Sexually Transmitted Infections
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Questions and Answers

What is the primary mode of transmission for Sexually Transmitted Infections?

  • Through sexual contact (correct)
  • Via airborne particles
  • By sharing personal items
  • Through contaminated water

    • Which pathogen is identified as the most commonly diagnosed STI in the US?

  • Syphilis
  • Human Immunodeficiency Virus (HIV)
  • Gonorrhea
  • Chlamydia trachomatis (correct)

    • What percentage of infected women experience asymptomatic Chlamydia infections?

  • 25%
  • 90%
  • 50%
  • 75% (correct)

    • What are the major symptoms associated with Chlamydia infections?

    <p>Painful urination and clear or yellow discharge</p> Signup and view all the answers

    How do Chlamydia trachomatis pathogens primarily spread within the body?

    <p>Through body secretions</p> Signup and view all the answers

    What is a hallmark of Chlamydia symptoms in patients?

    <p>A clear or yellow discharge</p> Signup and view all the answers

    What characteristics define Chlamydia trachomatis as a pathogen?

    <p>Small Gram-negative coccobacilli</p> Signup and view all the answers

    Which symptom is NOT commonly associated with chlamydial infection?

    <p>Liver inflammation</p> Signup and view all the answers

    What major group of pathogens do STIs include?

    <p>Bacteria, viruses, and protozoans</p> Signup and view all the answers

    Why are many cases of Chlamydia left undiagnosed?

    <p>Symptomless infections</p> Signup and view all the answers

    What is a common symptom of chlamydia in men?

    <p>Clear or yellow discharge</p> Signup and view all the answers

    What can untreated chlamydia lead to in women?

    <p>Ectopic pregnancy</p> Signup and view all the answers

    How does pelvic inflammatory disease (PID) most commonly arise?

    <p>Long-term untreated infections like chlamydia or gonorrhea</p> Signup and view all the answers

    Which bacteria is primarily responsible for gonorrhea?

    <p>Neisseria gonorrhoeae</p> Signup and view all the answers

    What is a classic symptom of gonorrhea in men?

    <p>Pus production</p> Signup and view all the answers

    Which of these STIs is known for being mostly asymptomatic and self-resolving?

    <p>HPV</p> Signup and view all the answers

    What should sexually active individuals prioritize to prevent the transmission of STIs?

    <p>Regular screenings</p> Signup and view all the answers

    What is one of the virulence factors of Neisseria gonorrhoeae?

    <p>Capsule</p> Signup and view all the answers

    What is a possible serious complication from untreated PID?

    <p>Ectopic pregnancy</p> Signup and view all the answers

    What causes the painless papules associated with molluscum contagiosum?

    <p>Viral infection</p> Signup and view all the answers

    Match the following STIs with their primary characteristics:

    <p>Chlamydia = Often asymptomatic, can lead to infertility Gonorrhea = Classic symptom includes prolific pus production Syphilis = Complex progressive disease with multiple stages HPV = Most common STI with potential for cancer</p> Signup and view all the answers

    Match the following symptoms with the corresponding STI:

    <p>Chlamydia = Pain and/or itchiness around the urethral opening Gonorrhea = Painful urination and/or sex PID = Abdominal pain and bloating Molluscum Contagiosum = Small painless papules developing on the skin</p> Signup and view all the answers

    Match the following complications with their causes:

    <p>Infertility in women = Untreated chlamydia Ectopic pregnancy = Pelvic inflammatory disease Scar tissue in fallopian tubes = Undiagnosed gonorrhea Eye infection = Neisseria gonorrhoeae</p> Signup and view all the answers

    Match the following pathogens with their properties:

    <p>Chlamydia trachomatis = Often asymptomatic and leads to serious complications Neisseria gonorrhoeae = Gram (-) diplococci Treponema pallidum = Causes syphilis Molluscum contagiosum = Causes painless skin-colored papules</p> Signup and view all the answers

    Match the following STIs with their treatment options:

    <p>Chlamydia = Easily treated with antibiotics Gonorrhea = Commonly treated with antibiotics for both infections Syphilis = Requires specific antibiotics HPV = Self-resolving for low-risk strains</p> Signup and view all the answers

    Match the following descriptions with the correct infection:

    <p>Pelvic Inflammatory Disease = Caused by untreated chlamydia or gonorrhea Gonorrhea = Can cause inflammation in male reproductive tract Chlamydia = Commonly diagnosed after pelvic exam HPV = Infection often resolves without symptoms</p> Signup and view all the answers

    Match the following features with the correct STI:

    <p>Gonorrhea = Infects mucosal epithelial cells Chlamydia = Inflamed cervix upon examination Treponema pallidum = Causes ulcers during secondary syphilis Molluscum contagiosum = Dimpled papules on the skin</p> Signup and view all the answers

    Match the following prevention methods with their relevant STIs:

    <p>Condoms = Effective in preventing chlamydia and gonorrhea transmission Regular screenings = Essential for sexually active individuals Vaccines = Help prevent HPV infections Antibiotics = Used for treatment of chlamydia and gonorrhea</p> Signup and view all the answers

