Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
1. What is an STI? (affect more than 20 million Americans per year, and 1/2 are
younger than 25 years. Hidden epidemic.: STI: is the general term for any disease that can be
spread by intimate and/or sexual contact.
Includes systemic diseases such as hepatitis and tuberculosis
Is prevalent in all socioeconomic and racial or ethnic groups
Individuals who have unprotected nonmonogamous sex have the greatest risk for STI exposure and infection.
2. Types of sexually transmitted urogenital infections: Bacterial -(gonorrhea-syphilis-chan-
croid-granuloma inguinale-bacterial vaginosis)
Viral
Protozoal
Parasitic
Fungal
3. Gonorrhea (Bacterial infection): Disseminated gonococcal infection (DGI)
•Rare systemic complication brought about by the spread of infection through the bloodstream
•Life-threatening condition causing a generalized rash and severe joint pain
Perihepatitis
•Spread of N. gonorrhoeae to the liver
Ophthalmia neonatorum
•Gonococcal eye infection in an infant from an infected mother (most states require prophylactic opthalmic antibiotics to
prevent gonococcal eye infection. Topical antibiotics may not be effective in eliminating neonatal infection and systemic
tx. is indicated for all newborns with known exposure. (onset of symptoms 1-12 days) Newborns may also develop
gonorrheal rhinitis.
4. Gonnorhea (Bacterial infection): Is caused by Neisseria gonorrhoeae.
Transmission generally requires the contact of epithelial surfaces such as vaginal, oral, or anal intercourse, and infection
in the adults can be in the vagina, rectum, oropharynx, and the urethra.
Pregnant woman can pass gonorrhea to her fetus through infected cervical and vaginal secretions, and a mother can
pass it to her newborn child. Following vertical transmission, the newborn eyes can be infected and result in blindness
if untreated.
Humans are the only natural hosts.
Presence of pili helps N. gonorrhoeae attach to the epithelial cells of mucous membranes.
5. Why is treatment for gonorrhea becoming more difficult?: because of rapidly devel-
oping resistance to antibiotics. CDC and WHO advise dual drug treatment to treat the infection and staunch increasing
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
resistance.
Antibiotic resistance is most common in those who frequently have oral and anal intercourse (men with men) CDC says
gonorrhea likely to become resistant to all antibiotics in the near future.
6. Common sites/complications of gonorrhea (Bacterial infection): •Endocervical canal
(inner portion of the cervix): most common site for women
•Urethra
•Skene and/or Bartholin glands
•Urethra or rectum: most common site for men
Complications:
•Pelvic inflammatory disease (PID)
•Sterility
•Disseminated infection
7. Clinical manifestations of gonorrhea (Bacterial infection): •Men: sudden onset of
painful urination or purulent penile discharge, or both (within a week from infection)
•Women (within 10 days of exposure or 1-2 days after the next period. More than half are asymptomatic
Symptoms often do not appear until they have spread to the upper reproductive tract (uterus, fallopian/uterine tubes,
and ovaries)
Dysuria (difficult/painful urination)
Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia (painful sex) , lower abdominal and/or
pelvic pain
Fever; mucopurulent discharge from the cervical os
8. treatment for gonorrhea (Bacterial infection): •Antibiotic (ceftriaxone)
•Multidrug administration to reduce resistance
•Resistant to many antibiotics
•Treatment of partners
•Avoidance of sex until infection resolved, then usage of condoms
9. What is syphilis? (Bacterial infection): On the increase from men having sex with men
Treponema pallidum (anaerobic spirochete)
•Is a corkscrew-shaped, anaerobic bacterium that cannot be cultured in vitro (grow in human organ or tissue only)
•Infects any body tissue
•Becomes a systemic disease shortly after infection
Maternal-fetal transmission can occur as early as 9 weeks' gestation.
