Sexually Transmitted Diseases Overview

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Questions and Answers

What is the most common cause of genital herpes?

HSV type 2 (correct)

Human immunodeficiency virus

Cytomegalovirus

HSV type 1

What is a common characteristic of symptoms during a primary infection of genital herpes?

Presence of systemic symptoms like malaise (correct)

Chronic urinary incontinence

Severe itching without pain

Single vesicle formation

Which diagnostic method is used for confirming genital herpes?

Ultrasound imaging of lesions

Blood serum analysis

Cytologic smear identifying multinucleated giant cells (correct)

CT scan of the abdomen

What is a significant feature of recurrent genital herpes compared to primary infection?

Usually less severe and shorter duration Signup and view all the answers

Which treatment is specifically antiviral for management of genital herpes?

Acyclovir in topical or oral form Signup and view all the answers

What typically occurs when CD4+ T-cell count drops below 200 in HIV-infected individuals?

Onset of opportunistic infections Signup and view all the answers

Which of the following is not commonly associated with AIDS-related complex?

Severe tonsillitis Signup and view all the answers

What is a common symptom of genital herpes lesions?

Extreme pain and tenderness Signup and view all the answers

What is the recommended treatment regimen for primary and secondary syphilis?

Benzathine penicillin G 2.4 million units IM as a single dose Signup and view all the answers

In cases of penicillin allergy during pregnancy, what is the recommended treatment for syphilis?

Erythromycin 500 mg orally every 6 hours for 2 weeks Signup and view all the answers

What is the rationale for desensitizing penicillin allergic women in the treatment of neurosyphilis?

To ensure the highest treatment effectiveness Signup and view all the answers

Which organism is responsible for the chronic infection known as lymphogranuloma venereum?

Chlamydia trachomatis Signup and view all the answers

Which symptom is associated with the secondary phase of lymphogranuloma venereum?

Painful inguinal and peri rectal lymphadenopathy Signup and view all the answers

How is the diagnosis of genital warts primarily confirmed?

Pap smear showing Koilocytic changes Signup and view all the answers

What type of virus causes genital herpes simplex virus (HSV) infection?

DNA virus Signup and view all the answers

Which treatment is NOT typically recommended for large warts associated with genital warts?

Oral antibiotics Signup and view all the answers

What is the definitive method for diagnosing syphilis?

Dark field microscopy Signup and view all the answers

Which of the following treatments is not used for chlamydial infections?

Penicillin treatment Signup and view all the answers

In which clinical phase of syphilis does lymphadenopathy commonly occur?

Secondary syphilis Signup and view all the answers

What is the incubation period for syphilis?

2 to 6 weeks Signup and view all the answers

What type of lesion is characteristic of tertiary syphilis?

Gumma Signup and view all the answers

Which of the following serologic tests is specific for syphilis?

Treponema Pallidum Immobilisation Test Signup and view all the answers

What is a common sign of primary syphilis?

Painless ulcer with indurated base Signup and view all the answers

What is indicated for women with syphilis of more than one year duration?

Lumbar puncture to rule out neurosyphilis Signup and view all the answers

Which organism is classified as a viral causative agent of sexually transmitted diseases?

Herpes Simplex Virus (HSV) Signup and view all the answers

What is a common symptom of gonorrhea?

Purulent vaginal discharge Signup and view all the answers

How is chlamydial infection primarily transmitted?

Sexual contact Signup and view all the answers

Which treatment regimen is recommended for treating both gonorrhea and chlamydia simultaneously?

Cefotaxime and doxycycline Signup and view all the answers

Which of the following is NOT a site of affection for gonorrhea?

Skin Signup and view all the answers

What is the incubation period for gonorrhea?

2 to 8 days Signup and view all the answers

Which organism is the most common cause of sexually transmitted disease among sexually active women?

Chlamydia trachomatis Signup and view all the answers

What is the main characteristic of the causative organism of chlamydia?

It is an obligate intracellular bacterium. Signup and view all the answers

Study Notes

Sexually Transmitted Diseases (STDs)

STDs are diseases spread through sexual contact.
Classification is based on the causative microorganism.

Bacterial STDs

N. Gonorrhoea: Causes gonorrhea.
Treponema Pallidum: Causes syphilis.
Chlamydia Trachomatis: Causes chlamydia.
Haemophilus Ducreyi: Causes chancroid.
Genital Mycoplasma: A type of genital bacteria.

Viral STDs

Herpes Simplex Virus (HSV): Causes herpes.
Human Papilloma Virus (HPV): Causes genital warts.
AIDS Virus (HIV): Causes AIDS.
Cytomegalovirus (CMV): Causes CMV.
Hepatitis B Virus: Causes hepatitis B.
Mullascum Contagiosum: Causes the skin condition.

Fungal STDs

Candidiasis: Causes a yeast infection.

Protozoal STDs

Trichomonas vaginalis: Causes trichomoniasis.
Giardia lamblia: Causes giardiasis.

Parasitic STDs

Scabies: A skin condition.
Pediculosis: Lice infestation.

Gonorrhea

Causative organism: Gram-negative intracellular diplococci (Neisseria gonorrhoeae).
Incubation period: 2 to 8 days.
Affects areas with thin epithelium (not stratified).
Can cause urethritis, bartholinitis, cervicitis, salpingitis.
Symptoms: Asymptomatic (carrier), purulent vaginal discharge, dysuria, frequency.
Signs: Urethritis, skenitis, salpingitis, signs of PID.
Treatment: Cefotaxime + Doxycycline, Ciprofloxacin + Doxycycline, Azithromycin, etc. Treatment should include sexual partners.

