STI(1247 exam 1)

male condom

no

no

from men to women

• gonorrhea
• syphyllis
• chlamydia

chlamydia and gonhorrea

sexual fluids during vag, oral or anal

• men: urethra
• women: cervix

• -may have none
• -men: urethral discharge, dysuria, swollen and tender testes
• -rectal chlamydia: discharge, rectal pain, bleeding

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

• h&p
• NAAT
• test for other std
• test sexual partners

• -nucleic acid amplification test
• -prefeered test for chlamydia and gonorrhea
• -detects infectious organisms
• -swab affected area or urine

azithromycin or doxycycline

• avoid sun
• no antacids, iron, dairy
• no when prego

• no sex for 1 week after treatment and until partner has completed treatment
• treat partner w/in 60 days
• retest in 3 months

ceftriaxone and azithromycin

• epididymitis(infertility, drainage pus)
• infertility

• infertility
• PID
• ectopic prego because of PID
• chronic pelvic pain

HSV 1 and HSV 2

• 1: oral but could occur anywhere
• 2: genitals but can also occur anywhere

• -direct skin contact or mucos membrane when infected person is symptomatic
• -could also be during asymptomatic shedding which is impossible to predict

• prodromol
• vesicular
• ulcerative
• final

• no lessions
• burning, itching or tingiling at site of innoculation

• -small vessicles appear on genitals, vagina, cervix, perineum, perianal
• -vessicles contain large quantities of infected virus

• lessions rupture and form shallow moist ulcerations
• -urine touching lessions can be painful
• -autoinnoculation can occur

• spontaneous crusting and epithelialization of erosions
• lessions heal spontaneously in 3 weeks

• triggers -stress, fatigue, illness, sunburn, immunosuppression, menses
• -prodromal stage s/s tingling, burning, itching

• -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

• -no cure
• -drugs just inhibit viral replication
• -acyclovir, valacyclovire, famciclovir

HPV

genital warts

• -skin to skin
• -can resolve spontaneously after 1-2 years

• -usually no s/s
• -less that 10 flesh colored growths
• -genitals, inner thigh, perianal, cervix/vagina
• -itching
• -bleeding

• multiple partners
• sex at young age
• immunosuppresion
• uncircumsized

asymptomatic

it is viral so no culture

NAAT

-mostly asymptomatic so cervical cancer

removal of any symptomatic wart

• -course therapy
• -laser, cryo, surgical, gel,

• -reccurence and reinfection is possible
• -gardisil and cervarix vaccine

• 11-12 yr old receive 2 doses 6 months apart
• 15-26 three doses

• bacterial
• treponema palladium

yes

great pretender

if you don't treat it it can become multisystemic

• -during sex
• direct contact with lesion
• mom to baby via blood stream

• 10-90 days
• average 21

• occurs-21 days after
• ineffectivity-high
• duration-3-6w
• s/s-single/multiple cancers and enlarged lymph nodes

• occurs- few weeks after cancre heals
• ineffectivity-high
• duration-1-2 years
• s/s- multiple systemic

• "hidden"
• occurs-weeks to years after initial infection
• ineffectivity-less than a yr more more than a year less
• duration- lifetime
• s/s- none

• "tertiary"
• occurs-1-20yrs after initial
• ineffectivity-non infectious
• duration-lifetime/fatal
• s/s-multisystemic

primary and secondary

• rashes
• moucus patches
• condylomata lata(moist papules)
• flu like symptoms

• gummas
• cardiovascular
• ocular syphillis
• neurosyphillis

chronic destructive lessions and can damge any organ

aneurysm, heart failure,

two step blood test

• nontreponeal test
• VDRL and RPR

• they are not specific to syphillis
• can have false positives

treponeal test confirm specic antibodies

• FTA-abs
• TP-Pa

antibiotic penicillin or doxycycline

teens

syphillis

t palladium

yes

syphillis

• direct contact with lesion
• sex

10-90 days

• primary
• secondary
• latent(hidden)
• late(tertiary)

• -21 days
• -sexual orphaces
• -3-6 weeks
• -heal on its own but progress to next stage
• -single or multiple cancres, enlarged lymph

• -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

• -weeks to years after initial infection
• -lifetime or progress
• -no s/s

• -rare, 1-20 after initial
• -lifetime, fatal
• -can effect any organ

• -highly
• -highly
• -<1yr infectious >1yr non infectious
• -non infectious

gummas: chronic destructive lessions, damage organs

cardiocascular: aneurysm, HF, heart valve

ocular: decrease aquity, perm blind

neurosyphilis: personality, demensia, speech, loss muscle

two stage testing

• blood:nontrep for screening
• specif trep for confirmation

• -nontrep test used for screening
• -vdrl and rpr
• -simple, cheap
• -NOT SPECIFIC FOR SYPHILLIS
• -false-positives

• trep test for confirmation
• -FTA-ABs and TP-PA
• -detect specific antitreponemal antibodies

yes always

penicillin

• -penicillin
• -doxycycline or tetracycline
• -aqueous procaine pen G