Unit 8 Chapter 34 – STI: Neisseria Gonorrhea

Neisseria Gonorrhea

• Gram-negative diplococcus that attaches to and penetrates columnar epithelium.
• Spread possible through the lymphatic system; causes complications in females, affecting cervix, urethra, and Skene/Bartholin glands.
• Diagnosis involves urine culture and discharge sample analysis.
• Clinical manifestations include discharge, dysuria, and infertility; often asymptomatic in females, while males experience urethritis.

Nongonococcal C.trachomatis/Chlamydia

• Similar pathogenicity to gonorrhea, acting on columnar epithelium.
• Screening recommended for sexually active individuals.
• Symptoms tend to be less severe compared to gonorrhea.

Syphilis

• A systemic infection by Treponema pallidum that causes vascular changes and inflammatory response.
• Diagnosis through serologic screening or rapid plasma tests.
• Incubation period ranges from 10 to 90 days with stages:
  • Primary: painless chancre.
  • Secondary: rash and flu-like symptoms post-chancre resolution.
  • Latent: asymptomatic phase lasting up to 40 years.
  • Tertiary: risk of cardiovascular and CNS damage, including aortic necrosis.

Genital Herpes

• Herpes simplex virus resides in ganglion neurons, reactivated by stress.
• Diagnosis confirmed via cell culture, with symptoms manifesting as fluid-filled vesicles after 3-7 days.

HPV

• Causes epithelial lesions, leading to genital warts and potentially cervical cancer.
• Diagnosis via pelvic exam, with lesions that are painful, pruritic, and can bleed easily.
• Communicability persists as long as lesions are present.

Disorders of Male Genitalia

Epididymitis

• Often bacterial, commonly caused by STDs like C.trachomatis and E.coli.
• Diagnosed through urine culture; symptoms include fever and dysuria.

Urethral Strictures

• Fibrotic narrowing due to scar tissue associated with prior gonorrhea or trauma.
• Diagnosed via retrograde urethrogram; leads to urine retention and infection risk.

Erectile Dysfunction

• Characterized by the inability to achieve or maintain an erection.
• Etiology includes arterial insufficiency, hormonal changes, and risk factors like hypertension and obesity.

Neoplasms of Penis

• Rare and primarily involves squamous cell carcinoma linked to chronic inflammation.

Neoplasms of Testis

• Includes both germinal (from germinal cells) and nongerminal (from Leydig cells) tumors, with a peak incidence in late adolescence to early adulthood.

Prostate Cancer

• Typically adenocarcinomas with increased risk beyond age 50.

Female Reproductive Disorders

Vaginitis (Vulvovaginitis)

• Inflammation due to bacterial overgrowth, common pathogens include Candida and N.gonorrheae.
• Symptoms include malodorous discharge and genital itching.

Bartholinitis

• Inflammation of Bartholin glands primarily due to gonorrhea; presents with tender, swollen glands and purulent drainage.

Uterine Leiomyomas (Fibroids)

• Benign growths influenced by estrogen, predominantly affecting premenopausal women; causes pain, bleeding, and pressure symptoms.

Ovarian Cysts

• Fluid-filled sacs on ovaries, often asymptomatic but may cause pain; size fluctuation correlated with menstrual cycle.

Endometriosis

• Presence of endometrial tissue outside the uterus; associated with dysmenorrhea and pelvic pain.

Cervical Cancer

• Linked to HPV and early sexual activity; diagnosed via PAP smear and pelvic exam.

Endometrial Cancer

• Cancer of the endometrial lining with symptoms including abnormal bleeding; linked to obesity and hormonal factors.

Vaginal and Vulvar Cancer

• Symptoms include discharge, spotting, and potential pain; diagnosed via pelvic exam and tissue biopsy.

Ovarian Cancer

• Leading cause of genital cancer, often asymptomatic until advanced stages; high mortality and linked to BRCA1/BRCA2 mutations.

Breast Disorders

Fibrocystic Breast Diseases

• Hormonal imbalances lead to palpable breast lesions; diagnosed via mammograms and biopsies.

Specific Benign Neoplasms

• Encapsulated masses like fibroadenomas; typically freely movable and palpable.

Breast Cancer

• Begins in glandular ducts, commonly found in the upper outer quadrant; presents as a hard, movable lump, with advanced symptoms indicating metastatic changes.

Aging Concepts

• Functional reserve decreases, leading to impaired adaptation to environmental changes.
• Notable declines: cardiovascular performance, respiratory capacity, renal filtration, and bone density.
• Increased risk of diseases and conditions such as hypertension and diabetes as related to aging processes.

Concepts of Genetics

• Distinction between phenotype (physical traits) and genotype (genetic makeup).
• Chromosome structure: 23 pairs including autosomes and sex chromosomes.
• Processes of mitosis (cell division) and meiosis (production of haploid cells), including genetic variability through crossing over.
• The influence of environmental factors on polygenic traits like heart disease and diabetes.
• Understanding chromosomal disorders, including trisomies and deletions.

Genetic Assessment and Prenatal Counseling

• Recommendations based on maternal age and familial history of genetic disorders.
• Awareness of environmental teratogens affecting fetal development, and the importance of pre-conception health.

Additional Disorders

• Autosomal dominant and recessive disorders present varying inheritance patterns; known examples include Marfan syndrome and cystic fibrosis.
• Sex-linked disorders predominantly affect males, exemplified by conditions like hemophilia A.

Explore the details of Neisseria Gonorrhea in this quiz. We cover its pathophysiology, etiology, diagnosis, and clinical manifestations. Understanding this sexually transmitted infection is crucial for recognizing its impact on health.