PATHO 3280 Exam 4 Study Guide - UNITS 8, 9, & 10
UNIT 8
Gonorrhea
Pathophysiology & Etiology
Associated with gram negative bacteria diplococcus N. gonorrheae
Transmission
o Exudates of an infected person makes direct contact with
mucous membranes of another person
o Leads to inflammatory response in the columnar epithelium of
infected area
Occurs most often in teens and young adults
Clinical Manifestations
Women
o Often asymptomatic
o Purulent discharge
o Dysuria
o Vaginal bleeding
o Commonly infected areas
Cervix
Urethra
Skene glands (located on either side of urethra – function
unknown)
Bartholin glands (located on either side of the vagina –
creates lubricating mucus)
Anus
Men
o Occurs after 3-6 days of incubation
o Dysuria
o Purulent urethra discharge with redness and swelling
Complications
Women
o Salpingitis
o Pelvic inflammatory disease (PID)
, o Ectopic pregnancy (due to scar tissue formation from
inflammation)
Men
o Epididymitis
Both genders
o Inflammation in other areas are also possible due to lymphatic
spread
Pharynx
Conjunctivae
o Urinary issues or infertility due to fibrosis/scarring from
inflammation
Chlamydia
Pathophysiology & Etiology
Associated with chlamydia trachomatis
Transmission
o Exudates of an infected person makes direct contact with
mucous membranes of another person
Leads to inflammatory response in the columnar
epithelium of infected area
o Mom to baby: “ophthalmia neonatorum”: infected eyes of
newborns during birth
Occurs most often in people ≤ 24 years old
Clinical Manifestations
Symptoms usually less severe than gonorrhea
Women
o Often asymptomatic
o Urethritis
o Cervicitis
Men
o Urethritis
Complications
Women
o Salpingitis
o Pelvic inflammatory disease (PID)
, o Ectopic pregnancy (due to scar tissue formation from
inflammation)
Men
o Epididymitis
Both genders
o Infertility due to fibrosis/scarring from inflammation
Syphilis
Pathophysiology & Etiology
Caused by an infection of treponema pallidum
Transmission:
o Enters through mucus membranes or abraded skin (sexual
contact) and travels through the lymph system
Inflammatory response in the vessels -> small artery &
arteriole function is decreased
Long term inflammation leads to fibrous thickening of
blood vessels and tissue necrosis
o Can also enter via the placenta
Inflammation in the fetus doesn’t happen until week 15 of
the pregnancy
Mom should be treated prior to this. If not, baby can have
physical and developmental disabilities.
Clinical Manifestations
Five phases
o Incubation
The first 10-90 days after the pathogen invades
o Primary
3-6 weeks
Chancre (painless ulceration) formed at the site of initial
infection
Usually genital area
Women may be asymptomatic because chancre is often
inside vagina or on cervix
o Secondary
Often self-limiting
, Low-grade fever, malaise
Sore throat
Headache
Lymphadenopathy
Mucosal and/or skin rash
o Latent
Time is variable – around 40 years
Asymptomatic except mucocutaneous lesions early on
Can still be contagious in early latency
Blood tests still + despite no symptoms
2/3 patients remain in this stage and never progress to the
late stage
5. Late
i. Symptoms depend on the area affected
ii. Most common areas
1. Cardiovascular
a. Aortic stenosis
b. Aortic insufficiency
2. Central Nervous System
a. Degeneration of cortical neurons leading to
paresis, blindness, and altered mental status
Herpes Simplex
Caused by infection of the herpes simplex virus
Transmission
o Both types: via sexual contact
o Type 2 also mom to baby via vaginal delivery
Initial infection leads to self-limiting lesions that heal
Virus remains latent in the neural ganglia and reactivates during
physical/emotional stress or immunosuppression.