    Match the following conditions with the possible outcomes if untreated:

    <p>Chlamydia = PIV and infertility are risks Gonorrhea = Severe genital pain and pus production PID = Scar tissue formation in fallopian tubes HPV = Potential to cause cervical cancer</p> Signup and view all the answers

    Match the following STI pathogens with their primary symptom:

    <p>Chlamydia trachomatis = Clear or yellow discharge Neisseria gonorrhoeae = Painful urination Trichomonas vaginalis = Vaginal discharge HIV = Flu-like symptoms</p> Signup and view all the answers

    Match the following characteristics with the corresponding STI pathogens:

    <p>Chlamydia trachomatis = Gram-negative coccobacilli Neisseria gonorrhoeae = Diplococcus Treponema pallidum = Spirochete Herpes Simplex Virus = Envelope virus</p> Signup and view all the answers

    Match the following terms with their descriptions related to STIs:

    <p>Asymptomatic = Showing no symptoms despite being infected Infectious = Capable of being transmitted to others Virulence = Ability of a pathogen to cause disease Incubation period = Time from exposure to symptomatic illness</p> Signup and view all the answers

    Match the following STI symptoms to the associated pathogen:

    <p>Chlamydia = Lower abdominal pain Gonorrhea = Greenish-yellow discharge Syphilis = Painless sores (chancre) Hepatitis B = Jaundice</p> Signup and view all the answers

    Match the following discharge types to their related STIs:

    <p>Clear discharge = Chlamydia Purulent discharge = Gonorrhea Frothy discharge = Trichomoniasis Blood-stained discharge = Cervical cancer</p> Signup and view all the answers

    Match the following complications with their corresponding STIs:

    <p>Pelvic Inflammatory Disease (PID) = Chlamydia Infertility = Gonorrhea Cervical cancer = Human Papillomavirus (HPV) Neonatal complications = Syphilis</p> Signup and view all the answers

    Match the following STI transmission modes to the respective STIs:

    <p>Chlamydia = Sexual contact only HIV = Blood, sexual contact, mother to child Herpes = Skin-to-skin contact Hepatitis A = Fecal-oral route</p> Signup and view all the answers

    Match the following STIs with their common testing methods:

    <p>Chlamydia = Urine test or swab Gonorrhea = Throat swab or urine test HIV = Blood test Syphilis = Blood test</p> Signup and view all the answers

    What are the two types of Herpes Simplex Virus (HSV) commonly recognized?

    <p>HSV1 and HSV2</p> Signup and view all the answers

    What is the typical time frame for HSV sores to initially appear after infection?

    <p>4 to 7 days</p> Signup and view all the answers

    Which symptom is generally associated with Herpes Genitalis?

    <p>Burning and itching</p> Signup and view all the answers

    How can Herpes of the Eye (Herpes Keratitis) occur?

    <p>When an infected finger touches the eye</p> Signup and view all the answers

    What is a potential consequence of HSV infecting the trigeminal nerve?

    <p>Reactivation causing cold sores</p> Signup and view all the answers

    Which of the following conditions is a rare but severe outcome of HSV infection?

    <p>Herpes Encephalitis</p> Signup and view all the answers

    What percentage of Americans are estimated to be exposed to HSV by the age of 50?

    <p>90%</p> Signup and view all the answers

    In what manner can HSV be transmitted aside from sexual contact?

    <p>Through childbirth</p> Signup and view all the answers

    What is the time it generally takes for HSV sores to heal?

    <p>7 to 10 days</p> Signup and view all the answers

    Which of the following is NOT a way that HSV can spread?

    <p>Breathing contaminated air</p> Signup and view all the answers

    Match the types of Herpes Simplex Virus (HSV) with their primary associated lesions:

    <p>HSV1 = Cold sores on genitals HSV2 = Cold sores on lips</p> Signup and view all the answers

    Match the transmission mode with its description:

    <p>Oral sex = Transmission through mouth-to-genital contact Childbirth = Virus passed from mother to child during delivery Contact with sores = Direct touch of active lesions Bodily fluids = Sharing fluids potentially contaminated with HSV</p> Signup and view all the answers

    Match the symptoms of Herpes Simplex Virus with their description:

    <p>Herpes labialis = Cold sores located around the lips Herpes genitalis = Cold sores located on the genitals Sores appearance = Occurs 4-7 days after initial infection Healing time = Approximately 10 days for sores to heal</p> Signup and view all the answers

    Match the complications of HSV with their implications:

    <p>Herpes whitlow = Abscess near fingernail or toenail Herpes infection of the eye = Can lead to lesions on the cornea Herpes encephalitis = Infection of the brain causing severe symptoms Severe mental disorders = Possible outcome of herpes encephalitis</p> Signup and view all the answers

    Match the statements about the Trigeminal Nerve with their implications:

    <p>Transmits sensation = Carries sensory information from the face Dormant HSV = Can reactivate leading to cold sores Connection to brain = HSV can travel to the brain HSV impact = May cause herpes encephalitis</p> Signup and view all the answers