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
Tests
•Darkfield microscopy and serologic testing
10. Where is the bacteria from syphillis present? (Bacterial infection): exudate from
moist mucosal or cutaneous lesions, the spirochete is usually transmitted to others during the first few years of infection.
11. Why does untreated early syphilis result in perinatal death (40-70%) during
pregnancy? (Bacterial infection): Because the spirochete can cross the placental membrane to infect
the fetus. However, simple tx with penicillin is 98% effective at preventing vertical transmission (from mother to baby
during the period immediately before and after birth) .
Therefore, all pregnant women should be screened at their first prenatal visit, and women at risk should be screened
again in the 3rd trimester and at the time of delivery.
12. The course of untreated syphilis consists of 4 stages:
Stage 1 Primary (usually painless, round, and hard sores)
Secondary
Latent
Tertiary: Primary syphilis: local invasion
Treponema pallidum multiplies in epithelium producing granulomatous tissue reaction (chancre)
From 12 days to 12 weeks after exposure
Average duration: 3 weeks
Granulomatous tissue reaction: hard chancre (eroded, painless, firm, and indurated [hard] ulcer)
Microorganisms drain with the lymphatic fluid
Firm, enlarged, and nontender regional lymph nodes
13. Stage 2, secondary syphilis: Secondary syphilis: systemic disease: blood-borne bacteria spread to
all major organs. There is a period in which the immune system can suppress the infection. Even without treatment,
spontaneous resolution of the skin lesions occurs and the individual enters the latent stages of infection.
systemic manifestations:
Develops 6 weeks after the first appearance of the chancre
Low-grade fever, malaise, sore throat, hoarseness
Anorexia, generalized adenopathy, headache, joint pain, and skin or mucous membrane lesions or rashes
Condylomata lata (a raised growth on the skin resembling a wart typically in the genital region)
14. Stage 3, Latent syphilis: Latent syphilis: May be subdivided into early and late stages; however serologic
studies show that syphilis is present, but there are no clinical manifestation. Transmission remains possible at this
phase.
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
Duration: as short as 1 year or as long as a lifetime
Divided into early and late stages
Medical evidence of the infection; asymptomatic individual
15. Stage 4, Tertiary syphilis: Tertiary syphilis: Is the most severe stage, involving significant morbidity and
mortality . The pathogenesis of syphilitics manifestations at this phase remain unclear. The destructive skin, bone,
and soft lesions (called gummas) of tertiary syphilis probably are caused by a severe hypersensitivity reactions to
the microorganisms. Within the cardiovascular system, infection with T. Pallidum may cause aneurysms, heart valve
insufficiencies, and heart failure.
Appearing after the latent stage
Most severe stage
Formation of gummas: destructive skin, bone, and soft tissue lesions
Destructive systemic manifestations
Neurosyphilis: tabes dorsalis (loss of coordination of movement general paresis (muscular weakness)
16. Congenital Syphilis: Congenital
caused by the passage of spirochete across the plasma membrane to affect any or all fetal tissues. The infection can
cause fetal death or growth abnormalities, including changes in fetal bones, teeth and neurologic system. Affected
Newborns can have growth abnormalities, rashes, hepatosplenomegaly, jaundice, CNS involvement including blindness
and deafness. A classically reported late manifestation of congenital
syphilis is notched incisors. While now rare, this stigma is used in historical studies of syphilis.
•Vasculitis, necrosis, fibrosis, and distribution of Treponema pallidum throughout the tissues
•Early and late stages
Tests
•Venereal Disease Research Laboratory (VDRL) antigen and the rapid plasma reagin (RPR) tests, both tests can have
false positives so a Treponemal test is used to verify when positive.
Treatment
•Parenteral injection of benzathine penicillin G
Penicillin also used for infants
•Treatment of sexual partners
•Condoms recommended until effective treatment is verified
17. chancroid (bacterial infection): Chancroid, or soft chancre is an acute infectious disease that was first
differentiated from syphilis in 1852.
