Lewis Ch 53 STDs
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| 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.
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| What organism causes NGU, Cervicitis, and Lymphogranuloma Venereum? | Chlamydia trachomatis
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| What organism causes Encephalitis, esophagitis, retinitis, and pneumonitis in immunocomprimised patients? | Cytomegalovirus (CMV)
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| What organism causes Hepatitis B? | Hepatitis B virus
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| What organism causes Genital Herpes? | Herpes simplex virus
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| What organism causes genital warts? | human papilloma virus
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| What organism causes Molluscum cantagiosum? | Poxvirus
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| What organism causes Gonorrhea? | Neisseria gonorrheae
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| What organism causes Syphilis? | Treponema pallidum
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| 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
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| Which STD is the second most reported? | Gonorrhea
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| What causes gonorrhea and how is it spread? | Niesseria gonorrheae. Spread by direct physical contact with the host, usually sexual contact
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| Which STD has an inoculation period of 3-8 days? | Gonorrhea
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| What is the inoculation period of gonorrhea? | 3-8 days
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| 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
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| 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
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| What are the initial clinical manifestations of gonacoccal infections in women? | often asymptomatic, vaginal discharge, dysuria, frequency, changes in menstruation
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| 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.
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| 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
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| 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)
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| What are the symptoms of anorectal gonorrhea? | soreness, itching, and discharge of the anus, usually symptoms are few
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| What gonoccocal infection can result from orogenital contact? | gonococcal pharyngitis
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| What are the complications of gonorrhea in men? | prostatitis, urethral strictures, sterility from orchitis or epididymitis.
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| What are the complications of gonorrhea in women? | PID, Bartholin's abscess, Ectopic pregnancy, infertility. DGI is rare
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| What are the symptoms of DGI? | skin lesions, fever, arthralgia, arthritis, or endocarditis
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| 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.
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| What affect does gonorrhea have on neonates? | Neonates are routinely treated with erythromycin ophthalmic ointment or silver nitrate to prevent ophthalmia neonatorum.
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| Why are neonates routinely treated with eye ointment or drops? | to prevent blindness from gonorrheal eye infections.
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| What are the diagnostic criteria for gonorrhea in men? | symptoms and a positive gram stain smear
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| What are the diagnostic criteria for gonorrhea in women? | Culture
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| Which sexually transmitted diseases can be cured? | Gonorrhea, Chlamydia, Syphilis
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| What is the treatment for Gonorrhea? | Most common is singular IM dose of Ceftriaxone (Rociphen) or Cefixime (Suprax), ciproflaxin (Cipro), ofloxan (Floxin), levofloxin (Levaquin)
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| What medication is often included in treatment of gonorrhea just in case there is a coexisting Chlamydial infection? | azithromycin (Zithromax) or doxycycline (Vibramycin)
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| What drug should be kept out of sunlight and not taken with antacids, iron products or dairy? | doxycycline (Vibramycin)
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| Which STDs can be treated but not cured? | Genital Warts and Herpes
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| 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.
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| What are three things your patients should avoid while being treated for Gonorrhea/Chlamydia? | sex, squeezing, and alcohol
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| 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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