    Match the HSV transmission methods with their characteristics:

    <p>Sexual contact = Main mode of HSV transmission Open sores = Direct contact with lesions can spread HSV Needle sharing = Healthcare worker exposure to infected fluids Childbirth = Virus transmission from mother during birth</p> Signup and view all the answers

    Match the healing characteristics of HSV sores with their timing:

    <p>Initial sore appearance = 4-7 days after infection Sores healing period = About 10 days HSV latency = Can remain dormant in the trigeminal nerve Reactivation = Triggers recurrence of cold sores</p> Signup and view all the answers

    Match the HSV treatment complications with their severity:

    <p>Herpes whitlow = Localized skin infection near nails Corneal lesions = Associated with herpes eye infection Encephalitis = Potentially fatal brain infection Minor infections = Less severe and can be managed easily</p> Signup and view all the answers

    Match the descriptions with the types of sores:

    <p>Herpes labialis = Cold sores on lips and oral areas Herpes genitalis = Cold sores on genitals Primary infection sores = Account for first outbreak symptoms Recurrence = Sores that occur due to reactivation of dormant virus</p> Signup and view all the answers

    What is the primary outcome of high-risk HPV types?

    <p>Development of cervical cancer</p> Signup and view all the answers

    How is the Gardasil vaccine designed to protect against HPV?

    <p>By introducing dead HPV proteins to stimulate an immune response</p> Signup and view all the answers

    Which statement about HPV transmission is accurate?

    <p>It can infect through tiny skin cuts and mucous membranes.</p> Signup and view all the answers

    What type of cells does HPV primarily infect?

    <p>Basal cells of the skin</p> Signup and view all the answers

    Which of the following methods is NOT recommended for treating genital warts?

    <p>Home remedies using over-the-counter creams</p> Signup and view all the answers

    What is the significance of PAP tests in HPV management for women?

    <p>They detect abnormal or precancerous cells on the cervix.</p> Signup and view all the answers

    What can happen if the immune system fails to eliminate all HPV during infection?

    <p>It can lead to a persistent infection.</p> Signup and view all the answers

    What is the recommended vaccination schedule for the Gardasil vaccine?

    <p>Three doses over six months for pre-teens</p> Signup and view all the answers

    What is a common outcome of low-risk HPV types?

    <p>Formation of warts around genitals and anus</p> Signup and view all the answers

    Which of the following reflects the nature of most HPV infections?

    <p>They usually resolve without medical intervention.</p> Signup and view all the answers

    Match the following types of HPV with their effects:

    <p>Low-risk HPV = Causes warts on genital and anal areas High-risk HPV = May lead to cervical cancer Common HPV = Causes skin warts on hands and feet Genital HPV = Affects the genitals and is sexually transmitted</p> Signup and view all the answers

    Match the following HPV-related tests with their purposes:

    <p>PAP test = Checks for abnormal cells on the cervix HPV test = Looks for genetic material from high-risk HPV Co-testing = Combination of PAP and HPV tests Self-examination = Not recommended for HPV detection</p> Signup and view all the answers

    Match the following vaccine details with their descriptions:

    <p>Gardasil = Protects against specific high-risk and low-risk HPVs Administered to both boys and girls = Should be given before sexual activity Three doses = Given over six months Does not treat existing infections = Only prevents HPV infections</p> Signup and view all the answers

    Match the following responses of the immune system with their outcomes:

    <p>Immune system destroys the virus = Infection clears within two years Linger infection = Virus persists without symptoms Cell multiplication = Infected cells may become precancerous Warts formation = Caused by low-risk HPV infection</p> Signup and view all the answers

    Match the following statements about HPV symptoms:

    <p>Most infections have no symptoms = Silent nature of many HPV strains Genital warts = Visible projections due to low-risk HPV Precancerous cells = Potential result from high-risk HPV Painful warts = May require healthcare provider removal</p> Signup and view all the answers

    Match the following HPV types with their common characteristics:

    <p>Type 16 = High-risk HPV linked to cervical cancer Type 18 = High-risk HPV associated with anal and oral cancers Type 6 = Low-risk HPV causing genital warts Type 11 = Low-risk HPV also linked to warts formation</p> Signup and view all the answers

    Match the following statements with their relevance to HPV:

    <p>No cure for HPV infections = Persistent nature of the virus Warts may resolve naturally = Immune response plays a role Treatment available for abnormal cells = Medical intervention required Self-treatment of genital warts = Not recommended and can worsen the condition</p> Signup and view all the answers

    Match the following consequences of untreated HPV with potential outcomes:

    <p>Cervical cancer = Result of persistent high-risk HPV Abnormal cell changes = Detected via PAP test Genital warts = Caused by low-risk HPV infections Anxiety and stigma = Common experiences among infected individuals</p> Signup and view all the answers

    Match the following descriptions with their related terms:

    <p>Skin-to-skin contact = Primary transmission mode for HPV Antibodies = Body's defense against HPV post-vaccination Cervical screening = Regular examination to prevent cancer HPV types = Varieties with differing risks associated</p> Signup and view all the answers

    What is the primary usual etiologic agent for Herpes Simplex Virus type 2?

