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Details Title: PID/STI/PATH 1 Description: 4.25.07 Total Flash Cards: 26 Created: 04/29/2007 10:53:40	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term what is PID? Definition Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. This may lead to tissue necrosis with/or without abscess formation. Pus can be released into the peritoneum. ⅔ of patients with laparoscopic evidence of previous PID were not aware they had had PID (Cecil's 5th ed). PID is often associated with sexually transmitted diseases, as it is a common result of such infections. PID is a vague term and can refer to viral, fungal, parasitic, though most often bacterial infections. PID should be classified by affected organs, the stage of the infection, and the organism(s) causing it. Although a sexually transmitted infection is often the cause, other routes are possible, including lymphatic, postpartum, postabortal (either miscarriage or abortion) or IUD related, and hematogenous spread. Term what are 4 most common STIs in US? Definition chlamydia, gonorrhea, HSV, HPV Term major sequale of PID? Definition ectopic, etc. Term what causes gonorrhea? Definition Neisseria gonorrhoeae Gram-negative diplococci Term what are the growth requirements of n. gon Definition Fastidious growth requirements: Complex media: Thayer-Martin or chocolate agar, Humid atmosphere supplemented with CO2 Term is NG mostly symptomatic? Definition No: Strictly a human disease. Asymptomatic carriage the major reservoir: More common in women (~ 50%)-- Rectal and pharyngeal infections Transmission by sexual contact Women with 50% acquisition after single exposure to infected man Men 20% acquisition after single exposure to infected woman Risk rises with number of encounters Term what are the clinical disease of gon? Definition Urethritis; Cervicitis; Salpingitis; Pelvic inflammatory disease (PID); Proctitis; Conjunctivitis; Pharyngitis; Disseminated disease (bacteremia) People with deficiencies in late components of complement at risk for systemic disease Term what is proctitis? Definition Proctitis is inflammation of the lining of the rectum, called the rectal mucosa. Proctitis can be short term (acute) or long term (chronic). Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Sexually transmitted diseases like gonorrhea, herpes, and chlamydia may also cause proctitis. Inflammation of the rectal mucosa may be related to ulcerative colitis or Crohn's disease, autoimmune conditions that cause inflammation in the colon or small intestine. Other causes include rectal injury, bacterial infection, allergies, and malfunction of the nerves in the rectum. Term How do you Dx gon? Definition Molecular probes used for direct detection on clinical specimens such as urine or cervical or penile secretions.: Replaced culture; Nucleic acid amplification tests (NAATs) *** Combination assays for N. gonorrhoeae and C. trachomatis (the syph); Gram stain of urethral drainage: 98% sensitive in symptomatic males < 60% in asymptomatic men and all women Culture: Selective media: modified Thayer-Martin Nonselective media: chocolate blood agar Organisms die rapidly of allowed to dry Term what is physiology of chlamidia? Definition Strict intracellular parasite of humans; Small gram-negative bacilli; there are Two human biovars: Trachoma: 15 serovars LGV: 4 serovars Term what are serovars? Definition A serovar or serotype is a grouping of microorganisms or viruses based on their cell surface antigens. Serovars allow organisms to be classified at the sub-species level; an issue of particular importance in epidemiology.[1] Term where does chlamydia grow? Definition Receptors for EB found on mucous membranes of: Urethra; Endocervix, endometrium and fallopian tubes; Anorectum; Respiratory tract; Conjunctivae Term with chlamd, what immune responses will you see? Definition Clinical disease : involves Cellular destruction and Host immune response of Neutrophils; Lymphocytes; Plasma cells. Reinfection is common. then you will see: No immunity; Vigorous inflammatory response; Tissue damage; Visual loss; Sterility Term Is chlamy more common in mles or females? Definition females Term can you pass chlamd onto babies? Definition Perinatal transmission results in neonatal conjunctivitis in 30-50% of exposed babies Term how do you DX chlam? Definition Cytology not sensitive; Culture specific but insensitive; Antigen detection: DFA, ELISA, ( Sensitivity variable). Molecular amplification assays (NAATs)***: Multiple methods (DNA or RNA sequences) Highly sensitive and specific; Combined with detection of N. gonorrhoeae Term what is a lower genital tract infection? Definition Cervicitis -mucopurulant (pus) from cervix caused by Gonorrhoe or Chlamaydia. These infections might be totally assymptomatic or just cause what a woman would describe as vaginal discharge Term if untreated, gon? Definition 1/2 time, it resolves on its own. 1/2 time, it causes upper vag tract (PID) Term what are 3 symptoms of PID? Definition Endometritis (endometrium); Salpingitis (Fallopian Tube); Oopheritis (Ovary) Term upper genital tract infection? Definition PID, caused by: Gonorrhea, chlamydia, anerobic and aerobic bacteria form vagina . once gon/chlam move to upper tract, immune system breaks down so that other (normally not present in UPPER, but normally present in vag) organisms will infect UPPER. Term PID symptoms Definition Abdomen: bilateral lower abdominal tenderness. Bowel sounds present. Pelvic Exam: The uterus and adnexa cannot be evaluated completely secondary to pain and guarding. Marked cervical motion tenderness. Green Purulent fluid copiously noted from cervix. Term lab findings for PID Definition White blood count 11.5 Pregnancy test negative Later gonorrhoea and chlymadia detected from cervical swabs (***nucleic acid amplification tests have replaced culture and can performed on urine specimens, endocerviacl swabs and male urethral swabs) Term what are minimum criteria for Dx of PID? Definition Lower abdominal pain; Adnexal tenderness; Cervical motion tenderness Term what are additional criteria for Dx of PID? Definition Fever; Elevated white count; Pus from cervix, mucopurulent cervicitis; Isolation of gonorrhea and/or chlamydia; Laparoscopic finding of inflamed fallopian tube with pus from fimbriated end (this means that the lower tract infection has moved up into FT) Term what are complications of acute PID? Definition Infertility caused by tubal scarring, pyosalpinx (pus in FT), hydrosalpinx (water in FT) distal tubal occlusion and/or scarring; Ectopic pregnancy (even if tubes aren't totall occluded, just scarred, egg won't be able to roll from FT); Chronic pelvic pain; Tuboovarian abscess and peritonitis (spreading to ovary and peritonitis) Term How Tx PID? Definition Broad spectrum antibiotics which are effective against Gonorrhoea, chlamydia, as well as the endogenous vaginal and lower GI flora such as anerobic bacteroides fragilis, and gram negative and gram positive aerobes . EARLY DETECTION IS KEY TO MINIMIZED damage