IB 140 Topic 9

How do you get an STI?
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What does this acidic environment do?Retards the Candida yeast fungal overgrowthWhat happens when the vaginal environment becomes basic?Supports the development of Candida yeast vaginitis infectionsWhat are some sexually transmitted infections?viral bacterial fungal protozoan lice scabiesIncidence?new cases/yearPrevalencenumber of new and existing casesUSA annual incidence of STIs from highest to lowestHPV Chlamydia Trichomoniasis Gonorrhea Genital Herpes Simplex Syphilis HIV Hepatitis BUSA annual prevalence of STIs from highest to lowestHPV Genital herpes simplex Trichomoniasis Chlamydia HIV Hepatitis B Gonorrhea SyphilisGlobal annual incidence of STIs from highest to lowestHPV Trichomoniasis Chlamydia Gonorrhea Genital herpes simplex Syphilis Hepatitis B HIVSexually transmitted infections: viralHuman papilloma virus Herpes simple virus Type 2 HIV hep B Hep C Molluscum contagiosumSexually transmitted infections: bacterialChlamydia trachomatis Neisseria gonorrhoeae Treponema pallidum (syphilis) Ureaplasma urealyticum (urethritis) Haemophilus ducreyi (chancroid) Haemophilus vaginalis (vaginitis and urethritis) Calymmatacterium granulomatous (granuloma inguinale)Sexually transmitted infections: FungalCandidal albicans (monilia vaginitis)Sexually transmitted infections: ProtozoanTrichomonas vaginalisSexually transmitted infections: Crab licePhthirus pubis, attach onto genital hairs and live on bloodSexually transmitted infections: ScabiesSarcoptes scabiei: burrow under the skin and are transmitted by skin to skin contactHow is trichonoma vaginalis transmitted?CoitusSymptoms of trichonoma vaginalis for women?Vaginitis with frothy, odorous discharge that develops 4-28 days post exposure Vulva, cervix, urthra, and bladder may also become inflamedSymptoms of trichomonas vaginalis for men?Most men are asymptomatic, but may develop urthritis or cystitisHow do you diagnose Trichomonas vaginalis?MicroscopeHow do you treat trichomonas vaginalis?MetronidazoleHow is chlamydia transmitted?Small bacteria transmitted by coitusWhat is the incubation period of chlamydia?7-28 daysPercentage of men that are asymptomatic for chlamydia?50Percentage of women that are asymptomatic for chlamydia?75How many cases of chlamydia of women in the USA occur between the ages of 15-19?Nearly halfWhat causes urethitis in both men and women resulting in yellow discharge from the urethra?ChlamydiaIn females where is the main site of infection for Chlamydia?Cervix, can cause yellow vaginal dischargeWhat can salpingitis lead to?Scarring and blockage of the oviducts which can cause infertility in women.During deliver where can chlamydia be transmitted to?Eyes of a newborn if chlamydia is present in vaginal canalWhat other disease may occur because of chlamydia?Pelvic inflammatory diseaseWhat can happen to newborn if chlamydia is transmitted?Infection can lead to conjunctivitis and pneumoniaWhat are newborns' eyes routinely treated with?Topical antibiotic i.e. erythromycin or silver nitrateDiagnosis of chlamydia?Urine(first stream) is collected and PCR evaluation detects genetic material from Chlamydia Culture of purulent materialTreatment of chlamydia?Aithormycin by mouth Doxycycline by mouthGonorrhea gram negative or positive?negativeWhat type of bacteria is gonorrhea?Diplococcus bacteriaHow is gonorrhea transmitted?During homosexual or heterosexual coitusWhat type of environment does gonorrhea thrive in?Moist membranes of the urogenital tract, mouth, oral cavity, anus, and eyesIn the USA which age group do most new cases appear? (Gonorrrhea)15-29 year old groupIncidence is especially high in two groups:Sexually active individuals under age 24 Men who have sex with menPercentage of men infected with gonorrhea develop symptoms?70-90Symptoms of gonorrhea for men?Purulent discharge from the urethra and redness of glans and penisGonorrhea in menUrethritis: urtheral inflammation Prostatitis: prostate inflammation Epididymiditis: epididymides inflammation Orchitis: testes inflammationPercentage of women show no signs of gonorrhea despite being infected?75Symptoms of gonorrhea for females?Develop whitish, yellowish, or greenish discharge from: vagina(vaginitis) cervix(cervicitis) Urethra(urethritis) bladder(cystitis)Complications for females (Gonorrhea)Endometritis: uterine infection Salpingitis: inflammation and infection of oviducts which can cause scarring