    <p>Herpes genitalis</p> Signup and view all the answers

    Which of the following statements about the latency of HSV-1 and HSV-2 is accurate?

    <p>HSV-1 latency occurs in the trigeminal ganglion.</p> Signup and view all the answers

    What type of skin lesions are typically associated with HSV-1?

    <p>On the face and mouth</p> Signup and view all the answers

    What is one of the primary modes of transmission for HSV-1?

    <p>Close contact, usually of the face</p> Signup and view all the answers

    Among the following, which group is reported to experience complications most frequently due to HSV-2?

    <p>Obstetric and gynecological personnel</p> Signup and view all the answers

    Which feature differentiates the transmission routes of HSV-1 from HSV-2?

    <p>HSV-1 is typically transmitted by close contact, while HSV-2 can be sexually transmitted.</p> Signup and view all the answers

    What characteristic is NOT typically associated with HSV-2 skin lesions?

    <p>Lesions on the mouth</p> Signup and view all the answers

    What is a common method used by doctors to diagnose syphilis?

    <p>Dark field microscopy of a shanker swab</p> Signup and view all the answers

    What does fluorescence antibody testing utilize to identify Treponema pallidum?

    <p>Specific antibodies that fluoresce</p> Signup and view all the answers

    Which of the following STIs is noted for having asymptomatic cases?

    <p>Chlamydia, gonorrhea, and latent syphilis</p> Signup and view all the answers

    How does dark field microscopy present the specimen?

    <p>With a dark background and bright colored specimen</p> Signup and view all the answers

    What characteristic of a shanker is significant for diagnosing syphilis?

    <p>It is painless and can be observed visually</p> Signup and view all the answers

    What is the most common means of infection for syphilis?

    <p>Sexual contact</p> Signup and view all the answers

    Which stage of syphilis is marked by the appearance of painless shankers?

    <p>Primary syphilis</p> Signup and view all the answers

    What are shankers in the context of syphilis infection?

    <p>Painless ulcers at the infection site</p> Signup and view all the answers

    What happens to shankers after the primary stage of syphilis?

    <p>They spontaneously heal</p> Signup and view all the answers

    How does syphilis pathogens enter the bloodstream?

    <p>Through sexual contact</p> Signup and view all the answers

    What is a common symptom associated with secondary syphilis?

    <p>Maculopapular rash</p> Signup and view all the answers

    Why are the primary symptoms of syphilis often unnoticed?

    <p>They are painless and inconspicuous</p> Signup and view all the answers

    What are chondylo-mata-lata in secondary syphilis?

    <p>Painless genital growths resembling warts</p> Signup and view all the answers

    What is a potential risk of infection during primary syphilis?

    <p>High infectiousness through open lesions</p> Signup and view all the answers

    How is congenital syphilis transmitted?

    <p>Across the placenta from mother to fetus</p> Signup and view all the answers

    What is the causative agent of syphilis?

    <p>Treponema pallidum</p> Signup and view all the answers

    Which characteristic is unique to spirochetes like treponema pallidum?

    <p>Formation of endoflagella</p> Signup and view all the answers

    What is the primary reason for not culturing treponema pallidum for diagnosis?

    <p>They cannot survive outside the host for long.</p> Signup and view all the answers

    In what way do treponema differ from other spirochetes like Borrelia?

    <p>Treponema have tighter, regular coils.</p> Signup and view all the answers

    Which method is commonly used to diagnose syphilis?

    <p>Serological testing</p> Signup and view all the answers

    What term is used to describe the spiral bacteria that cause syphilis?

    <p>Treponema</p> Signup and view all the answers

    Which statement accurately describes humans in relation to treponema pallidum?

    <p>Humans are the natural host for treponema pallidum.</p> Signup and view all the answers

    What characteristic of treponema pallidum complicates its diagnosis?

    <p>It's primarily asymptomatic in early infection.</p> Signup and view all the answers

    Where do rashes associated with secondary syphilis most notably occur?

    <p>On the palms and soles</p> Signup and view all the answers

    What is the infectious status of a person in the tertiary syphilis stage?

    <p>No longer contagious</p> Signup and view all the answers

    What major health issues can result from tertiary syphilis?

    <p>Nerve, heart, and joint damage</p> Signup and view all the answers

    Which symptom is a hallmark of congenital syphilis in infants?

    <p>Nasal discharge known as snuffles</p> Signup and view all the answers

    What is one of the long-term complications of untreated syphilis infection?

    <p>Development of Hutchinson teeth</p> Signup and view all the answers

    How long can the asymptomatic phase of latent syphilis potentially last?

    <p>3 to 30 years</p> Signup and view all the answers

    Which of the following is a common feature of gummas associated with tertiary syphilis?

    <p>Painless swollen masses</p> Signup and view all the answers

    What crucial action should a pregnant woman take regarding STIs like syphilis?

