Sexually Transmitted Diseases
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| How does herpes present? | *Fluid-filled vesicles on the cervix, labia, rectum, vulva, vagina, or skin of females *Fluid-filled vesicles on the glans penis, foreskin, or penile shaft of men.
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| How long does the initial lesions of herpes persist? | 3 - 10 days
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| How long does the recurrent lesions of herpes persist? | 7 - 10 days
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| What is the medical management of herpes? | *Lesions heal spontaneously *Lidocaine *Acyclovir (Zovirax) *Valacyclovir (Valtrex) *Famciclovir (Famvir)
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| What is the organism that causes syphilis? | T. Pallidum
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| How is syphilis transmitted? | *Transmission through sexual contact *Contact with infectious lesions *Sharing of needles *Prenatal infection is possible
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| What are the stages of syphilis? | *Primary Stage *Secondary Stage *Latent Stage *Tertiary Stage
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| How is syphilis diagnosed? | Lab tests: VDRL, RPR
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| What is the medical management of syphilis? | Parenteral penicillin (antibiotics)
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| What is the organism that causes gonorrhea? | N. gonorrhoeae (bacteria)
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| How is gonorrhea diagnosed? | Cultures
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| What is the medical management of gonorrhea? | *Ceftriaxone (Rocephin) *Cefixime (Suprax)
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| What happens if the vesicles from herpes rupture? | Vesicles may rupture and develop into shallow, painful ulcers that are erythematous with marked edema and tenderness.
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| Does the medical management of herpes cure it? | Not a cure for HSV, but it shortens the duration of viral shedding, the healing time of genital lesions, and suppresses 75% of recurrences with daily use
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| True or False: syphilis only affects the mucous membranes and the reproductive tract | False. The spirochete penetrates intact skin as well as openings in the mucous membranes of the genital organs, rectum, and mouth.
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| What is the primary stage of syphilis? | chancre appears (a painless erosion or papule that ulcerates superficially with a scooped-out appearance)
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| What is the secondary stage of syphilis? | *Skin rashes. *Moist, raised, gray-to-pink lesions of the genital or perirectal skin. *Enlarged lymph nodes
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| What is the Latent stage of syphilis? | *Dementia. *Pain or loss of sensation in the legs. *Destruction of the aorta. *Destructive inflammatory masses can appear in any organ
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| What is Type one herpes? | Cold sores ect
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| What is Type two herpes? | Sexually transmitted
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| What is the tertiary stage of syphilis? | *Heart and blood vessels (cardiovascular syphilis) often involved. *Central nervous system (neurosyphilis) often involved. *Tabes dorsalis. *Paresis. *Various psychoses may result.
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| How is syphilis diagnosed? | *Venereal Disease Research Laboratory (VDRL) slide test. *Rapid Plasma Reagin (RPR).
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| What should all PTs with syphilis be checked for as well? | Gonorrhea
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| What is the medical management of syphilis? | Parenteral penicillin (Tx of choice)
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| What is the organism that causes gonorrhea? | N. gonorrhoeae (Bacteria)
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| What is the incubation period of gonorrhea? | 3 - 5 days
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| What are the S/Sx of gonorrhea in men? | *Men may be asymptomatic after the incubation period but in a short time develop signs and symptoms. *Urethritis. *Dysuria. *Infection with a purulent discharge. *Edema of the affected area.
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| What are the S/Sx of gonorrhea in women? | *Most remain asymptomatic. *May have a greenish-yellow discharge from cervix. *Purulent discharge from the urethra. *Pruritus. *Burning and pain of the vulva *Vaginal engorgement and erythema *Abdominal pain and distention
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| What are the non-gender specific S/Sx of gonorrhea? | *Pharyngitis. *Tonsillitis. *Rectal burning, pruritus, purulent rectal discharge.
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| How is gonorrhea diagnosed? | Cultures from the site of infection isolate the organism and establish an identification.