Chlamydial Infections

Causative organism: Chlamydia trachomatis, an obligate intracellular bacterium.
Several serotypes; some cause LGV; others lead to genital infections (D-K).
C. trachomatis is a common STD among sexually active women.
Sites of Affection: Cervicitis, urethritis, salpingitis, pelvic inflammatory disease (PID). Not a common cause of vaginitis, but a common cause of vaginal discharge.
Symptoms: Yellowish mucopurulent vaginal discharge, dysuria, frequency.
Diagnosis: Microscopic examination of saline smears (white blood cells without clue cells, yeast, or trichomonas), tissue culture, detection of chlamydial antigens by monoclonal antibodies or ELISA.
Treatment: Doxycycline, Erythromycin, Azithromycin. Include sexual partners in treatment.

Syphilis

Causative organism: Treponema pallidum (spirochete).
Congenital or acquired (STD).
Incubation period: 2 to 6 weeks.
Clinical phases:
- Primary: Painless ulcer (chancre) with a hard base, on genitals or extragenitals (mouth, anus), with lymph node enlargement.
- Secondary: Systemic manifestations, rash (red macules and papules on palms and soles), Condylomata lata (raised gray lesions), lymphadenopathy.
- Tertiary: Cardiovascular or neurological manifestations, gummas (necrotic lesions) on skin and bones.
Diagnosis: Dark-field microscopy (discharge), serological tests (VDRL, RPR, FTA-ABS, Treponema pallidum immobilization test).
Treatment: Penicillin is the drug of choice, different regimens for different stages. For penicillin allergy, alternative regimens such as Doxycycline exist (depending on stage). For pregnant women, Erythromycin. For women with more than a year history, lumbar puncture is essential to rule out neurosyphilis.

Lymphogranuloma Venereum (LGV)

Chronic infection of lymphatic tissues in the genital region (vulva, urethra, rectum, cervix).
Common in tropical areas.
Causative organism: Chlamydia trachomatis.
Incubation period: 3-4 days.
Clinical picture:
- Primary: Shallow painless ulcers.
- Secondary: Painful inguinal and perirectal lymphadenopathy, buboes (swollen lymph nodes).
- Tertiary: Rupture of buboes leading to sinus and fistula formation.
Diagnosis: Polymerase chain reaction (PCR) for C. trachomatis.
Treatment: Oral Tetracycline or Erythromycin for 2-3 weeks, aspiration of buboes.

Genital Warts

Causative organism: Human papillomavirus (HPV).
Highly contagious DNA virus
Types 16 & 18: Flat warts, risk of cervical intraepithelial neoplasia (CIN)
Types 6 & 11: Exophytic warts (no malignant potential).
Vulva, vagina, perineum, anus, cervix are common sites.
Diagnosis: Pap smear (Koilocytes, perinuclear halos), colposcopy.
Treatment:
- Small warts: Topical application of podophyllic, trichloroacetic acid, 5-fluorouracil.
- Large warts: Cryotherapy, electrocautery, laser therapy.

Genital Herpes Simplex Virus (HSV)

Caused by DNA virus (highly contagious).
HSV-2 more common than HSV-1 for genital herpes.
Initial infection: Skin → lumbosacral dorsal root ganglia → persistent but subclinical infection.
Recurrent infections: Activation of virus in ganglia → peripheral nerves → skin lesions.
HSV-1 causes oral herpes (fever blisters).
Incubation: 2-7 days.
Primary infection symptoms: 10-day duration, general symptoms (malaise, fever), multiple vesicles coalesce into superficial ulcers (vagina, cervix).
Associated pain, tenderness, inguinal lymphadenopathy.
Subclinical infections in 50%
Diagnosis: Cytologic smear (multinucleated giant cells), viral culture.
Treatment:
- General: Keeping lesions dry, analgesics.
- Specific: Antiviral (acyclovir) - oral or topical (shortens duration, reduces viral shedding).
- Follow-up with Pap smears.

Acquired Immunodeficiency Syndrome (AIDS)

Caused by Human Immunodeficiency Virus (HIV).
HIV attacks CD4+ T lymphocytes, lowering immune response.
Opportunistic infections occur when CD4+ cell count falls below 200.
CD4 is a specific antigen on T lymphocytes.
HIV infection weakens ability of host to fight invading organisms.
Clinical picture: Asymptomatic carrier state years, persistent lymphadenopathy, thrombocytopenia, AIDS-related complex (oral candidiasis, pneumonias, viral infections [HSV, CMV], tuberculosis [TB], toxoplasmosis).
Diagnosis: History (STD, homosexuality, blood transfusion, drug use), persistent lymphadenopathy, fungal, bacterial, or viral infections, ELISA (high rates of false positives), Western Blot, Viral Culture.
Treatment: Primarily prophylactic to prevent infection: health education, safe sexual practices, testing before blood transfusions, addiction treatment.

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Description

This quiz covers a comprehensive overview of sexually transmitted diseases (STDs), including their classifications based on the causative microorganisms: bacterial, viral, fungal, protozoal, and parasitic STDs. It's essential for understanding the different types of infections, their causes, and implications for health.