    <p>Get screened before and during pregnancy</p> Signup and view all the answers

    Which stage of syphilis occurs after the primary and secondary stages if left untreated?

    <p>Tertiary syphilis</p> Signup and view all the answers

    What happens to the risk of contagion during the late latent and tertiary stages of syphilis?

    <p>Risk of contagion decreases significantly</p> Signup and view all the answers

    Study Notes

    Sexually Transmitted Infections

    • Sexually Transmitted Infections (STIs) are acquired through sexual contact (vaginal, anal, and/or oral sex).
    • STIs are caused by various pathogens, including bacteria, viruses, and protozoans.
    • STIs are commonly categorized clinically based on their major symptoms.

    STIs with Discharge

    • Chlamydia is the most commonly diagnosed STI in the US, with an estimated 10% of humans carrying the bacteria in their genital tracts.
    • Chlamydia trachomatis serotypes D-K are the primary cause of Chlamydia STI.
    • Chlamydia is a small, Gram-negative coccobacilli that infects cells intracellularly and alternates between dormant (elementary bodies) and active (reticulate bodies) forms.
    • Chlamydia is often asymptomatic, with approximately 50% of infected men and 75% of infected women showing no symptoms.
    • Chlamydia symptoms may include:
      • Pain in the lower abdomen and genitals
      • Painful urination
      • Painful sex
      • Clear or yellow discharge
    • Chlamydia is diagnosed during pelvic exams by identifying an inflamed cervix and confirming the infection through testing.
    • Left untreated, Chlamydia can lead to permanent scarring and infertility in both men and women.
    • Chlamydia is the most common cause of Pelvic Inflammatory Disease (PID).

    Pelvic Inflammatory Disease (PID)

    • PID is a complication of long-term STIs on the female reproductive tract.
    • PID involves inflammation and scarring of the reproductive organs, particularly the fallopian tubes.
    • PID can lead to infertility and ectopic pregnancies.
    • PID symptoms may include:
      • Abdominal pain
      • Bloating
      • Painful urination
      • Painful sexual contact
      • Bleeding between periods
    • PID is primarily caused by untreated chlamydia and gonorrhea infections.

    Neisseria gonorrhoeae & Gonorrhea

    • Gonorrhea is a sexually transmitted bacterial infection caused by Neisseria gonorrhoeae.
    • Neisseria gonorrhoeae is a Gram-negative diplococcus with several virulence factors, including a capsule, pili, and an IgA protease enzyme.
    • Gonorrhea is transmitted through body secretions and infects the mucosal epithelial cells of the genital tract.
    • Gonorrhea is often asymptomatic, with approximately 10% of infected men and 50% of infected women exhibiting no symptoms.
    • Gonorrhea symptoms may include:
      • Pain in the genitals
      • Painful urination
      • Painful sex
      • Pus production
    • Left untreated, Gonorrhea can lead to permanent scarring and infertility in both men and women.
    • Gonorrhea can also cause PID in women.
    • Gonorrhea is easily treated with antibiotics.
    • Condoms can effectively prevent transmission of both chlamydia and gonorrhea when used properly.

    STIs with Ulcerative Lesions

    • Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum.
    • Syphilis is a complex progressive disease with multiple stages.

    Human Papillomavirus (HPV)

    • HPV is the most common STI in the US, with around 70% of humans becoming infected by middle age.
    • Most HPV infections are asymptomatic and self-resolve.
    • Low-risk HPV strains can cause warts (painless, skin-colored papules).
    • High-risk HPV strains can cause cancer of the cervix, penis, anus, or throat.

    Molluscum Contagiosum

    • Molluscum contagiosum is a viral skin infection transmitted through direct contact.
    • Molluscum contagiosum is often seen as an STI, with small, painless papules developing on or around the genitals.
    • Molluscum contagiosum papules are usually pink, white, or skin-colored with a dimple in the center.
    • Molluscum contagiosum infections typically self-resolve and cause no further complications.

    STIs with No External Symptoms

    • Hepatitis B and Hepatitis C viruses are sexually transmitted and can lead to liver cancer.

    Sexually Transmitted Infections (STIs)

    • STIs are infections acquired through sexual contact (vaginal, anal, or oral).
    • STIs are caused by various pathogens, including bacteria, viruses, and protozoa.
    • Most commonly diagnosed STI in the US is Chlamydia.
    • The second most common STI in the US is thought to be Chlamydia.
    • Most infections are asymptomatic.
    • Main symptom of STIs with discharge is clear or yellow discharge.
    • Chlamydia infections can cause permanent scarring and infertility if left untreated.
    • Pelvic Inflammatory Disease (PID) is a consequence of untreated Chlamydia or Gonorrhea.
    • PID causes inflammation, scarring, and damage to the fallopian tubes, leading to infertility or ectopic pregnancy.

