Pathophysiology Chapter 34

  1. Define Urethritis
    inflammation of the urethra
  2. Define Cervicitis
    Inflammation of the cervix
  3. Define Salpingitis
    Inflammation of the uterine tubes
  4. Define Pelvic inflammatory disease (PID)
    Results when acute salpingitis spreads into the pelvis
  5. What is the effect of Local Inflammatory STIs?
    Cause urethritis, salpingitis, PID
  6. What are the two classes of local inflammatory STIs?
    • Gonococcal
    • Nongonococcal
  7. What is the treatment for Local Inflammatory STIs?
  8. What is the Etiology of Gonococcal Infection?
    • Inflammation of epithelial tissue by organism Neisseria gonorrhoeae
    • -->Gram-negative Diplococcus
  9. What is the transmission of Gonococcal Infection?
    Direct contact with infectious mucous membranes from infected person
  10. 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
  11. 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
  12. 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
  13. 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
  14. What is the treatment for gonorrhea?
    • Ceftriaxone
    • Cefixime
    • Spectinomycin
    • Cephalosporin
  15. What is the treatment for chlamydia?
    • Azithromycin
    • Doxycycline
  16. What are the STIs with Systemic Involvement?
    • Syphilis
    • Lymphogranuloma venereum
    • Genital Herpes
  17. 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
  18. 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
  19. What are the five phases of Syphilis?
    • Incubation Period
    • Primary Phase
    • Secondary Phase
    • Latent Phase
    • Late Phase
  20. What is the incubation period?
    10-90 days
  21. 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
  22. What is the Secondary stage?
    • Characterized by:
    • Low-grade fever
    • Malaise
    • Sore Throat
    • Headache
    • Lymphadenopathy
    • Mucosal or cutaneous rash
  23. What is the Latent Phase?
    • No symptoms are present
    • May experience infectious mucocutaneous lesions
    • May last >40 years
  24. 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
  25. How do you diagnose Syphilis?
    • Serologic screening test
    • Darkfield examination of tissue and exudates
    • Direct fluorescent antibody tests
  26. How do you treat Syphilis?
    • Penicillin
    • Tetracycline
    • Doxycycline
Card Set
Pathophysiology Chapter 34
Sexually Transmitted Infections