of tissue leading to infertility because of oviduct blockage Pelvic inflammatory disease: general infection of pelvic tissuesOral sex can lead to infection of...pharynx with gonococcusIf gonorrhea is transmitted across placenta to fetus in first trimester there is an increased risk...of a miscarriageWhat happens when gonorrhea is present int he birth canal?it can infect newborns eyes on deliveryDiagnosis of GonorrheaUrine (first stream) is collected and PCR evaluation detects genetic material from gonococcus Culture of purulent material Swab of throat or rectumTreatment of GonorrheaCeftriaxone injection Doxycycline by mouthTreponema pallidum is...spirocete bacteriumWhere does syphilis thrive?Moist regions of the bodyPercentage of syphilis transmitted by sex?90How else can syphilis be transmitted?Into an open sore on the skinIn 2006 ____ of the new cases (syphilis) in the USA were in gay men60In 1998 ____ of the new cases in the USA were in gay men5 percentSyphilis: Primary StageChancre sore develops at site where syphilis entered the body These painless chancres are .5 to 1.0 inches in diameter, with hard edge and soft center On resolution of chancre, primary stage is over Person is contagious during primary stageWhere does syphilis occur on men?glans or corona of penisWhere does syphilis occur on women?vulva, cervix or vaginal wallOral coitus can result in sores on...lips, tongue, or throatChancres appear _____ after entrance of microbe and last for ______ weeks10-90 days, 1-5 weeksSyphilis:Secondary stagedevelops 2-6 weeks after primary stage Rash develops on upper body, upper extremities, and other areas of skin Rash is painless and not itchyOther symptoms of syphilis:secondary stage?hair loss, sore throat, swollen lymph nodes, painful joints, and poor appetiteWhen does the secondary stage go away?2-6 weeks, but may recur over next two years Person is contagious during secondary stageSyphilis: latent stageCan last for years and person will have no or few symptoms Half of the patients who enter the latent phase, never progress on to tertiary phasePeople in latent stage are not contagious except...for pregnant women who can transmit to fetusSyphilis:tertiary stagedevelops as microbe invades tissues throughout the body and develop large rumor-like in skin, muscle, intestines, liver, lungs, heart, and endocrine glands, eyes, brain, and spinal cordPeople in tertiary stages are not contagious except...pregnant women who can transmit to fetusTertiary cardiovascular syphilisDevelops 10-40 years after infection resulting in infection of the heart and blood vessels which can be fatalTertiary neurosyphilisdevelops 10-20 years after infection when the central nervous system are infected; these people can develop blindness, paralysis, dementia, psychosis, and deathSyphilis: congentitalEach year one to two million pregnant women have active syphilis in pregnancy Infected pregnant women in all stages of syphilis can pass syphilis on to their fetuses in the 3rd trimester of pregnancy____of these fetuses miscarry30%What percentage of babies are born with congenital syphilis and are contagious in 1st and 2nd years of life?70If untreated over ____will go on to develop tertiary syphilis in 10-20 years20%Congenital syphilis includes...blindness, deafness, flattening of the bridge of the nose, and notched central incisor teethDiagnosis of syphilisVDRL and RPR blood testsTreatment of syphilisBenzathine Penicilin G injected Tetracycline ErythomycinOf 100 types of HPB, over ____types are sexually transmitted40Female genital tissues that may be infected: (HPV)vulva, perineum, labia, cervixMale genital tissues that may be infected: (HPV)Prepuce, glans, coronal ridge, urethra, and scrotumWhat area can be infected for both sexes? (HPV)Anal_____million Americans are infected with HPV20How many adolescents and young adults are infected with HPV?10 millionPercentage of sexually active 14-18 years old have HPV?20Most of the HPV that are sexually transmitted are ______ and ________asymptomatic and transientCertain types of HPV causes genital warts which isCondyloma acumintaSoft cauliflower like warts appear _____weeks to ______ months after exposure to certain types of HPV3, 8Which types of HPV is not associated with cancer?6,11,42,43,44What is the percentage of people that may have genital warts at any given time? (sexually active men and women)1%What are the four types of HPV that are associated with cervical cancer?16,18,31,45_____% of