Clinical Manifestations
Type 1
o Above waist – mouth, lips, eyes, etc.
o 1-2 days of paresthesia prior to skin lesions
o Single or a cluster of tender vesicles that then crust and heal
(Happens over 3-10 days)
UNIT 8
Gonorrhea
Pathophysiology & Etiology
Associated with gram negative bacteria diplococcus N. gonorrheae
Transmission
o Exudates of an infected person makes direct contact with
mucous membranes of another person
o Leads to inflammatory response in the columnar epithelium of
infected area
Occurs most often in teens and young adults
Clinical Manifestations
Women
o Often asymptomatic
o Purulent discharge
o Dysuria
o Vaginal bleeding
o Commonly infected areas
Cervix
Urethra
Skene glands (located on either side of urethra – function
unknown)
Bartholin glands (located on either side of the vagina –
creates lubricating mucus)
Anus
Men
o Occurs after 3-6 days of incubation
o Dysuria
o Purulent urethra discharge with redness and swelling
Complications
Women
o Salpingitis
o Pelvic inflammatory disease (PID)
, o Ectopic pregnancy (due to scar tissue formation from
inflammation)
Men
o Epididymitis
Both genders
o Inflammation in other areas are also possible due to lymphatic
spread
Pharynx
Conjunctivae
o Urinary issues or infertility due to fibrosis/scarring from
inflammation
Chlamydia
Pathophysiology & Etiology
Associated with chlamydia trachomatis
Transmission
o Exudates of an infected person makes direct contact with
mucous membranes of another person
Leads to inflammatory response in the columnar
epithelium of infected area
o Mom to baby: “ophthalmia neonatorum”: infected eyes of
newborns during birth
Occurs most often in people ≤ 24 years old
Clinical Manifestations
Symptoms usually less severe than gonorrhea
Women
o Often asymptomatic
o Urethritis
o Cervicitis
Men
o Urethritis
Complications
Women
o Salpingitis
o Pelvic inflammatory disease (PID)
, o Ectopic pregnancy (due to scar tissue formation from
inflammation)
Men
o Epididymitis
Both genders
o Infertility due to fibrosis/scarring from inflammation
Syphilis
Pathophysiology & Etiology
Caused by an infection of treponema pallidum
Transmission:
o Enters through mucus membranes or abraded skin (sexual
contact) and travels through the lymph system
Inflammatory response in the vessels -> small artery &
arteriole function is decreased
Long term inflammation leads to fibrous thickening of
blood vessels and tissue necrosis
o Can also enter via the placenta
Inflammation in the fetus doesn’t happen until week 15 of
the pregnancy
Mom should be treated prior to this. If not, baby can have
physical and developmental disabilities.
Clinical Manifestations
Five phases
o Incubation
The first 10-90 days after the pathogen invades
o Primary
3-6 weeks
Chancre (painless ulceration) formed at the site of initial
infection
Usually genital area
Women may be asymptomatic because chancre is often
inside vagina or on cervix
o Secondary
Often self-limiting
, Low-grade fever, malaise
Sore throat
Headache
Lymphadenopathy
Mucosal and/or skin rash
o Latent
Time is variable – around 40 years
Asymptomatic except mucocutaneous lesions early on
Can still be contagious in early latency
Blood tests still + despite no symptoms
2/3 patients remain in this stage and never progress to the
late stage
5. Late
i. Symptoms depend on the area affected
ii. Most common areas
1. Cardiovascular
a. Aortic stenosis
b. Aortic insufficiency
2. Central Nervous System
a. Degeneration of cortical neurons leading to
paresis, blindness, and altered mental status
Herpes Simplex
Caused by infection of the herpes simplex virus
Transmission
o Both types: via sexual contact
o Type 2 also mom to baby via vaginal delivery
Initial infection leads to self-limiting lesions that heal
Virus remains latent in the neural ganglia and reactivates during
physical/emotional stress or immunosuppression.
Clinical Manifestations
Type 1
o Above waist – mouth, lips, eyes, etc.
o 1-2 days of paresthesia prior to skin lesions
o Single or a cluster of tender vesicles that then crust and heal
(Happens over 3-10 days)
