STD's

• Chlamydial infection
• Gonorrhea
• syphilis
• chancroid
• HIV
• Hepitsis

Eitology: yeast like fungus, caused by the change in the vaginal pH (Candida albicans)

• Common causes:
• pregnancy, diabetes mellitus, oral contraceptive, antibiotic theapy
• Symptoms: vaginal and perineal itching, inflamation, burning on urination, vaginal discharge white with a typical cottage cheese appearance

Treatment: may be with butoconazole, miconazole, clotrimazole, nystatin, terconazole by vaginal application for 3 to 5 days

Reoccurent yeast infections that resist treatment are assoicated with diabetes melllitus or HIV infections

vagina and microscopic tears in mucosa feom intercourse provide favorable conditions for infection

• Caused by trichomonas vaginalis
• Symptoms: purulent vaginal discharge that is thin or frothy malodorous, and yellow-green or brownish. May have itching, edema, and redness
• Diagnosics: wet mount
• Treatment: Metronidazole (Flagyl) or tenidazile (tindamax) in a single oral dose.
• Teaching: do not drink alchol for 24 hours prior to or after discontinuing medication, refrain from sex until a cure is established, reoccurance if partner is not treated

Causes: are not known although tissue trauma and vainal intecourse have been identified as probale causes Multiple partners, douching

Symptoms: thin, grayish white vaginal discharge that has a fisy odor

Dignostics: saline wet mount

Treatment: matronidazole or clindamcin to restablish normal flora

Teach: refrain from sex until cured or use a condom, do not drink alchol for 24 hours prior to or after discontinuing medication

• Causes: Chlamydia trachomatis
• high in sexually active teens

• Symptoms: usually asymptomatic may exibit symptoms of yellowish vaginal discharge and painful urination
• Gonorrhea and chlamydia usually coexist
• If untreated leads to scaring of the fallopian tubes and is the primary cause of PID, infertility or ectropic pregnancy

Treatment: usually directed at both chlamydial infection and gonorrhea. azithromycin (Zithromax), doxycycline (Vibramycin),ofoxacin (floxin), lavofloxacin (Levaquin), and erythromycin.

Teach: must treat partner and use a condom until cure is established

Causes: Neisseria gonorrhoeae

• Symptoms: often asymptomatic in women may include purulent discharge, dysuria, and painful intercourse
• If left untreated associated with PID, scaring of the fallopian tubes and is the cause of infertility or ectropic pregnancy

Dignostics: positive culture

Treatment: cefixime (suprax), ceftriaxine (rocephin), and ciprofloxaxin (cipro)

Teach: all partners should be treated simultaneously, intercourse should be avoided or use a condom

• Causes: Treponema palidum
• Three stages:
• 1) Primary syphilis is painless chancre that develops on the genitalia, anus, or lips, or in the oral cavity, treated with one dose of penicillin
• if untreated the chancre heals in about 6 weeks the disease is highly infectious at the primary stage

about 2 months after the initial infection the symptoms of

2) secondary syphilis, including enlargement of the spleen and liver, headache, anorexia, and a generalized maculopapular skin rash called condlomata lata may develop on the vulva. Condlomata resemble warts and are highly contagious. Treated with two doses of penicillin

• latent phase may last for several years
• 3) tertiary stage heart, blood vessels and central nervous system general paralysis and psychosis

Diagnostics: VDRL, RPR, FTA-ABS

Treatment: of all stages is penicillin G, Ceftriaxone and doxycycline is used for people who can not use penicillin

• Two types
• type 1 usually oral pharyngeal infection
• type 2 usually genital lesions
• transmission occutrs through direct contact with an infected person

with in 2 to 12 days after primary infection blisters (vesicles) may cause pain, tenderness, dyspareunia (pain during intercourse), flu like symptoms, these blisters rupture within 1 to 7 days and form ulcers that take an average of 7 to 10 says to heal

the virus remains dormant in the nerve ganglia and reactivates periodically (stress, fever, and menses may cause reoccurance)

Diagnositcs: clinical symptoms confirmed by viral culture of fluid from the blisters (vesicles)

Treatment: antiviral drugs acyclovir, famciclovie, and valacyclovir help reduce symptoms, shedding, and recurrent episodes however there is no cure

Teach: abstain from sex while lesions are present and until they are culture negitive due to shedding that may occur during this time

Veneral and genital warts

Symptoms: dry, wartlike growths may be small, discrete and asymptomatic or they may cvluster and resemble cauliflower

colposcopy, pap smear are usually done to detect abnormal growths and tissue displasia

• Treatment: Goal is to remove the warts and is determined by the site and extent of the warts
• 1) application of medication podpphyllin solution or gel
• 2) cryo theropy, electrodesiccation, electrocautery or laser
• 3) interfeon, an antineoplastic drug some times used in women over are 18

CDC recommends immunizing girls and women age 9-26 and immunocomprimised males

Causes: direct contact with body fluids of infected person

HIV testing is routine for all pregnant women

STD's is an implication that a person should be tested

no cure

treating specific infections

teach the signs and symptoms that require medical attention

• explain diagnositc or screening tests
• reinforce information for effective treatment and prevention

Etiology: primary sources are Chlamydial infections, gonorrhea (bacteria) untreated cause tubal scarring and may lead to ectopic pregnancy or infertility

Manifestations: asymptomatic or have subtle mild symptoms. others may have pelvic pain, fever, purulent vaginal discharge, nausea, anorexia, and irregular vaginal bleeding

Assessment: abdominal tenderness, and pain of the uterus and cervix when they are moved during bimanual examination urinalysis is needed to rule out urinary tract infection. cultures for Chlamydial infection, gonorrhea or other infections to determine the course of treatment

Treatment: intravenous combinations of antibiotics cefoxitin of cefotetan plus doxycyline or clindamcin plus gentamicin usually be changed to oral within 48 hours for a duration of 14 days

Prevention: avoid exposure to diseases or preventing reoccuring infections. Limit sexual partners, use barrier methods of birth control

secondary prevention: preventing lower genital tract infections,seek medical attention promplty after having unprotected sex with someone suspected of having a STD and when unusual discharge or lesions appear, take medications as perscribed, periodic medical evaluations