Study online at https://quizlet.com/_ctm0kt
1. What is an STI? (affect more than 20 million Americans per year, and 1/2 are
younger than 25 years. Hidden epidemic.: STI: is the general term for any disease that can be
spread by intimate and/or sexual contact.
Includes systemic diseases such as hepatitis and tuberculosis
Is prevalent in all socioeconomic and racial or ethnic groups
Individuals who have unprotected nonmonogamous sex have the greatest risk for STI exposure and infection.
2. Types of sexually transmitted urogenital infections: Bacterial -(gonorrhea-syphilis-chan-
croid-granuloma inguinale-bacterial vaginosis)
Viral
Protozoal
Parasitic
Fungal
3. Gonorrhea (Bacterial infection): Disseminated gonococcal infection (DGI)
•Rare systemic complication brought about by the spread of infection through the bloodstream
•Life-threatening condition causing a generalized rash and severe joint pain
Perihepatitis
•Spread of N. gonorrhoeae to the liver
Ophthalmia neonatorum
•Gonococcal eye infection in an infant from an infected mother (most states require prophylactic opthalmic antibiotics to
prevent gonococcal eye infection. Topical antibiotics may not be effective in eliminating neonatal infection and systemic
tx. is indicated for all newborns with known exposure. (onset of symptoms 1-12 days) Newborns may also develop
gonorrheal rhinitis.
4. Gonnorhea (Bacterial infection): Is caused by Neisseria gonorrhoeae.
Transmission generally requires the contact of epithelial surfaces such as vaginal, oral, or anal intercourse, and infection
in the adults can be in the vagina, rectum, oropharynx, and the urethra.
Pregnant woman can pass gonorrhea to her fetus through infected cervical and vaginal secretions, and a mother can
pass it to her newborn child. Following vertical transmission, the newborn eyes can be infected and result in blindness
if untreated.
Humans are the only natural hosts.
Presence of pili helps N. gonorrhoeae attach to the epithelial cells of mucous membranes.
5. Why is treatment for gonorrhea becoming more difficult?: because of rapidly devel-
oping resistance to antibiotics. CDC and WHO advise dual drug treatment to treat the infection and staunch increasing
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
resistance.
Antibiotic resistance is most common in those who frequently have oral and anal intercourse (men with men) CDC says
gonorrhea likely to become resistant to all antibiotics in the near future.
6. Common sites/complications of gonorrhea (Bacterial infection): •Endocervical canal
(inner portion of the cervix): most common site for women
•Urethra
•Skene and/or Bartholin glands
•Urethra or rectum: most common site for men
Complications:
•Pelvic inflammatory disease (PID)
•Sterility
•Disseminated infection
7. Clinical manifestations of gonorrhea (Bacterial infection): •Men: sudden onset of
painful urination or purulent penile discharge, or both (within a week from infection)
•Women (within 10 days of exposure or 1-2 days after the next period. More than half are asymptomatic
Symptoms often do not appear until they have spread to the upper reproductive tract (uterus, fallopian/uterine tubes,
and ovaries)
Dysuria (difficult/painful urination)
Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia (painful sex) , lower abdominal and/or
pelvic pain
Fever; mucopurulent discharge from the cervical os
8. treatment for gonorrhea (Bacterial infection): •Antibiotic (ceftriaxone)
•Multidrug administration to reduce resistance
•Resistant to many antibiotics
•Treatment of partners
•Avoidance of sex until infection resolved, then usage of condoms
9. What is syphilis? (Bacterial infection): On the increase from men having sex with men
Treponema pallidum (anaerobic spirochete)
•Is a corkscrew-shaped, anaerobic bacterium that cannot be cultured in vitro (grow in human organ or tissue only)
•Infects any body tissue
•Becomes a systemic disease shortly after infection
Maternal-fetal transmission can occur as early as 9 weeks' gestation.
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
Tests
•Darkfield microscopy and serologic testing
10. Where is the bacteria from syphillis present? (Bacterial infection): exudate from
moist mucosal or cutaneous lesions, the spirochete is usually transmitted to others during the first few years of infection.
