Insel11e ppt18

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  • Table 18-1 Annual New Cases of STDs in the United States
  • Table 18-2 Sexually Transmitted Pathogens and Associated Disease
  • Figure 18-1 The general pattern of untreated HIV infection
  • Figure 18-2 Routes of HIV transmission among adults
  • Figure 18-3 The life cycle of HIV: How antiviral drugs work
  • Figure 18-4 What’s risky and what’s not: The approximate relative risk of HIV transmission of various sexual activities.
  • Symptoms appear in 7-21 days
  • Insel11e ppt18

    1. 1. Chapter 18© 2010 McGraw-Hill Companies. All Rights Reserved.
    2. 2. The Major STDs Also known as sexually transmitted infections (STIs) Spread of an infection from person to person mainly through sexual activity STDs that pose a major health threat: 1. HIV/AIDS 2. Hepatitis 3. Syphilis 4. Chlamydia 5. Gonorrhea 6. Herpes 7. Human papillomavirus (HPV) CDC (2008) estimated 65 million Americans were infected with an STD, and about 19 million Americans become newly infected with an STD each year © 2010 McGraw-Hill Companies. All Rights Reserved. 2
    3. 3. Table 18.1 Annual new cases of STDs in theUnited States © 2010 McGraw-Hill Companies. All Rights Reserved. 3
    4. 4. Table 18.2 Sexually transmitted pathogensand associated diseases © 2010 McGraw-Hill Companies. All Rights Reserved. 4
    5. 5. HIV Infection and AIDS Human immunodeficiency virus (HIV) is the virus which causes AIDS (acquired immunodeficiency syndrome) Leading cause of death in some parts of the world Approximately 65 million people around the world have been infected with HIV since the epidemic began  Nearly 1% of the world’s population  About 3 million new infections per year 25% of HIV-infected Americans are unaware of their condition © 2010 McGraw-Hill Companies. All Rights Reserved. 5
    6. 6. What is HIV Infection? Chronic disease that progressively damages the body’s immune system  HIV attacks and invades CD4 T-cells, monocytes and macrophages  HIV enters a human cell and converts its own genetic material, RNA, into DNA People with AIDS are vulnerable to a number of serious opportunistic (secondary) infections Once initial symptoms resolve, the asymptomatic period may last from 2 to 20 years © 2010 McGraw-Hill Companies. All Rights Reserved. 6
    7. 7. Transmitting the Virus HIV lives only within cells and body fluids Three primary means of transmission:  Specific kinds of sexual contact  Direct contact to infected blood  HIV-infected women to her fetus or to infant during breastfeeding  Not through casual contact © 2010 McGraw-Hill Companies. All Rights Reserved. 7
    8. 8. Figure 18.1 The general pattern of untreatedHIV infection © 2010 McGraw-Hill Companies. All Rights Reserved. 8
    9. 9. Populations of Special Concern forHIV Infection Most common means of exposure:  Sexual activity between men  Injection drug use  Heterosexual contact African American men and women are vastly overrepresented among U.S. people newly diagnosed with AIDS © 2010 McGraw-Hill Companies. All Rights Reserved. 9
    10. 10. Figure 18.2 Routes of HIV transmission amongAmericans © 2010 McGraw-Hill Companies. All Rights Reserved. 10
    11. 11. Symptoms of HIV Infection Within a few days or weeks, some people will develop flulike symptoms  Specialized test HIV RNA assay Symptoms take months or years to develop, but as immune system weakens, variety of symptoms develop  Pneumocystis pneumonia (fungal infection)  Kaposi’s sarcoma  Difficult-to-treat yeast infections in women  Tuberculosis © 2010 McGraw-Hill Companies. All Rights Reserved. 11
    12. 12. Diagnosing HIV Infection Most common tests check for the presence of antibodies to the virus  HIV antibody test  ELISA (first test)  Western blot or immunoflourescence assay is done to confirm results If HIV positive, the next step is to determine the disease’s severity to plan appropriate treatment © 2010 McGraw-Hill Companies. All Rights Reserved. 12
    13. 13. Diagnosing AIDS HIV-positive and either has developed an infection defined as an AIDS indicator or has a severely damaged immune system Reporting  All diagnosed cases of HIV or AIDS must be reported to public health authorities Treatment  No cure  Antiviral drugs  Postexposure prophylaxis (PEP)  Treatments for opportunistic infections  HIV and pregnancy  Treatment challenges © 2010 McGraw-Hill Companies. All Rights Reserved. Sexually Transmitted Diseases 13
    14. 14. Figure 18.3 The life cycle of HIV: How antiviraldrugs work © 2010 McGraw-Hill Companies. All Rights Reserved. 14
    15. 15. What About a Vaccine? Vaccines are being tested in humans Licensed AIDS vaccine is not estimated to be at least a decade away  Some experts concede the possibility that a vaccine may never be developed How can you protect yourself?  Make careful choices about sexual activity  Don’t share drug needles  Participate in an HIV education program © 2010 McGraw-Hill Companies. All Rights Reserved. 15
    16. 16. Figure 18.4 What’s risky and what’s not: Theapproximate relative risk of HIV transmission of varioussexual activities © 2010 McGraw-Hill Companies. All Rights Reserved. 16