women have cervical cancer have one or more of these types of HPV95_____% of American teens and adults carry human papilloma virus in their mouths7Prevention of HPVCondoms HPV vaccine, as early as 9 years of ageDiagnosis of HPVAntibody tests and DNA tests for HPV types from cervical cells Pap smear of cervix to rule out development of cancerTreatment of wartsPodophyllin: antimitotic agent Imiquimod: immunosuppreassant Liquid NitrogenHPV VaccineQuadrivalent HPV vaccine (gardasil) for the prevention (and not treatment of 4 different types of HPV Protects against 16 and 18 which causes 70% of cervical cancers Protects against HPV 6&11, which causes 90% of genital wartsRecommended dose vaccine for females and males 9-26 years?3How does herpes simplex type 2 virus occur?Infection results in retention of the virus in nerve fibers for lifeWhere does herpes simplex type 2 infect?Genital area, but can occur within oral cavity from oral sexHow is herpes simplex 2 transmitted?Typically transmitted from a person who has an active lesion, however, can be transmitted from a person who has no visible lesions or symptomsThrough genital, anal, or oral contact, tiny blisters develop that change into painful round sores in _____-_____ days and may progress to ulcers4,7Infection area in men (Herpes simplex 2)prepuce, glans, urthra, shaftInfection area in females (Herpes simplex 2)labia, prepuce, urethral orifice, vagnal introitus, and cervixWhen do lesions resolve? (Herpes simplex 2)1-2 weeksWhere does the virus remain dormant in?Sensory nerve fibers and intermittent recurrences of skin lesions may occurHerpes simplex type 2 virus diagnosisPCR or culture of tissueHerpes simplex type 2 virus treatmentAcyclovir by mouth can limit the frequency and length of outbreaksHerpes simplex 1 causes..cold sores around the mouth and infects over 90% of adultsHerpes 1 is very similar to Herpes 2 and Herpes 2 can....infect humans around the mouth while herpes 1 can infect genitaliaOral sex can result in...herpes 2 infection around the mouth and herpes 1 infection of the genitaliaIf a Mom has active genital lesions at the time of a vaginal delivery what can happen to the newborn?Potentially acquire herpes simplex and this can result in infant deathIf women has active lesion what is she recommended to have?C-sectionIf newborn has herpes simplex what is the treatment?IV acyclovirHep B vs. Hep CHep B= small circular DNA virus in the hepadnavirus family Hep C = linear, single-stranded, RNA virus in the Flaviviridae familyHow are hep c and b transmitted?Through blood so they can be sexually transmitted when there is blood exposureWhere did HIV 1 and 2 believe to be emerged from?West and Central Africa in humans in the early 20th centuryWhere did HIV-1 come from?SIV-1 in chimpanzees in AfricaWhere did HIV-2 come from?SIV-2 in sooty magnabey monkees in AfricaHIV-1 origin?originated in southern Cameroon through the evolution of SIV - infects wild chimpanzeesHIV-2 origin?Derived from SIV, a virus of the sooty mangabey, a monkey living in West Africa from southern SenegalSIV origin?ancestor to HIV, and is at least between 32,000 and 75,000 years old, SIV strains found in monkeys on BiokoHow do humans acquire SIV?Humans who participate in bushmeat activitiesHow is SIV compared to HIV?SIV is a weak virus is suppressed and cleared by the human immune system within weeks of infectionSIV to HIV?Several transmissions of SIV from individual to individual in quick succession are required to allow it enough time to mutate into HIVHIV-1 origin around...1910What is linked to the emergence of HIV?Emergence of large African citiesEarliest documented case of HIV in Africa?1959Where is HIV present?blood, semen, cervical and vaginal secretions, breast milk, saliva, and tearsWhere is HIV primarily transmitted in?bloodHIV transmittion routes?Blood inoculation Perintal -across placenta -during birth -breastfeeeding SexPercentage of men less likely to acquire HIV if circumcised?50Where are uncircumcised men more likely to retain STI?Under foreskinHIV diagnosisdetection of hiv antibodies in blood or saliva viral rna testHIV preventioncondoms breast milk can be heated to a low temperature pregnant women who are hiv positive recieve AZT Truvada orallyNRTI (HIV treatment)interfere with synthesis of viral DNANNRTIsinterfere with synthesis of viral DNAProtease inhibitorsinterfere with correct cutting of viral proteinsFusion inhibitorsprevent passage of virus into the cell