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53 STDs

Lewis Ch 53 STDs

What STDs need to be reported and where do we report them? Gonorrhea and Syphilis and in most states Chlamydia are reported to the state or local public health authorities.
What organism causes NGU, Cervicitis, and Lymphogranuloma Venereum? Chlamydia trachomatis
What organism causes Encephalitis, esophagitis, retinitis, and pneumonitis in immunocomprimised patients? Cytomegalovirus (CMV)
What organism causes Hepatitis B? Hepatitis B virus
What organism causes Genital Herpes? Herpes simplex virus
What organism causes genital warts? human papilloma virus
What organism causes Molluscum cantagiosum? Poxvirus
What organism causes Gonorrhea? Neisseria gonorrheae
What organism causes Syphilis? Treponema pallidum
What factors have contributed to the increase incidence of STDs? Early sexual development and longer life span, Larger population, Sensual media, oral contraceptives instead of condoms, More…sexual freedom, leisure time, travel, urbanization
Which STD is the second most reported? Gonorrhea
What causes gonorrhea and how is it spread? Niesseria gonorrheae. Spread by direct physical contact with the host, usually sexual contact
Which STD has an inoculation period of 3-8 days? Gonorrhea
What is the inoculation period of gonorrhea? 3-8 days
A man comes into the clinic with urethritis, dysuria, profuse, purulent discharge from you know where. He had sex with a new partner a couple days ago. What do you suspect? Gonorrhea
What are the clinical manifestations of gonococcal infection in men? urethritis, dysuria, purulent discharge that shows up 2-5 days after infection and maybe swollen testicles
What are the initial clinical manifestations of gonacoccal infections in women? often asymptomatic, vaginal discharge, dysuria, frequency, changes in menstruation
What are the manifestation of a gonococcal infection in a woman after incubation? redness and swelling at contact site, greenish yellow purulent exudates that might stay local or spread by direct tissue extension to the uterus, fallopian tubes and ovaries.
How might a gonococcal infection be different in a young gal who is not having her period yet? Prepubertal girls may have vulvar/vaginal infection due to lack of estrogen
Which sex is more efficient at transmitting gonorrhea and why? Transmission is more efficient from men to women because the vagina makes a nicer home for Niesseria gonorrhea. (N.gonorrhea is fragile to drying, heat, and washing)
What are the symptoms of anorectal gonorrhea? soreness, itching, and discharge of the anus, usually symptoms are few
What gonoccocal infection can result from orogenital contact? gonococcal pharyngitis
What are the complications of gonorrhea in men? prostatitis, urethral strictures, sterility from orchitis or epididymitis.
What are the complications of gonorrhea in women? PID, Bartholin's abscess, Ectopic pregnancy, infertility. DGI is rare
What are the symptoms of DGI? skin lesions, fever, arthralgia, arthritis, or endocarditis
Why are complications of gonorrhea more likely in women? Because men notice symptoms early and have them treated. Women usually don’t seek treatment until a complication develops.
What affect does gonorrhea have on neonates? Neonates are routinely treated with erythromycin ophthalmic ointment or silver nitrate to prevent ophthalmia neonatorum.
Why are neonates routinely treated with eye ointment or drops? to prevent blindness from gonorrheal eye infections.
What are the diagnostic criteria for gonorrhea in men? symptoms and a positive gram stain smear
What are the diagnostic criteria for gonorrhea in women? Culture
Which sexually transmitted diseases can be cured? Gonorrhea, Chlamydia, Syphilis
What is the treatment for Gonorrhea? Most common is singular IM dose of Ceftriaxone (Rociphen) or Cefixime (Suprax), ciproflaxin (Cipro), ofloxan (Floxin), levofloxin (Levaquin)
What medication is often included in treatment of gonorrhea just in case there is a coexisting Chlamydial infection? azithromycin (Zithromax) or doxycycline (Vibramycin)
What drug should be kept out of sunlight and not taken with antacids, iron products or dairy? doxycycline (Vibramycin)
Which STDs can be treated but not cured? Genital Warts and Herpes
When would be an especially appropriate time to tell your patient to avoid squeezing his penis, sexual contact, and alcohol? While under treatment for gonorrhea infection.
What are three things your patients should avoid while being treated for Gonorrhea/Chlamydia? sex, squeezing, and alcohol
Early sexual development and longer life span, Larger population, Sensual media, oral contraceptives instead of condoms, More…sexual freedom, leisure time, travel, urbanization have contribute do what? Increase in incidence of STDs
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