-
what is the best form of protection against std
male condom
-
do female condoms prevent std
no
-
do contraceptions provide barrier protection
no
-
which way are sti's most commonly transfeered
from men to women
-
which diseases must be reported to the public health
- gonorrhea
- syphyllis
- chlamydia
-
which stis are bacterial
chlamydia and gonhorrea
-
how is chlamydia and gohnorrhea transmitted
sexual fluids during vag, oral or anal
-
in chlamydia and gohnorrhea what is the most common site for men and women
- men: urethra
- women: cervix
-
s/s for chlamydia and gonorrhea
- -may have none
- -men: urethral discharge, dysuria, swollen and tender testes
- -rectal chlamydia: discharge, rectal pain, bleeding
-
the biggest s/s difference between chlamydia and gonorhhea
chlamydia: women have purulent vag discharge, bleeding dysuria, pain with intercourse, cervical redness
gonorhhea: most are asymptomatic or minors/s. increased vag discharge, dysuria, frequency, cervical redness
-
chlamydia and gonorrhea diagnosis
- h&p
- NAAT
- test for other std
- test sexual partners
-
what is NAAT
- -nucleic acid amplification test
- -prefeered test for chlamydia and gonorrhea
- -detects infectious organisms
- -swab affected area or urine
-
chlamydia treatment
azithromycin or doxycycline
-
azithromycin pt teaching
- avoid sun
- no antacids, iron, dairy
- no when prego
-
chlamydia and gonorrhea pt teaching
- no sex for 1 week after treatment and until partner has completed treatment
- treat partner w/in 60 days
- retest in 3 months
-
gonorrhea treatment
ceftriaxone and azithromycin
-
chlamydia and gonorrhea complications in men
- epididymitis(infertility, drainage pus)
- infertility
-
chlamydia and gonorrhea complications in women
- infertility
- PID
- ectopic prego because of PID
- chronic pelvic pain
-
what causes genital herpes
HSV 1 and HSV 2
-
what is the diff b/t HSV 1 and HSV 2
- 1: oral but could occur anywhere
- 2: genitals but can also occur anywhere
-
how is herpes transmitted
- -direct skin contact or mucos membrane when infected person is symptomatic
- -could also be during asymptomatic shedding which is impossible to predict
-
herpes stages
- prodromol
- vesicular
- ulcerative
- final
-
prodromol stage
- no lessions
- burning, itching or tingiling at site of innoculation
-
vesicular stage
- -small vessicles appear on genitals, vagina, cervix, perineum, perianal
- -vessicles contain large quantities of infected virus
-
ulcerative stage
- lessions rupture and form shallow moist ulcerations
- -urine touching lessions can be painful
- -autoinnoculation can occur
-
final stage
- spontaneous crusting and epithelialization of erosions
- lessions heal spontaneously in 3 weeks
-
recurrent genital herpes triggers and when they occur
- triggers -stress, fatigue, illness, sunburn, immunosuppression, menses
- -prodromal stage s/s tingling, burning, itching
-
how is herpes confirmed
- -NAAT is the only confirmed
- -visual exam
- -culture to diff b/t 1 and 2
- -blood test
antibodies usually appear about 12 weeks after exposure
-
herpes treatment
- -no cure
- -drugs just inhibit viral replication
- -acyclovir, valacyclovire, famciclovir
-
genital warts are caused by
HPV
-
which of the stis is not reportable in many states
genital warts
-
genital wart transmission
- -skin to skin
- -can resolve spontaneously after 1-2 years
-
genital wart s/s
- -usually no s/s
- -less that 10 flesh colored growths
- -genitals, inner thigh, perianal, cervix/vagina
- -itching
- -bleeding
-
who is at risk for getting genital warts
- multiple partners
- sex at young age
- immunosuppresion
- uncircumsized
-
when is hsv most transmitted
asymptomatic
-
what culture confirms genital warts
it is viral so no culture
-
how is genital warts diagnosed
NAAT
-
what is the main complication of genital warts
-mostly asymptomatic so cervical cancer
-
what is primary goal of wart treatment
removal of any symptomatic wart
-
what is treatment for genital warts
- -course therapy
- -laser, cryo, surgical, gel,
-
genital wart pt teaching
- -reccurence and reinfection is possible
