This document provides information on several sexually transmitted infections (STIs) including gonorrhea, syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, herpes simplex, and AIDS. For each STI, the document outlines the causative agent, incubation period, signs and symptoms, diagnosis, treatment, and prevention. The majority of the document is devoted to providing detailed information on gonorrhea, including transmission routes, clinical manifestations, complications, and management approaches.

2.  Gonorrhea
 Syphilis
 Chancroid
 Granuloma Inguinale

3.  LymphoGranulomaVenereum
 Herpes Simplex
 Infectious Mononucleosis
 AIDS

4. GONORRHEA
CLAP/ FLORES BLANCAS/ GLEET
Is a sexually transmitted bacterial
disease involving the mucosal lining
of the genitourinary tract, the
rectum and the pharynx

5. Neisseria gonorrhoeae or gonococcus
3 – 21 days average 3 – 5 days
Infected persons remain
communicable as long as the
organisms are present in secretions
and discharges

6. 1. Contact with exudates from the
mucous membranes of infected
persons , usually as a result of
sexual activity
2. Occur in utero upon the rupture of
membranes, as observed in infants
delivered by caesarean section after
the membrane ruptures.
3. Transmitted through direct contact
with contaminated vaginal secretions
of the mother as the baby comes out
of the birth canal

7. 4. Sexual contact (orogenetal,
anogenetal) between opposite sexes
as well as the same sex
5. Fomites

8. a) Burning sensation and frequent
urination
b) Yellowish purulent vaginal
discharges
c) Redness and swelling of the
genitals
d) Burning sensation and itching of
the vaginal area
e) Urinary frequency and pain in
urination

9. f) Urethritis or cervicitis occurs few
days after exposure
g) Endometritis salpingitis or pelvis
peritonitis are symptoms of uterine
invasion which may lead to
infertility. There are signs of pelvic
infection like fever, nausea and
vomiting, and abdominal
pain/tenderness

10. h) Pregnant women with gonorrhoea
may infect the eye of her baby
during the passage through the
birth canal

11. a) dysuria with purulent discharge
(gleet) from the urethra two-seven
days after exposure
b) Rectal infection common in
homosexuals
c) Inflammation of the urethra can
cause strictures which can prevent
the passage of urine
After 3 – 6 day incubation period , the
following may be noted:

12. d) Prostitis
e) Urethritis
f) Pelvic pain and fever
After 3 – 6 day incubation period , the
following may be noted:

13.  Dysuria
 Urinary frequency and incontinence
 Purulent discharge
 Itching
 Red and edematous meatus

14.  Occasional itching
 Burning and pain due to exudates
from the adjacent infected area
 Vulval symptoms are more severe
before puberty and after menopause

15.  Engorgement , redness, and swelling
 Profuse purulent discharge
 RUQ pain
 Other possible symptoms
 pharyngitis, tonsillitis, rectal burning

16.  Severe pelvic pain and lower
abdominal pain
 Muscle rigidity, tenderness and
abdominal distension
 Tachycardia may develop in patients
with PID and salpingitis

17. 1) Sterility and pelvic inflammatory
disease in women
2) Epididymitis
3) Arthritis ,endocarditis
4) Conjunctivitis
5) Meningitis

18. In Females
Thayer Martin medium
In Males
Gram stain

19. a) For uncomplicated gonorrhoea in
adults:
 Ceftriaxone 125 mg – 250 mg IM
single dose; Doxycycline 100 mg
orally BID for 7 days
b) For pregnant women
 Ceftriaxone 125 mg – 250 mg IM
single dose, Erythromycin 500 mg
orally for 7 days.
c) Aqueous procaine penicillin 4 million
units injected IM ANST

20. d) Recommended initial regimen
disseminated gonococcal infection in
adults and adolescents is:
 1gm Ceftriaxone IM or IV every 24
hrs. for pts. allergic to beta-lactam
antibiotics, 2g spectinomycin IM
every 12 hrs.