11. Why does untreated early syphilis result in perinatal death (40-70%) during
pregnancy? (Bacterial infection): Because the spirochete can cross the placental membrane to infect
the fetus. However, simple tx with penicillin is 98% effective at preventing vertical transmission (from mother to baby
during the period immediately before and after birth) .
Therefore, all pregnant women should be screened at their first prenatal visit, and women at risk should be screened
again in the 3rd trimester and at the time of delivery.
12. The course of untreated syphilis consists of 4 stages:
Stage 1 Primary (usually painless, round, and hard sores)
Secondary
Latent
Tertiary: Primary syphilis: local invasion
Treponema pallidum multiplies in epithelium producing granulomatous tissue reaction (chancre)
From 12 days to 12 weeks after exposure
Average duration: 3 weeks
Granulomatous tissue reaction: hard chancre (eroded, painless, firm, and indurated [hard] ulcer)
Microorganisms drain with the lymphatic fluid
Firm, enlarged, and nontender regional lymph nodes
13. Stage 2, secondary syphilis: Secondary syphilis: systemic disease: blood-borne bacteria spread to
all major organs. There is a period in which the immune system can suppress the infection. Even without treatment,
spontaneous resolution of the skin lesions occurs and the individual enters the latent stages of infection.
systemic manifestations:
Develops 6 weeks after the first appearance of the chancre
Low-grade fever, malaise, sore throat, hoarseness
Anorexia, generalized adenopathy, headache, joint pain, and skin or mucous membrane lesions or rashes
Condylomata lata (a raised growth on the skin resembling a wart typically in the genital region)
14. Stage 3, Latent syphilis: Latent syphilis: May be subdivided into early and late stages; however serologic
studies show that syphilis is present, but there are no clinical manifestation. Transmission remains possible at this
phase.
, Unit 3 NU 545
Study online at https://quizlet.com/_ctm0kt
Duration: as short as 1 year or as long as a lifetime
Divided into early and late stages
Medical evidence of the infection; asymptomatic individual
15. Stage 4, Tertiary syphilis: Tertiary syphilis: Is the most severe stage, involving significant morbidity and
mortality . The pathogenesis of syphilitics manifestations at this phase remain unclear. The destructive skin, bone,
and soft lesions (called gummas) of tertiary syphilis probably are caused by a severe hypersensitivity reactions to
the microorganisms. Within the cardiovascular system, infection with T. Pallidum may cause aneurysms, heart valve
insufficiencies, and heart failure.
Appearing after the latent stage
Most severe stage
Formation of gummas: destructive skin, bone, and soft tissue lesions
Destructive systemic manifestations
Neurosyphilis: tabes dorsalis (loss of coordination of movement general paresis (muscular weakness)
16. Congenital Syphilis: Congenital
caused by the passage of spirochete across the plasma membrane to affect any or all fetal tissues. The infection can
cause fetal death or growth abnormalities, including changes in fetal bones, teeth and neurologic system. Affected
Newborns can have growth abnormalities, rashes, hepatosplenomegaly, jaundice, CNS involvement including blindness
and deafness. A classically reported late manifestation of congenital
syphilis is notched incisors. While now rare, this stigma is used in historical studies of syphilis.
•Vasculitis, necrosis, fibrosis, and distribution of Treponema pallidum throughout the tissues
•Early and late stages
Tests
•Venereal Disease Research Laboratory (VDRL) antigen and the rapid plasma reagin (RPR) tests, both tests can have
false positives so a Treponemal test is used to verify when positive.
Treatment
•Parenteral injection of benzathine penicillin G
Penicillin also used for infants
•Treatment of sexual partners
•Condoms recommended until effective treatment is verified
17. chancroid (bacterial infection): Chancroid, or soft chancre is an acute infectious disease that was first
differentiated from syphilis in 1852.