    Chlamydia trachomatis

    • Chlamydia trachomatis serotypes D-K are responsible for genital infections.
    • Chlamydia is a Gram-negative coccobacilli that infects intracellularly.
    • Has a two-stage lifecycle: dormant elementary body and active reticulate body
    • Infects the mucosal epithelial cells of the genital tract in both males and females.
    • About 10% of men and 75% of women are asymptomatic.
    • In men, discharge is commonly observed with pain and/or itchiness around the urethral opening.
    • In women, it is typically diagnosed after a pelvic exam where inflammation of the cervix is identified.
    • Untreated Chlamydia is the most common cause of PID.

    Neisseria gonorrhoeae (Gonorrhea)

    • Gonorrhea is a Gram-negative diplococci with virulence factors such as a capsule, pili, and IgA protease.
    • Infects the mucosal epithelial cells of the genital tract in both males and females.
    • About 10% of men and 50% of women are asymptomatic.
    • The hallmark symptom of gonorrhea is prolific pus production.
    • Gonorrhea can lead to permanent scarring and infertility in men if untreated.
    • In women, gonorrhea can also cause PID and increase the risk of ectopic pregnancy.
    • Condoms are effective in preventing the transmission of both Chlamydia and Gonorrhea when used properly.

    Treponema pallidum (Syphilis)

    • Syphilis is caused by a Gram-negative spirochete, Treponema pallidum.
    • Syphilis is a complex progressive disease with multiple stages that will be discussed in a later lecture.

    Human Papillomavirus (HPV)

    • Most common STI in the US.
    • Most infections are asymptomatic and self-resolve.
    • The virus can cause warts (painless skin-colored papules) in symptomatic cases.
    • High-risk HPV strains can lead to cancer of the cervix, penis, anus, or throat.

    Molluscum Contagiosum

    • Molluscum contagiosum is transmitted through direct contact and usually affects the genitals.
    • It manifests as small, painless papules on or near the genitals.
    • The papules usually self-resolve without complications.

    Hepatitis B and C Viruses

    • Hepatitis B and C viruses are sexually transmitted and are asymptomatic.
    • Increases the risk of liver cancer.
    • Details on these viruses will be covered in later digestive system modules.

    Herpes Simplex Virus (HSV)

    • HSV is a virus that causes cold sores and genital sores.
    • There are two types of HSV: HSV1 and HSV2.
    • HSV1 is commonly associated with oral lesions, while HSV2 is associated with genital sores.
    • HSV2 can also cause oral sores and HSV1 can cause genital sores.
    • Approximately 90% of Americans are exposed to HSV by the age of 50.
    • HSV is a sexually transmitted disease that can be spread through oral sex, vaginal sex, or anal sex.
    • HSV can also be spread through childbirth, contact with open sores, or sharing bodily fluids.

    HSV Transmission and Timeline

    • Individuals can be infected with HSV without experiencing symptoms.
    • After infection, it takes about 4 to 7 days for HSV to produce the first sores.
    • Sores take approximately 10 days to heal.

    Symptoms of HSV

    • Herpes Labialis (cold sores on lip): HSV affects epithelial cells of the lips, gums, inside of the cheek, and tongue.
    • Herpes Genitalis: HSV affects epithelial cells of the genitals, including the tip of the penis, shaft of the penis, vulva, vaginal wall, and cervix. Symptoms include pain, burning, and itching.
    • Herpetic Whitlow: This is an abscess that can occur near the fingernail or toenail after a person is accidentally pricked by a needle contaminated with HSV.
    • Herpes of the Eye (Herpes Keratitis): HSV can affect the eye when an infected finger touches the eye. Symptoms include lesions on the cornea.
    • Herpes Encephalitis: This is a rare and serious infection of the brain. It can cause symptoms such as headache, mental disorders, depression, and death.

    HSV and Nerve Cells

    • HSV can go dormant in a nerve cell, usually in the cell body of a nerve, and cause burning and itching.
    • The trigeminal nerve is responsible for sensations felt in the face.
    • If HSV goes dormant in a neuron of the trigeminal nerve, it can reactivate and cause another cold sore.
    • HSV can travel up the trigeminal nerve to the brain to cause herpes encephalitis.
    • Herpes encephalitis is rare and more common in patients with weakened immune systems.

    Herpes Simplex Virus

    • Herpes simplex virus (HSV) is a common virus that causes cold sores and genital sores.
    • HSV exists in two forms: HSV-1 and HSV-2.
    • HSV-1 was previously thought to only cause oral lesions, and HSV-2 only genital lesions.
    • Current knowledge suggests that HSV-2 can cause oral lesions and HSV-1 can cause genital lesions.
    • 90% of Americans are exposed to HSV by age 50.

    Transmission

    • HSV is a sexually transmitted disease.
    • Transmission can occur through oral, vaginal, or anal sex.
    • Childbirth is a common mode of transmission.
    • Contact with open sores can transmit the virus.
    • Sharing bodily fluids, like a healthcare worker pricked by a needle used for a patient with HSV, is another mode of transmission.