21. e) All regimen should be continued for
24 hrs. to 48 hrs. after improvement
begins
 400 mg Cefixime P.O. twice daily or
500 mg Ciprofloxacin P.O. 2 x daily.
 1 g single dose of Ceftriaxone IM and
irrigation of infected eye with normal
saline solution

22. 1. Watch for adverse effects during
therapy
2. Esplain that until cultures prove
negative, he/she is still infectious
and can transmit gonococcal
infection.
3. Practice standard precaution
4. Information shld. Be confidential
5. Isolation
6. Arthritis apply moist heat

23. 7. Infant born to mothers positive for
gonorrhoea should be instilled with
one percent silver nitrate or any
recommended ophthalmic
prophylaxis onto eyes at the time of
birth
8. Report all gonorrheal cases
9. Health education

24. 1. Sex Eduaction
2. Case finding, contact tracing
3. Reporting of gonorrheal case

25. SYPHILIS
LUESVENEREUM/
MORBUSGALLICUS
Is a chronic, infectious sexually
transmitted disease that usually
begins in the mucous membranes
and quickly becomes systemic

26. TreponemaPallidum
10-90 days. The average 3 weeks
Indefinite

27. A. Discharges from obvious or
concealed lesions of the skin or
mucous membranes.
 The semen, blood, tears and urine of
infected persons
 Mucous discharges from the nose,
eyes, genital tract or bowels
 Surface lesions contain spirochetes in
very high numbers

28. 1. Direct transmission
2. Indirect contact
3. Through placenta of syphilitic mother
4. Transmitted from syphilitic baby to a
wet nurse or to anyone carelessly
diapers

29. a) Chancres erupt in genitalia, anus,
nipples, tonsils, eyelids.
b) Painless start as paule and then
erode
c) Disappear after 3 – 6 weeks even
without treatment
d) Lympadenopathy unilateral or
bilateral
e) Internal surfaces such as cervix and
vaginal wall

30. 8 weeks after onset of the initial
chancre
a) Macular, popular, pustular or nodular
b) Uniform in size well-defined and
generalized
c) Macules often erupt between rolls of
fat on the trunk and on the arms,
palms, soles, face and scalp
d) Condylomatalata

31. 8 weeks after onset of the initial
chancre
e) Headache, anorexia, malaise,
weightloss, nausea and vomiting
sore throat slight fever
f) Alopecia
g) Nails become brittle and pitted

32. a) Serologic test will prove reactive
b) 2/3 of patients remain asymptomatic
until death
a) Considered as a destructive but
non- infectious stage.
b) Late syphilis has three subtypes:

33. I.
 Develop between 1 – 10 years after
the infection
 Gumma. A chronic, superficial nodule
or a deep granulomatous lesion that is
solitary, asymmetric, painless,
endurated.
 Gummas can be found in any long
bones of the legs

34. II.
 Liver
 Upper resp. tract
 Severe cases destruction of the bones

35. III.
 Once the treponeme enters the fetal
circulation, dissemination to all the
tissues occur at once. The treponeme
multiplies and infects many organs
 Macerated
 Livid red color
 Spleen and liver found to be enlarged
on autopsy

36.  Lesions of the skin and mucous
membranes:
 Bullous rash syphyllitic pemphigus
 Wrinkling of the skin
 Syphilitic nonychia
 Mucous patches
 Liver and Spleen
 Infants abdomen is protuberant

37. Interstitial Keratitis late lesion
 Begins at any age 4-30 years
 Circumcorneal vascularization of the
sclera
 Corneal scarring

38.  Severe damage to several organs
and nervous system
 Heart disease insanity and brain
damage
 Death in newborn

39. 1. Dark Field illumination test
2. Fluorescent treponemal antibody
absorption test
3. VDRL slide test
4. CSF analysis
1. Penicillin IM 2.4 million units
2. More than a year duration 2.4
million unit of Penicillin G/week for
3 weeks

40. 1. Stress to the client the importance of
completing the treatment even after
the symptoms subside
2. Infected individuals to inform their
partner that they should be tested if
necessary, treated
3. Practice universal precaution
4. Keep the lesion dry as much as
possible

41. 1. Report cases to the DOH
2. Control prostitution
3. Require sex workers to have regular
check ups
4. Proper sex education should be given
in early life at home, in schools and
in the community
5. Look for cases of syphilis infection
6. Contact tracing

42. CHANCROID
SOFT CHANCRE/ SOFT SORE/
SULCUS MOLE
Is a sexually transmitted disease
characterized by painful genital
ulcers and inguinal adenitis. It
affects males more than females

43. Haemophilus discreyi
1 – 14 days average 1 – 5 days

44. 1. The shallow surface contains many
polymorphonuclear cells, red blood
cells, and debris.
2. The wide middle zone is
edematous and shows endothelial
proliferation of blood vessels but
lacks fibroplasticrepair.
3. In deep zone, there is densed
infiltration of plasma cells and
lymphocytes

45. 1. Small lesions appear at the groin or
inner thigh. In males, it may appear
on the penis and in females, on the
vulva, vagina and cervix.
2. Sometimes these lesions may erupt
on the lips, tongue, breast, or
navel.
3. The papules rapidly ulcerate,
becoming painful, soft and
malodorous.

