PHRM 514 STD's Fall 2012 (1)

Syphilis diagnosis n microscopic examination from

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Syphilis:  Diagnosis n Microscopic examination   from  specimens collected from lesions or  enlarged lymph nodes with identification  of: § T. pallidum  spirochete § Antibodies to  T. pallidum n Serologic testing § Nontreponemal § Treponemal Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Centers for Disease Control and Prevention.  Sexually Transmitted Diseases Treatment Guidelines.  MMWR  2010;59(RR-12):1-116.
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Darkfield Micrograph of  Treponema Pallidum Treponema pallidum.  Centers for Disease Control and Prevention.   ; 2012.
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Syphilis Diagnosis n Nontreponemal § Venereal Disease Research  Laboratory (VDRL), rapid  plasma reagin (RPR) test § Positive indicates the  presence of any stage of  syphilis or congenital syphilis § May see false positives § Reported quantitatively –  decline with treatment and  may become nonreactive § Used for screening and for  following progression of  disease, recovery after  therapy, and reinfection n Treponemal § Fluorescent treponemal  antibody absorption (FTA- ABS),  T. pallidum  hemagglutination assay  (TPHA)  § More sensitive § Used for confirming diagnosis § Not used for following  treatment § Remain reactive for life in  most patients Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Centers for Disease Control and Prevention.  Sexually Transmitted Diseases Treatment Guidelines.  MMWR  2010;59(RR-12):1-116.
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Herpes Simplex Virus (HSV)
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Herpes Simplex Virus Statistics n Estimated seroprevalence of HSV2 in  those age 14 to 49 years from 2005 to  2008 = 16.2% n  Overall decrease in prevalence n 306,000 office visits in 2009 Centers for Disease Control and Prevention.  Sexually Transmitted Disease Surveillance 2010.  Atlanta: U.S. Department of Health and Human Services; 2011.
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Genital Herpes n Caused by the herpes simplex virus (HSV) § Type 1—usually associated with “cold sores” § Type 2—usually associated with genital herpes n Transmitted when infected secretions come in  contact with mucosal surfaces: § Urethra § Oropharynx § Cervix § Conjunctivae or abraded skin Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028.
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Genital Herpes:  Pathophysiology n Virus replicates in skin and mucus 
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