Sexually Transmitted Infections
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| Reproductive tract infection | encompasses both sexually transmitted infections and other common genital tract infections
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| how many sti infection every year? | more than 19 million Americans are infected with STIs every year
almost half of these are between the ages of 15 and 24
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| common sti infections: | chlamydia,
gonorrhea,
human papillomavirus,
herpes simplex virus type 2,
syphilis,
and HIV infection;
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| How to help patient with prevention of STI: | include questions about a woman's sexual history, risky sexual behaviors, and drug-related risky behaviors as a part of her assessment
Use openended questions
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| Chlamydia (Chlamydia trachomatis) | it is the most commonly reported STI in American women.
Can lead to:
Pelvic inflammatory disease
increased risk of ectopic pregnancy
neonate developing conjunctivitis or pneumonia
silver nitrate solution or antibiotic ointment does not stop transm
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| Screening for Chlamydia (asymptomatic condition) | during 1st prenatal visit, then late in 3rd trimester if mother is under 25, or has new or multiple partners, or was previously positive.
Sexually active adolescents under 25 should get tested every year
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| Treatment of Chlamydia | doxycycline and azithromycin
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| Gonorrhea (asymptomatic) | oldest communicable disease in the United States and second to chlamydia in reported cases. (asymptomatic)
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| salpingitis | general term for infection of the uterus lining, fallopian tubes, or ovaries.
>>Occurs in the 1st trimester of pregnancy with cervical gonorrhea
Ophthalmia neonatorum can cause blindness in neonate
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| Treatment of gonorrhea | cefixime or ceftriaxone
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| Syphilis | caused by Treponema pallidum, a motile spirochete.
Transmission is thought to be by entry in the subcutaneous tissue through microscopic abrasions that can occur during sexual intercourse.
It has multiple stages
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| Primary Syphilis | characterized by a primary lesion, the chancre, that appears 5 to 90 days after infection.
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| Secondary Syphilis | occurs 6 weeks to 6 months later,
characterized by a widespread, symmetric maculopapular rash on the palms and soles and generalized lymphadenopathy.
The infected individual also may experience fever, headache, and malaise.
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| Screening for Syphilis | may show false negative if in active phase
retest 1-2 months later
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| Treatment of Syphilis | Penicillin
Although doxycycline, tetracycline, and erythromycin are alternative treatments for penicillin-allergic clients, both tetracycline and doxycycline are contraindicated in pregnancy, and erythromycin is unlikely to cure a fetal infection.
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| Jarisch-Herxheimer reaction | Can occur when treated for syphilis
acute febrile reaction often accompanied by
headache,
myalgias,
and arthralgias
that develop within the first 24 hours of treatment.
Treated with analgesics and antipyretics.
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| Pelvic Inflammatory Disease(PID) | infectious process that most commonly involves the uterine (fallopian) tubes (salpingitis), uterus (endometritis), and more rarely, the ovaries and peritoneal surfaces.
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| PID Screening | screen in sexually active young women with the following:
lower abdominal tenderness, bilateral adnexal tenderness, and cervical motion tenderness.
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| Human Papillomavirus | >also known as condylomata acuminata, or genital warts,
>is the most common viral STI seen in ambulatory health care settings.
>20 millions
>Lesions enlarge during pregnancy
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| Screening for HPV | A woman with HPV lesions may complain of symptoms such as a profuse, irritating vaginal discharge, itching, dyspareunia, or postcoital bleeding.
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| Treatment of HPV | warts may resolve on their own
no treatment is the best
bathing with oatmeal solution and drying with cool hair dryer can provide relief
wear cotton underwear to keep the area dry
maintain healthy lifestyle to boost immunity
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| Prevention of HPV | Two vaccines are available: Cervarix and Gardisil
Practice safe sex
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| Genital Herpes Simplex Virus | HSV infection results in painful recurrent genital ulcers and is caused by two different antigen subtypes of herpes simplex virus: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2).
#2 transmitted sexually
#1 transmitted nonsexually
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| Symptoms of HSV | An initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria and may last 2 to 3 weeks.
Cervicitis can occur
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| Screening for HSV | history of headache, fever, or myalgia is suggestive.
Local symptoms such as vulvar pain, dysuria, itching or burning at the site of infection, and painful genital lesions that heal spontaneously also are highly suggestive of HSV infections.
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| Treatment of HSV | No known cure
medications include acyclovir, valacyclovir, and famciclovir.
Cleaning lesions twice a day with saline will help prevent secondary infection.
using warm sitz baths with baking soda and keeping area dry
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| Hepatitis A | fecal-oral route by ingestion of contaminated food
also transmitted sexually
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| Hepatitis B virus (HBV) | most threatening to the fetus and neonate
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| Management of Hepatitis | increase rest periods, eat a high-protein, low-fat diet; and increase fluid intake.
Give the vaccine
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| Hepatitis C | readily transmitted through exposure to blood
treatment:
Interferon-alfa alone or with ribavirin for 6 to 12 months is the main therapy for chronic HCV-related liver disease
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| HIV | 37,000 new infections every year!
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| Counseling for HIV testing has two parts | explanation part
result is given is 2nd part
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| Treatment of HIV |
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