir sulfate (Ziagen)

Block virus ability to breakdown larger protein molecules into smaller functional units.

Protease Inhibitors

(PIs)

Protease Inhibitors Examples:

Indinavir (Crixivan)

Ritonavir (Norvir)

Atazanavir sulfate (Reyataz)

Fosamprenavir calcium (Lexiva)

Fosamprenavir calcium (Lexiva)

Protease Inhibitors

Atazanavir sulfate (Reyataz)

Protease Inhibitors

Ritonavir (Norvir)

Protease Inhibitors

Indinavir (Crixivan)

Protease Inhibitors

Protease Inhibitors

Side effects:

Binds to reverse transcriptase.

Nonnucleoside reverse transcripstase inhibitors (NNRTIs)

Blocks DNA and RNA replication.

Nonnucleoside reverse transcripstase inhibitors (NNRTIs)

Nonnucleoside reverse transcripstase inhibitors (NNRTIs) Examples

Delavirdine (Rescriptor)

Efavirenz (Sustiva)

Nevirapine (Viramune)

Side effects:Nonnucleoside reverse transcripstase inhibitors (NNRTIs)

- Transient rash
- Nausea

- Diarrhea

- Hepatotoxicity

- Nephrotoxicity

- Depressed bone marrow (Rescriptor)

Hepatitis Transmission

•RNA, Hepa __ virus

Hepatitis A

•“Infectious hepatitis”

Hepatitis A

•Poor sanitation

Hepatitis A

•Worldwide distribution

Hepatitis A

•Mortality 1%, with full recovery

Hepatitis A

•Active Immunity (Havrix)

Hepatitis A

•Passive Immunity (HAIg)

Hepatitis A

Hepatitis A IP:

3-5 weeks

Hepatitis A:MOT:

Fecal-oral route, person-person, food handlers, contaminated water

Hepatitis A:Diagnostics

•Anti HAV IgM – active infection

•Anti HAV IgG – old infection; no active disease

Management: Supportive & symptomatic

– active infection

•Anti HAV IgM – active infection