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| Within how cultures from gonorrhea secretion are taken can a definitive diagnosis be provided? | 24 - 48 hours
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| What other infection has been found in 45% of gonorrhea cases? | Coexisting chlamydial infection
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| Fill in the blanks: Treatment of gonorrhea in the early stage __________ but ___________ is common. | is curable, recurrance
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| What is the medical management of gonorrhea? | *ceftriaxone (Rocephin) *cefixime (Suprax)
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| When is Tx of gonorrhea initiated without awaiting culture results? | if there is a history of sexual contact with a partner known to have gonorrhea
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| What should be avoided while on Tx for gonorrhea? | Intercourse and alchohol
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| What is the organism that causes Trichomoniasis? | T. vaginalis (protozoa)
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| Trichomoniasis affects what percentage of sexually active women and men? | 15% of women, and 10% of men.
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| What is the incubation period of Trichomoniasis? | 4 - 28 days
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| Fill in the blanks: T. vaginalis thrives when the vaginal mucosa is more _________ than normal | Alkaline
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| What percentage of women are asymptomatic of trichomoniasis? | 70%
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| What are the S/Sx of trich in men? | *Mild to severe transient urethritis. *Dysuria. *Urinary frequency. *Pruritus. *Purulent exudate.
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| What are the S/Sx of trich in women? | *Profuse, frothy, gray, green, or yellow, malodorous discharge. *Menorrhagia. *Dysmenorrhea *Pruritus. *Edema. *Tenderness of vagina. *Dysuria.
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| How is trich diagnosed? | microscopic examination of the vaginal discharge that identifies T. vaginalis.
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| What is the Tx of trich? | Oral metronidazole (Flagyl) in small doses for 7 days or a single large dose
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| What should the PT on Tx for trich avoid? | alcoholic beverages because alcohol can cause reaction with the medication such as disorientation, headache, cramps, vomiting, and possible convulsions.
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| What can metronidazole do to the PTs urine? | turn urine dark brown.
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| What is the medical name for venereal warts? | Condyloma
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| What causes condyloma? | human papilloma virus (HPV)
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| What is the medical management of condyloma? | *HPV cannot be cured, just removed *Podophyllin *Surgical removal *Frozen
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| What organism causes candidiasis? | Candida albicans and Candida tropicalis
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| When does candidiasis infection most often occur? | *when the glucose level rises from diabetes mellitus *when resistance is lowered from diseases such as carcinoma.
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| How is candidiasis diagnosed? | Gram stain
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| What is the medical management of candidiasis? | *Controlling diabetes mellitus *Discontinuing antibiotics/oral contraceptives *Nystatin (Mycostatin)
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| What are the common STDs chlamydia causes? | *Cervicitis and urethritis are the most common *Epididymitis *Sappingitis *PID *Conjunctivitis and pneumonia in newborns
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| What STD may be the most common, but due to it not being a reportable disease actual number of cases is unknown? | Chlamydia
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| Who is chlamydia most common in? | young, promiscuous, indigent, unmarried women who live in the inner city and in those who have a prior history of STDs.
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| True or False: Chlamydia may be asymptomatic | True
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| How is chlamydia diagnosed? | *Culturing *Direct fluorescent antibody (DFA)
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| What is the medical management of chlamydia? | *Tetracycline *Doxycycline (Vibramycin) *Ofloxacin (Floxin) *Azithromycin (Zithromax) *Erythromycin
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| What chlamydia Tx is the drug of choice for use during pregnancy? | Erythromycin
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| What is being prescribed for primary herpes genitalis to shorten the duration of the healing of genital lesions? | acyclovir (Zovirax)
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| Acyclovir (Zovirax) suppresses what percentage of recurrance of herpes with daily use? | 75%
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| because of penicillin-resistant strains of N. gonorrhoeae, penicillin, the former drug of choice for treatment of gonorrhea, has been changed to what? | ceftriaxone (Rocephin)
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| What should most PTs with an STD wear? | Loose-fitting clothing and cotton underwear
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| What increases the pH of the vagina, and what organism thrives when the vaginal mucosa is more alkaline? | *Frequent douching and use of oral contraceptives and antibiotics raise the normal pH of the vagina *T. Vaginalis
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