    Symptoms

    • The first sores appear 4-7 days after initial infection.
    • Sores take about 10 days to heal.
    • Herpes labialis is the term for cold sores on the lips.
    • Herpes labialis can occur on the gums, inside the cheeks, and the tip of the tongue.
    • Herpes genitalis refers to cold sores on the genitals.
    • Herpes genitalis can occur on the tip of the penis, the shaft of the penis, the vulva, the vaginal wall, and the cervix.

    Pathophysiology

    • HSV enters epithelial cells.
    • HSV alters the cell's protein production to create more copies of the virus.
    • The cell eventually dies.
    • White blood cells may attack HSV-infected cells or cause apoptosis (programmed cell death).

    Complications

    • Herpes whitlow: an abscess near the fingernail or toenail.
    • Herpes infection of the eye: can cause lesions on the cornea.
    • Herpes encephalitis: an infection of the brain that can cause headache, mental disorders, depression, and can be fatal if left untreated. This is rare and mainly occurs in patients with weak immune systems.

    Trigeminal Nerve

    • The trigeminal nerve is a nerve in the face that transmits sensation from the face, including the lips.
    • HSV can become dormant in the cell body of the trigeminal nerve and reactivate, leading to cold sores.
    • The trigeminal nerve connects to the brain. HSV can travel up to the brain and cause herpes encephalitis.

    Human Papillomavirus (HPV)

    • HPV is a group of over 100 viruses that infect people.
    • Most HPVs are common, causing skin warts on hands and feet.
    • About 40 types infect the genitals and are the most common sexually transmitted infections.
    • Genital HPVs can be low-risk or high-risk.
      • Low-risk types cause warts around genitals and anus.
      • High-risk types can lead to cervical cancer and other genital, oral, or anal cancers.

    Transmission and Infection

    • HPV spreads through skin-to-skin contact during sexual activity.
    • The virus enters through tiny skin cuts in the genital area, throat, and anus.
    • HPV infects the skin's basal layer, replicating within cells.
    • The immune system usually destroys infected cells within two years.
    • Persistent infections occur when the immune system doesn't eliminate all viruses.
    • Low-risk HPV causes warts around genitals.
    • High-risk HPV damages cells' genetic material, leading to precancerous and cancerous cells.

    Preventing HPV Infection

    • No cure exists for any HPV infection.
    • The Gardasil vaccine protects against two common high-risk HPV types causing genital cancers and two common low-risk types causing genital warts.
    • Pre-teen girls and boys should receive three doses of the vaccine over six months for optimal protection.
    • The vaccine introduces dead HPV proteins into the bloodstream, stimulating the immune system to produce HPV-specific antibodies.
    • The vaccine doesn't protect against all HPV types or treat existing infections.

    Detecting and Treating HPV Infections

    • Most infections are asymptomatic (no symptoms).
    • PAP tests are recommended for women to detect abnormal or precancerous cells on the cervix, even if they've been vaccinated.
    • Combined with an HPV test, the tests are called co-testing.
    • Treatment for abnormal or cancerous cells depends on the woman's age, medical history, and cell type.
    • Abnormal and cancerous cells can be treated, although there is no cure for HPV infection.
    • Genital warts can disappear as the immune system fights off the infection.
    • Healthcare providers can examine and recommend removal methods like cryotherapy, electrocautery, or surgical removal for painful or persistent warts.
    • Do not treat genital warts at home.

    Human Papillomavirus (HPV)

    • HPV is a group of over 100 viruses that can infect people.
    • Most HPV types cause skin warts on the hands and feet.
    • About 40 HPV types affect the genitals and are sexually transmitted.

    Genital HPV

    • Some genital HPVs are low-risk and may cause warts on and around the genitals and anus.
    • Other genital HPVs are high-risk and can lead to cervical and other genital, oral, or anal cancers.

    HPV Infections

    • Most HPV infections cause no symptoms.
    • HPV is spread through skin-to-skin contact during vaginal, oral, or anal sex.
    • The virus enters through tiny cuts in the skin around or inside the penis, vagina, throat, or anus.
    • The virus infects cells in the bottom layer of skin.
    • For most people, the immune system destroys the virus within two years.
    • In some, the immune system doesn’t destroy the viruses, leading to a lingering infection.
    • HPV-infected cells may multiply over several weeks or months.
    • If the cells are infected with low-risk HPV, warts form around the genitals.
    • If the HPV is high-risk, it may damage cells’ genetic material, causing cells to become precancerous.

    Cervical Cancer & HPV

    • Cervical cancer is the most common cancer from high-risk genital HPV.

    HPV Vaccine

    • The Gardasil vaccine protects against two of the most common high-risk HPVs that cause genital cancers and two of the most common low-risk HPVs that cause genital warts.
    • Pre-teen girls and boys should receive three doses of the vaccine over six months.
    • The vaccine injects dead HPV proteins into the bloodstream, stimulating the immune system to create antibodies against specific HPVs.
    • The vaccine does not protect against other types of HPV not included in the vaccine and doesn’t reliably treat existing infections.

    PAP Test

    • Women should have a PAP test to check for abnormal or precancerous cells on their cervix, even if they’ve had the HPV vaccine.

