Essentials of Human Diseases and Conditions 4th edition Margaret Schell Frazier Jeanette Wist Drzymkowski
Learning Objectives • Identify risk factors for sexually transmitted diseases (STDs). • Explain what a silent STD is, and give an example. • Name the complications of untreated gonorrhea. • Recall how trichomoniasis is diagnosed. • Explain how genital herpes is transmitted. • Explain why women with genital herpes are advised to have regular Pap (Papanicolaou) smears.
Learning Objectives (cont’d.) • Describe the stages of untreated syphilis. • Explain why hepatitis B is classified as sexually transmitted. • List the possible causes of dyspareunia in men and women. • Name drugs that can contribute to impotence. • Name a common causative factor in male and female infertility.
Learning Objectives (cont’d.) • Explain the value of prostate-specific antigen (PSA) as a screening test. • Discuss the medical interventions for prostatic cancer. • Explain how varicocele may contribute to male infertility. • Explain why physicians encourage monthly testicular self-examinations for younger men.
Learning Objectives (cont’d.) • Explain what causes the dysmenorrhea associated with endometriosis. • Discuss the importance of early diagnosis and prompt treatment of pelvic inflammatory disease. • Discuss the advantages and possible risks of hormone replacement therapy for the postmenopausal woman.
Learning Objectives (cont’d.) • Explain how uterine prolapse, cystocele, and rectocele may be corrected surgically. • List the risk factors for cervical cancer. • Name the leading cause of deaths attributed to female reproductive system disorders. • List some possible causes of ectopic pregnancy.
Learning Objectives (cont’d.) • Explain how a pregnant woman is monitored for toxemia. • Describe abruptio placentae. • List the factors that place women at higher risk for breast cancer.
The Normally Functioning Reproductive Systems • The human reproductive system is classified into two groups: • Gonads: produces germ cells and hormones • Testes (males) • Ovaries (females) • Ducts: transport germs cells
The Normally Functioning Reproductive Systems (cont’d.) • Both the male and female reproductive systems are vulnerable to a number of diseases or dysfunctions • The origin of these conditions may be: • Functional • Structural • Emotional
Sexually Transmitted Diseases • More than 20 infectious diseases are spread by sexual contact • Sexually transmitted diseases (STDs) are spread from one person to another through bodily fluids (blood, semen, vaginal secretions) during vaginal, anal, or oral sex • Some spread by direct contact with infected skin
Sexually Transmitted Disease Risk Factors A person is at greater risk for getting an STD if he or she: • Has sex without knowledge of partner’s history • Shares drug-related needles • Has sex with multiple partners • Has direct skin contact with an open wound of an infected person
Chlamydia • One of the most frequently reported infectious diseases in the U.S. • More common than gonorrhea and the leading cause of pelvic inflammatory disease and sterility in women • Sometimes called the silent STD because it often has no symptoms
Chlamydia (cont’d.) • Symptoms • When symptoms are present they are evidenced in both females and males and include: • Females • Thick vaginal discharge with burning sensation • Itching • Abdominal pain • Pain during intercourse (dyspareunia)
Chlamydia (cont’d.) • Males • Discharge from penis with burning sensation • Itching • Burning sensation when urinating • Scrotum may be swollen
Chlamydia (cont’d.) • Treatment • Antibiotic therapy is given to both partners • Initially: a single injection • Followed by: oral antibiotics • Patients are encouraged to abstain from intercourse until both partners are cured
Gonorrhea • A common STD with symptoms similar to chlamydia • Additional symptoms: • A discharge of pus from the genital tract in both males and females • Difficult or painful urination • Symptoms vary in severity
Gonorrhea (cont’d.) • Treatment • Antibiotic therapy for both partners • Because many strains of the bacteria that cause gonorrhea have become resistant to standard antibiotic therapy (tetracycline and penicillin), follow-up cultures are routinely ordered to ensure a complete cure
Gonorrhea (cont’d.) • Neglecting treatment can lead to the following complications: • Pelvic inflammatory disease • Blood poisoning (septicemia) • Septic arthritis
Trichomoniasis • Infection of the lower genitourinary tract • Affects about 15 percent of sexually active people • Most infected men and women are without symptoms
Trichomoniasis (cont’d.) • Symptoms • When symptoms are present they are evidenced in both females and males and include: • Difficult or painful urination • Itching • Women: profuse greenish yellow discharge from the vagina
Trichomoniasis (cont’d.) • Diagnosis • Discharge from either the male or female is typically studied for the microorganism responsible. • Urinalysis may be performed • Cervix may also be examined for the presence of small hemorrhages with a strawberry-like appearance
Trichomoniasis (cont’d.) • Treatment • Anti-infective drugs are given orally or in some cases vaginally. • Follow-up examinations to ensure the infection has been eliminated
Genital Herpes • Infection of the skin in the genital area resulting in painful genital sores • Spread by direct skin-to-skin contact • Caused by herpes simplex virus type 2 (HSV-2) • Large percentage of infections go unnoticed
Genital Herpes (cont’d.) • Symptoms • One or more blister-like lesions on or around the genitals or anus • Swollen glands • Fever • Headache • Painful urination
Genital Herpes (cont’d.) • Diagnosis • Presence of characteristic lesions on the male or female genitalia • An antigen test or tissue culture may confirm the diagnosis.