- -gardisil and cervarix vaccine
-
when should ppl receive hpv vaccine
- 11-12 yr old receive 2 doses 6 months apart
- 15-26 three doses
-
syphilis is a ___ infection caused by ____
- bacterial
- treponema palladium
-
is syphilis a reportable disease
yes
-
syphilis is also known as the ___
great pretender
-
what makes syphilis diff
if you don't treat it it can become multisystemic
-
syphillis transmission
- -during sex
- direct contact with lesion
- mom to baby via blood stream
-
-
syphillis primary
-occurs
-ineffectivity
-duration
-s/s
- occurs-21 days after
- ineffectivity-high
- duration-3-6w
- s/s-single/multiple cancers and enlarged lymph nodes
-
syphillis secondary
-occurs
-ineffectivity
-duration
-s/s
- occurs- few weeks after cancre heals
- ineffectivity-high
- duration-1-2 years
- s/s- multiple systemic
-
syphillis latent
-occurs
-ineffectivity
-duration
-s/s
- "hidden"
- occurs-weeks to years after initial infection
- ineffectivity-less than a yr more more than a year less
- duration- lifetime
- s/s- none
-
syphillis late
-occurs
-ineffectivity
-duration
-s/s
- "tertiary"
- occurs-1-20yrs after initial
- ineffectivity-non infectious
- duration-lifetime/fatal
- s/s-multisystemic
-
which stages will heal on their own
primary and secondary
-
syphillis stage s/s
- rashes
- moucus patches
- condylomata lata(moist papules)
- flu like symptoms
-
tertiary syphillis complications
- gummas
- cardiovascular
- ocular syphillis
- neurosyphillis
-
gummas
chronic destructive lessions and can damge any organ
-
cardiovascular syphilis
aneurysm, heart failure,
-
how is syphillis diagnosed
two step blood test
-
syphillis blood tests
- nontreponeal test
- VDRL and RPR
-
facts about the nontreponeal test
- they are not specific to syphillis
- can have false positives
-
specific tests for syphillis
treponeal test confirm specic antibodies
-
how is syphillis treated
antibiotic penicillin or doxycycline
-
what age group is more sucesptable to HPV
teens
-
what disease is known as the great pretender
syphillis
-
which bacteria causes syphillis
t palladium
-
do you have to report syphillis
yes
-
if you don't treat this disease then it becomes multisystemic
syphillis
-
how is syphilis transmitted
- direct contact with lesion
- sex
-
incubation for period for syphillis
10-90 days
-
stages of syphillis
- primary
- secondary
- latent(hidden)
- late(tertiary)
-
syphilis primary stage
-when
-where
-how long
if untreated
-s/s
- -21 days
- -sexual orphaces
- -3-6 weeks
- -heal on its own but progress to next stage
- -single or multiple cancres, enlarged lymph
-
syphilis secondary stage
-when
-where
-s/s
-duration
- -few weeks after cancre heels
- -mouth, anogenital, trunk
- -multiple systemic: rash on trunk, patches in mouth, condylomata(moist anogenital), flu like s/s
- -1-2 years
-
syphilis latent stage
-when
-duration
-s/s
- -weeks to years after initial infection
- -lifetime or progress
- -no s/s
-
syphilis late(tertiary)stage
-when
-duration
-s/s
- -rare, 1-20 after initial
- -lifetime, fatal
- -can effect any organ
-
how infectious
primary
secondary
latent
late
- -highly
- -highly
- -<1yr infectious >1yr non infectious
- -non infectious
-
late syphilis complications
gummas: chronic destructive lessions, damage organs
cardiocascular: aneurysm, HF, heart valve
ocular: decrease aquity, perm blind
neurosyphilis: personality, demensia, speech, loss muscle
-
how is syphilis diagnosed
two stage testing
- blood:nontrep for screening
- specif trep for confirmation
-
Syphillis
Blood tests
- -nontrep test used for screening
- -vdrl and rpr
- -simple, cheap
- -NOT SPECIFIC FOR SYPHILLIS
- -false-positives
-
Syphillis
specific test
- trep test for confirmation
- -FTA-ABs and TP-PA
- -detect specific antitreponemal antibodies
-
if a person is treated for syphilis would they still have a positive test
yes always
-
how is syphilis treated
penicillin
-
treatment
-all stages
-if penicillin is contraindicated
-neurosyphilis
- -penicillin
- -doxycycline or tetracycline
- -aqueous procaine pen G
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