    17. 17. Chlamydia Most prevalent bacterial STD in the U.S. Can cause sterility in men and women  In women, it can lead to pelvic inflammatory disease and ectopic (tubal) pregancy  In men, chlamydia is the most common cause of epididymitis, and causes half of all cases of urethritis Symptoms  Usually asymptomatic in women  Vaginal discharge, burning with urination, watery discharge from penis, pain around testicles and in lower abdominals © 2010 McGraw-Hill Companies. All Rights Reserved. 17
    18. 18. Chlamydia Diagnosis  Examination of tissue samples or urine Treatment  Once diagnosed, infected person and partner are given antibiotics © 2010 McGraw-Hill Companies. All Rights Reserved. 18
    19. 19. Gonorrhea 350,000 new cases reported to the CDC in 2007 Bacterial infection Can cause sterility, arthritis, heart problems, PID, ectopic pregnancy, urethritis, and gonococcal conjunctivitis in infants of infected mothers Symptoms  Usually asymptomatic in women, though frequent burning during urination, menstrual irregularities, pelvic pain, and discharge may occur  Thick yellow-white discharge, and painful urination in men © 2010 McGraw-Hill Companies. All Rights Reserved. 19
    20. 20. Gonorrhea Diagnosis  Microscopic exam of discharge can diagnose infection Treatment  Oral antibiotics can be taken for treatment ○ Growing number of drug-resistant strains of gonorrhea is a major concern© 2010 McGraw-Hill Companies. All Rights Reserved. 20
    21. 21. Pelvic Inflammatory Disease Leading cause of infertility in young women Symptoms  Long and painful periods, discharge, spotting, low abdominal pain, fever, chills, nausea, and vomiting Diagnosis  Diagnosis made on basis of symptoms, physical examination, ultrasound, and laboratory tests Treatment  Antibiotics and hospitalization are normally required © 2010 McGraw-Hill Companies. All Rights Reserved. 21
    22. 22. Human Papillomavirus Infection  Most common STD in the U.S.  Causes a variety of human diseases:  Common warts  Genital warts  Genital cancers  Highly contagious  New vaccination for HPV: Gardasil  Protects against four types of HPV virus that account for 90% of genital warts and 70% of cervical cancers  Most effective before the onset of sexual activity © 2010 McGraw-Hill Companies. All Rights Reserved. 22
    23. 23. Human Papillomavirus Infection Symptoms  Small bump on the skin or a large, warty growth  Cauliflower-like mass  May cause irritation and bleeding Diagnosis  Diagnosed based on the appearance of lesions  Often detected during routine PAP tests Treatment  Treatment focuses on reducing the number and size of warts ○ Cryosurgery (freezing) ○ Electrocautery (burning) ○ Laser surgery © 2010 McGraw-Hill Companies. All Rights Reserved. 23
    24. 24. Genital Herpes 1 in 5 adults in the U.S. has genital herpes Two forms cause genital herpes and oral-labial herpes  HSV 1 (Type 1) ○ Associated with cold sores and fever blisters ○ Oral-labial herpes ○ 50-80% of U.S. adults have antibodies to HSV-1  HSV 2 (Type 2) ○ Almost always sexually transmitted ○ Usually occurs during adolescence and early adulthood ○ Approximately 22% of adults have antibodies to HSV 2 Remains in the body for life© 2010 McGraw-Hill Companies. All Rights Reserved. 24
    25. 25. Genital Herpes Symptoms  90% of infected people have no symptoms  First episode causes flulike symptoms and genital lesions  Virus remains alive in an inactive state and an outbreak can occur at any time Diagnosis  Diagnosed through examination of sores and culturing of fluid taken from sores Treatment  No cure  Antiviral drugs taken at the beginning of an outbreak can shorten the severity and duration of symptoms © 2010 McGraw-Hill Companies. All Rights Reserved. 25
    26. 26. Hepatitis B Inflammation of the liver which can cause serious and permanent damage to the liver Highly contagious but preventable with vaccine Transmitted through the exchange of bodily fluids Symptoms  Flulike symptoms, nausea, vomiting, dark-colored urine, abdominal pain, and jaundice Diagnosis and treatment  Diagnosed through a blood test  No cure Prevention © 2010 McGraw-Hill Companies. All Rights Reserved. 26
    27. 27. Syphilis Can be effectively treated with antibiotics Symptoms  Primary phase: 10-90 days after exposure ○ Characterized by painless ulcers, called chancres  Secondary phase: 3-6 weeks after exposure ○ Characterized by flulike symptoms and highly contagious skin rash  Late, or tertiary, phase ○ Damage to organs, dementia, cardiovascular damage, blindness, and death Diagnosis and treatment  Diagnosed by examination of infected tissues and with blood tests  Treated by antibiotics but damage from late stages of infection can be permanent© 2010 McGraw-Hill Companies. All Rights Reserved. 27
    28. 28. Other STDs Trichomoniasis  Most common curable STD among young women  Single-celled organism Bacterial vaginosis (BV)  Abnormal vaginal discharge caused by unhealthy species of normal vaginal bacteria Pubic lice and scabies  Contagious parasitic infections © 2010 McGraw-Hill Companies. All Rights Reserved. 28
    29. 29. What You Can Do Education Diagnosis and treatment  Get vaccinated  Be alert for symptoms  Get tested  Inform your partners  Get treated Prevention  Talk openly about your concerns  Know your potential partner © 2010 McGraw-Hill Companies. All Rights Reserved. 29
    30. 30. Chapter 18© 2010 McGraw-Hill Companies. All Rights Reserved.

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