Genital Herpes (cont’d.) • Treatment • There is no cure. • Prescription drugs are routinely used to reduce the frequency and duration of outbreaks. • Women with genital herpes are at increased risk for cervical cancer and are encouraged to obtain a Pap smear every six months for screening.
Genital Warts (Condylomata Acuminata) • A genital infection that causes raised cauliflower-like growths in or near the vagina or rectum or along the penis • Warts are caused by the human papillomavirus (HPV) and is usually transmitted through sexual contact.
Genital Warts (cont’d.) • Symptoms • Possible itching or burning • Discomfort varies by size, number, and location • Added risk factor • Women with HPV infection are at greater risk for cervical cancer
Genital Warts (cont’d.) • Treatment • Topical drug therapy • Surgical procedures • Cryosurgery: freezing and removing affected tissue • Electrodesiccation: removing warts using lasers • Some genital warts disappear without treatment
Syphilis • A chronic, sexually transmitted infection that can affect the entire body if left untreated
Syphilis (cont’d.) • Symptoms manifest in four stages: • Presence of a painless but highly contagious local lesion called a chancre (pronounced “shang-ker”) found on the genitalia • Within one-two months, the primary lesion heals, but the infection spreads throughout the body and can cause similar lesions anywhere
Syphilis (cont’d.) • Symptom stages • The infection begins spreading systemically throughout the body and may present with: • Fever • Headache • Aching joints • Mouth sores • Rashes on palms or soles of feet
Syphilis (cont’d.) • Symptom stages • A latent period follows where the infection is without symptoms but can be transmitted in the first few years of this stage. • This stage can last from one to 40 years and varies by person.
Syphilis (cont’d.) • Symptom stages • In the final stage, lesions (called gummas) invade the body organs and systems and cause widespread damage that can be disabling and life-threatening.
Syphilis (cont’d.) • Treatment • Can be cured with a course of antibiotic therapy using penicillin G • Patients are monitored with follow-up blood tests for up to one year to ensure elimination of infection.
Chancroid • A bacterial infection of the genitalia that causes a shallow and painless lesion on the skin or mucous membrane that appears seven to 10 days after sexual contact with an infected person • Symptoms: • Over time, ulcer usually deepens and oozes pus
Chancroid (cont’d.) • Treatment • Antibiotic therapy • Lesions must sometimes be drained surgically • Good personal hygiene • Refrain from sexual contact during treatment
Hepatitis B • An infection of the liver that is caused by a DNA virus • The disease has a long incubation and symptoms may become severe or chronic, causing serious damage to the liver
Hepatitis B (cont’d.) • Causes • Can be transmitted by: • Contaminated blood or blood derivatives in transfusions • Sexual contact with an infected person • Use of contaminated needles and instruments
Hepatitis B (cont’d.) • Symptoms • Fatigue • Loss of appetite • Nausea • Abdominal discomfort • Dark urine • Clay-colored bowel movements • Yellowing of the skin and eyes (jaundice)
Hepatitis B (cont’d.) • Treatment • Some cases are self-limiting • Medications to control nausea and pain • Low-fat, high-carbohydrate diet • Restriction of physical activity • Alcohol should be avoided at all costs because of its potential to strain the liver • Antiviral therapy for chronic cases
Hepatitis B (cont’d.) • Prognosis • Acute cases: prognosis is good • Liver heals and regenerates • May take several months • Chronic cases: prognosis is poor • Inflammation causes destruction of liver cells and possible liver failure
Sexual Dysfunction • Sexual dysfunction is the abnormal or impaired function of sexual behavior resulting from physical and/or mental imbalances in the system
Dyspareunia • Refers to recurrent painful or difficult sexual intercourse • Can occur in men and women but is more common in women
Dyspareunia (cont’d.) • Physical causes (women) • Intact hymen • Insufficient lubrication • Presence of an STD • Use of spermicide • Endometriosis • Pelvic inflammatory disease • Presence of cysts or tumors in pelvic region
Dyspareunia (cont’d.) • Psychological causes (women) • Past trauma • Sexual abuse • Fears (including fear of pregnancy) • Anxiety