    HPV Test

    • A separate HPV test looks for genetic material from high-risk HPV types.
    • A PAP test and HPV test together are called "co-testing".

    Treatment & Removal

    • There is no cure for HPV infections.
    • Abnormal and cancerous cells can be treated.
    • Warts may go away without treatment as the immune system fights off the HPV infection.
    • If warts are painful or don't go away, a healthcare provider can remove them.
    • Removal methods include:
      • Freezing with cryotherapy
      • Burning with an electric current (electrocautery)
      • Surgical removal

    Herpes Simplex Virus 1 (HSV-1)

    • Usually causes Herpes labialis (cold sores), ocular herpes, gingivostomatitis (inflammation of the mouth) and pharyngitis (inflammation of the throat)
    • Transmitted through close contact, typically of the face
    • Remains dormant (latent) in the trigeminal ganglion
    • Causes skin lesions on the face and mouth
    • Can cause complications for personnel working on the oral cavity, resulting in up to 30% of cases

    Herpes Simplex Virus 2 (HSV-2)

    • Typically causes genital herpes
    • Transmitted through sexual contact or close contact
    • Remains latent (dormant) mainly in the sacral ganglia
    • Causes skin lesions on the internal and external genitalia, thighs, and buttocks.
    • Can cause complications for obstetric and gynecological personnel, leading to the majority of cases.
    • Can result in Whitlows (infection of the fingers) and neonatal encephalitis (inflammation of the brain in newborns).

    Syphilis

    • Syphilis is caused by a spirochete bacteria called Treponema pallidum.
    • Treponema pallidum is a gram-negative bacteria with internal flagella.
    • Humans are the only natural host for Treponema pallidum.
    • It can be transmitted through sexual contact with an infected person or via direct contact with mucous membranes or abraded skin.
    • The spirochete has hook tips with which it binds to epithelial cells before entering the bloodstream.
    • Syphilis can also occur congenitally. The spirochete can cross the placenta and infect the developing fetus.
    • Syphilis can also be spread through blood transfusions but this is very rare in the US because we screen our blood supplies rigorously.

    Stages of Syphilis

    • Syphilis has four distinct stages, each with unique symptoms and characteristics:
      • Primary Syphilis:
        • Starts approximately three weeks after infection.
        • Characterized by the formation of painless ulcers called "shankers" at the site of infection, often on the genitals.
        • Can occur anywhere on the body, including the gums, lips, tongue, fingers, nipples.
        • Shankers heal spontaneously within two to six weeks, leaving no scarring or evidence.
        • The spirochete enters the bloodstream after the shanker heals.
      • Secondary Syphilis:
        • Occurs after the primary shanker heals and the spirochete enters the bloodstream.
        • Lasts for weeks to months.
        • Systemic infection with a wide range of symptoms, including a maculopapular rash on the body that can be felt with the hand.
        • The rash can also appear on the palms of the hands and the soles of the feet.
        • Other symptoms include fever, headache, and wart-like growths in the genital area called condylomata lata.
        • Swollen lymph nodes in the adjacent areas can also be seen.
        • The patient is still contagious during this stage.
      • Latent Syphilis:
        • Occurs after the symptoms of secondary syphilis disappear.
        • Asymptomatic, lasting for three to thirty years.
        • The patient is contagious during the early latent phase (first one to two years) but not contagious during the late latent phase and in the tertiary syphilis stage.
      • Tertiary Syphilis:
        • Develops after decades if the patient remains untreated.
        • Not contagious.
        • The immune system is fighting the infection, but the spirochete can cause permanent damage to various organs.
        • Symptoms include: gummas (painless, swollen masses that invade skin and bones), nerve damage, heart damage, skin damage, joint damage, eye damage.
        • May cause neurosyphilis (mental deterioration, psychological problems) in the elderly.

    Diagnosing Syphilis

    • Direct Microscopy:
      • Darkfield microscopy can be used to visualize the spirochetes from a swab of a shanker.
      • Fluorescence antibody testing uses antibodies specific for Treponema pallidum.
    • Serological Tests: These use antibodies to test for the presence of Treponema pallidum in blood samples.

    Congenital Syphilis

    • Occurs in the fetus of an infected pregnant woman, typically during the primary and secondary stages.
    • The spirochete can cross the placenta and infect the fetus during pregnancy.
    • Symptoms of congenital syphilis include:
      • Runny nose (snuffles)
      • Peeling skin rash
      • Bone deformities
    • Later, the child may develop Hutchinson teeth (tiny notches on teeth), blindness, and deafness.

    Importance of Screening and Treatment

    • It is crucial for pregnant women to be screened for syphilis.
    • If left untreated, syphilis can lead to devastating consequences, including death.
    • Syphilis is readily curable with penicillin.

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    This quiz covers the key aspects of sexually transmitted infections (STIs), with a focus on Chlamydia. Learn about the causes, symptoms, and clinical classifications of STIs. Test your knowledge on how STIs are transmitted and their impact on health.

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