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8 Cards in this Set
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Viruses: Genital Herpes: herpes simplex virus type 2 AIDS: HIV Fungi Thrush: Candida Albicans |
STDs are a worldwide problem. But there’s a social stigma so people don’t admit to having them so it’s harder to diagnose. Long term consequences: - cancer (human papilloma virus causes cervical cancer) - infertility - chronic health diseases - congenital diseases |
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STIs: the infectious agents don’t shed in large numbers as they’re transmitted by contact and have a restricted niche of the moist GU tract, which makes them hard to culture. Sometimes there may be multiple infections, as one may mask the symptoms of the other. |
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Can be classed by: DISCHARGE: gonorrhoea and chlamydia ULCERATION: Syphillus and chancroid |
Woman tend to have more at a younger age then men have more at older age |
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GONORRHOEA: gram negative gonnococcus that’s transmitted person to person via contact UNCOMPLICATED INFECTION: MEN: painful urethra. Urethra is primary site WOMEN: mild vaginitis; asymptotic so hard to diagnose. Cervix is primary site. |
COMPLICATED INFECTION: MEN: Epidymitis which can cause infertility WOMEN: pelvic inflammatory disease Affects more woman then men, especially those that are immune compromised. Appears as septicaemia, rash and/or arthritis |
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ENTRY: gonococcus have pilli that act as an virulence factor and adhere to epithelial surface and enter, and replicate in basement membrane. Can be transcytosed and phagocytosis which causes a lot of inflammation which damages the mucous membrane. So the gonococcus is released onto the mucous membrane as the discharge |
DIAGNOSE: take a swab and - look microscopically for gram negative bacteria - culture swab in medium and do biochemical tests eg oxidase test TREATMENT: one dose of penicillin. But it developed resistance to use Doxycycline which is also anti-chlamydia so can treat that too if it’s being masked |
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CHLAMYDIA: chlamydia trachomatis. Cannot be grown on afar. Has 2 growth phases - elementary bodies which are extracellular and stable. Infect cells and replicate - reticulate bodies which are intracellular and condense into elementary bodies and are released onto mucous membrane (discharge) to infect other cells. MEN: non-gonnococcal urethritis. And post-gonoccal urethritis after gonorrhoea treatment. Can use doxycycline WOMEN: effects cervix and urethra (urethritis). If left untreated, can cause pelvic inflammatory disease which can lead to infertility |
DIAGNOSIS: difficult to grow on agar Immunofluroscence: by microscopy but can’t apply to large numbers Immunoassay: can apply to large numbers but less specific Molecular techniques: PCR which is applicable to large numbers and specific Woman have it more at younger age, men at older age. Wide distribution so can’t associate with specific social group. Can be asymptomatic so need a screening programme. |
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SYPHILLUS: by Treponema Pallidum which is spirrila. Infection via broken skin. Penis in men, vagina and cervix in women. 10% are oral. 4 stages Primary = painless ulcer Secondary = systemic illness Latent = no obvious signs Tertiary = cardiovascular and neurological signs |
DIAGNOSIS: cannot be cultured. Use dark field microscopy Antibodies in fluroscence microscopy Prevalent more in MSM |
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CHANCRIOD: more common in tropics, less common in Europe and USA. - cause painful ulcer that can lead to lymphadenopathy. Difficult it HIV patients. |
DIAGNOSIS: caused by gram negative coccus-bacillus Haemophillic ducreyi so hard to cultivate and can be resistant to antibiotics. - clinical presentation and exclusion of Syphillus - microscopy of ulcer - culture in multiple media - PCR to detect antigens More prevalent in the elderly |
