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Wellness Exam 2 Study GuideSexually Transmitted Diseases- The Major STDso “STDs” or “STIs” – infectious disease that are spread from person to person mainly through sexual activity.o 7 main STDs that pose a major health threat HIV/AIDS Hepatitis Syphilis Chlamydia Gonorrhea Herpes Human papillomavirus (HPV)o Caused by viruses, bacteria, fungi and protozoa Pathogrens that commonly cause STDs:o US has highest rate of STDs of any developed nation At current rates, ½ of all young people will acquire an STD by age 25. 2007 report from CDC showed that many of the most common STDs are on the rise in the USBACTERIAChlamydia trachomatis  causes PIDGardnerella vaginalis  causes vaginitisHaemophilus ducreyi  causes chancroidNeisseria gonorrhoeae  causes gonhorrheaTreponema pallidum  causes syphillisVIRUSESHepatitis B virus (HBV)Herpes simplex viruses (HSV)Human immunodeficiency virus(HIV)Human papillomavirus (HPV) 2008 CDC estimated approx. 65 million Americans infected with STD and 19 million become newly infected with an STD each year- HIV Infection and AIDSo HIV (human immunodeficiency virus) causes AIDS (acquired immunodeficiency syndrome) AIDS kills most of its victims, esp in parts of the world where no adequate Txo About 65 million people have been infected with HIV since the epidemic began  this isabout 1% of the world’s population About 34 million are currently infected; most will die w/in next 10 years About 70% of them live in sub-Saharan Africa- AIDS = #1 cause of death in Africa- What is HIV Infection?o Chronic disease that progressively damages the body’s immune systemo Makes your body less able to resist infectiono HIV attacks immune system by invading and taking over CD4 T cells, lymphocytes, macrophages and monocyteso HIV enters a human cell and converts its own genetic material (RNA) into DNAo The viral DNA then takes over the CD4 cell and makes it produce more copies of HIV; also causes CD4 cells to stop performing their normal immune functionso Those with AIDS are vulnerable to opportunistic (secondary) infections (most common isyeast/fungal infection)o Asymptomatic period aka latency phase; can last from 2-20 yrs (avg = 11 yrs in untreated adults)o As CD4 levels decrease, HIV RNA levels increase  takes 2-12 weeks for body to make antibody for HIV- Transmitting the Viruso HIV lives only within cells and body fluidso Transmitted by blood and blood products, semen, vaginal and cervical secretions, and breast milko HIV’s 3 primary routes for transmission: Sexual contact Direct exposure to infected blood From an HIV infected mother to her fetus during pregnancy OR to her infant during breastfeeding- Populations of Special Concern for HIV Infectiono The top 3 most commons means of HIV exposure in America: Sexual activity between men IV abuse Heterosexual contacto Women, especially African American women and Latinas, make up an increasingly large proportion of all U.S. AIDS cases HIV is increasingly becoming a disease that affects ethnic minorities, women andthe pooro Af. Amer. men and women are vastly overrepresented among people newly diagnosed with AIDS- Symptoms of HIV Infectiono Within a few days or weeks (avg 2-4 wks after exposure to virus), people will develop initial symptoms which are flu-like  body ache, low grade fever, etc This stage is called the primary acute infectiono Most common infection in HIV patients is Pneumocystitis carinii pneumonia (fungal)o Kaposi’s sarcoma (rare cancer) is commonly seen in HIV patients, esp meno Symptoms take months or even years to develop but as the immune system weakens, a variety of more problems developo HIV infected women often have difficult to treat yeast infectionso Cases of TB increasingly being reported- Diagnosing HIV Infectiono Most common tests check for presence of antibodies to the virus First test done = HIV antibody test  used for screening (cheap and widely available test). If positive, followed up with… ELISA  standard test for HIV. If positive, this is followed up with… Immunofluorescence assay or Western blot  this confirms resultso If tests determine HIV positive, next step is to determine severity of disease To do this, count the CD4 in the blood- Treatmento Antiviral drugs Reverse transcriptase inhibitors such as AZT (zidovudine) work by inhibiting the integration of HIV RNA into human cells Protease inhibitors target the protein HIV uses to create a protein coat for each viral copy Entry inhibitors block HIV from entering and infecting cells HAART = highly active antiretroviral therapy (high dose of 4-5 antiviral meds) – can reduce HIV in blood to undetectable level Post exposure Prophylaxis (PEP) – 28 days of HAART. Should be started with 3 days (72 hrs) of exposure to virus- **This Tx option is used if you are exposure to virus, but not definitely positive- Chlamydiao Most common bacterial STD in U.S.o Can cause sterility in men and women Women: can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy Men: most common cause of epididymitis (inflam. of sperm-carrying ducts); causes half of all cases of urethritis (inflame. of urethra)o Symptoms Women: vaginal discharge, painful/bleeding intercourse, abdominal cramps, lymphatic pain around groin Men: painful urination, watery discharge from penis, lymphatic pain around groino Treatment Typically diagnosed through lab tests on a urine sample or small amt of fluid (discharge) from urethra or cervix Both patient and partner given antibiotics after diagnosed- Gonorrheao Can cause arthritis, rashes, eye infections, PID, epididymitis, urethritis and gonococcal conjunctivitis or gonorrheal infection of blood or joints in infants of infected motherso Being infected with gonorrhea increases likelihood that HIV will be transmittedo Symptoms Men: urinary discomfort, thick, yellow-white discharge, inflamed lips of urethral opening, enlarge lymph nodes in groin region Women: most are asymptomatic. If do have Sx  painful urination, increased vaginal discharge, severe menstrual cramps- Up to 40% of untreated women develop PIDo Diagnosis/Treatment Microscopic exam of discharge or urine can diagnose infection Oral antibiotics can cure- Growing number of drug-resistant strains of gonorrhea = major concern;only 1 class of antibiotics remain effective


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FSU HSC 4711 - Exam 2 Study Guide

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