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Define Urethritis
inflammation of the urethra
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Define Cervicitis
Inflammation of the cervix
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Define Salpingitis
Inflammation of the uterine tubes
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Define Pelvic inflammatory disease (PID)
Results when acute salpingitis spreads into the pelvis
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What is the effect of Local Inflammatory STIs?
Cause urethritis, salpingitis, PID
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What are the two classes of local inflammatory STIs?
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What is the treatment for Local Inflammatory STIs?
antibiotics
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What is the Etiology of Gonococcal Infection?
- Inflammation of epithelial tissue by organism Neisseria gonorrhoeae
- -->Gram-negative Diplococcus
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What is the transmission of Gonococcal Infection?
Direct contact with infectious mucous membranes from infected person
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What is the pathogenesis of Gonococcal Infection?
- Gonococcus attaches to and penetrates columnar epithelium
- -Bacteria enter the submucosal connective tissue and initiate immune responses
- -Mast cells, neutrophils, and plasma cells are the most involved in the immune response
- Direct extension of infection occurs through lymphatic system
- Once spread, localized infection occurs
- -Causes formation of cysts and abscesses
- -Purulent exudate damages tissue
- -Fibrous tissue replaces inflamed tissue
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What are the clinical manifestations of Gonococcal infection in Women?
- Usually asymptomatic
- Vaginal discharge
- Normal or Abnormal bleeding
- Affects urethra, Bartholin & skene glands, anus, cervix
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What are the clinical manifestations of Gonococcal infection in Men?
- Dysuria
- Purulent urethral discharge
- Redness and swelling at infection site
- Untreated-->infection may produce abscesses in both sexes
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What is the pathogenesis of Nongonococcal Infections?
- Caused by Chlamydia trachomatis
- Acts on columnar epithelium
- Spread by extension to oviducts
- Results in pelvic inflammatory disease
- Transmission during birth may result in ophthalmia neonatorum
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What is the treatment for gonorrhea?
- Ceftriaxone
- Cefixime
- Spectinomycin
- Cephalosporin
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What is the treatment for chlamydia?
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What are the STIs with Systemic Involvement?
- Syphilis
- Lymphogranuloma venereum
- Genital Herpes
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What is the Etiology of Syphilis?
- Systemic infection of vascular system
- Caused by Treponema pallidum
- Acquired when organism penetrates intact mucous membrane or abraded skin during sexual contact
- Incubation phase: goes thru body, invades other organs
- Transmission of fetus may occur transplacentally
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What is the pathogenesis of Syphilis?
- Causes changes in vascular system
- Inflammatory response in tissue
- Terminal arterioles and small arteries become obliterated and no longer functional
- Long-term inflammation of vascular tissue results in fibrosis leading to necrosis
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What are the five phases of Syphilis?
- Incubation Period
- Primary Phase
- Secondary Phase
- Latent Phase
- Late Phase
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What is the incubation period?
10-90 days
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What is the Primary Phase?
- Formation of chancre
- -->Painless, ulcerative lesion that arises at original spirochete portal of entry
- Resolve spontaneously within 3-6 weeks
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What is the Secondary stage?
- Characterized by:
- Low-grade fever
- Malaise
- Sore Throat
- Headache
- Lymphadenopathy
- Mucosal or cutaneous rash
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What is the Latent Phase?
- No symptoms are present
- May experience infectious mucocutaneous lesions
- May last >40 years
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What is the Late phase?
- Manifestations depend on area of arterial lesion and extent of circulatory insufficiency
- Cardiovascular system-aortic insufficiency
- Nervous system-shuffling walk, paralysis, blindness
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How do you diagnose Syphilis?
- Serologic screening test
- Darkfield examination of tissue and exudates
- Direct fluorescent antibody tests
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How do you treat Syphilis?
- Penicillin
- Tetracycline
- Doxycycline
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