46. 4. The papules blees easily and
produce pus.
5. Within two to three weeks, inguinal
adenitis may develop, creating
suppurated, inflamed nodes that
may rupture into large ulcer
buboes.
6. During the healing stage, phimosis
may develop

47.  Gram stain of ulcer exudate
 Biopsy
 Darkfield examination and serologic
test
 Azithromycin 500 mg, taken orally
as a single dose
 Erythromycin 500 mg, 1 cap BID X
7 days
 Ciftriaxone 250mg IM as a single
dose

48. 1. Standard precaution should be
practiced.
2. Check for drug allergy.
3. Lotion, cream, or oil should be
applied on lesion.
4. Instruct the patient to abstain from
sexual contact until healing is
complete(two weeks).
5. The patient should wash his/her
genitalia daily with soap and water.

49. 1. Advice client to avoid sexual contact
with infected persons.
2. Use condoms during sexual activity.
3. Wash the genitalia with soap and
water after sexual activity

50. Donavaniagranulomatis
Sexual contact
ULCERATIVE spreading lesion
of the genitalis and groins

51. Culture of the lesions
Tetracycline
AVOID THE MODE OF
TRANSMISSION

52. LYMPHOGRANULOMA INGUINALE
Transmitted through irregular sexual
contact

53. FILTRABLE VIRUS
7 – 12 days
SEXUAL CONTACT

54.  Small evanescent lesion
 Peri anal strictures
Frei Test

55. Aureomycin
AVOID THE MODE OF
TRANSMISSION

56. Herpes Simplex
is a viral disease characterized by
the appearance of sores and blisters
anywhere on the skin. These sores
usually occur either around the
mouth and nose, or on the genitals
and buttocks (thus nickname “virus of
love”)

57. Herpes Simplex
Herpes simplex is related to the
viruses that cause infectious
mononucleosis (Epstein-Barr virus),
chickenpox and shingles.

58. 1. This virus can cause cold sores that
usually infect during infancy and
childhood.
2. The sore is characterized by tiny,
clear, fluid-filled blisters.
3. The sore most commonly affects the
lips, mouth, nose chin or cheeks
and occurs shortly after exposure.
It may also develop[ on wounds on
the skin

59. 4. Patients may barely notice the
symptoms or need medical
attention for relief of pain
5. The disease can be transmitted by
kissing and sharing kitchen utensils
and towels.
6. Patients usually catch the infection
from family members or friends
who carry the virus

60. 7. The sores usually catch of the
primary infection appear two to
twenty days after contact with an
infected person and usually last
from seven to ten days

61. 1. This type causes genital sores,
affecting the buttocks, penis, vagina
or cervix, and last two to twenty
days.
2. Most people get the infection from
sexual contact with an infected
person.
3. The virus affects about 20% of
sexually active individuals.

62. 4. The virus can also be spread by
touching an unaffected part of the
body after touching the herpes
lesion.
5. Manifestation includes minor rash or
itching and painful sores, fever,
muscular pain and burning
sensation during urination.

63.  The clinical manifestation of herpes
simplex virus infection ranges from
mild to fatal disease, depending on
the age and other characteristics of
the host, the organs involved and the
nature of the infection

64. 1. Oral herpes. Gingivostomatis in young
children is the most common clinical
manifestation of the initial infection
with HSV.
 Vesicular and ulcerative lesions occur
in the buccal mucosa and may involve
the tongue.
 Inflammation of the gums, cervical
adonophathy and fever are present.

65. 1. Oral herpes. Gingivostomatis in young
children is the most common clinical
manifestation of the initial infection
with HSV.
 Excessive salivation results from pain
on swallowing in infants and young
children.
 Feeding is painful and fluid intake
poor.

66. 2. Labial Herpes. The lips may
occasionaly be involved in the
primary infection commonly known
as cold sore or fever blisters
3. Ocular Herpes. Herpetic Keratitis is a
major medical problem leads to loss
of vision.
Primary Keratitis may be
accompanied by conjunctivitis and
preauricular lymphadenopathy

67. 2. Labial Herpes. The lips may
occasionaly be involved in the
primary infection commonly known
as cold sore or fever blisters
3. Ocular Herpes. Herpetic Keratitis is a
major medical problem leads to loss
of vision.
Conjunctivitis - primary infection
Recurrent Keratitis unilateral

68. 4. Cutaneous Herpes HSV may affect the
skin on any part of the body.
5. Ertemamultiforme. This allergic reaction
of the skin is sometimes
complication of HSV.
6. Genital herpes considered one of the
most common sexually transmitted
diseases

69.  New borns – Neonatal herpetic
 Eczema Varicelli form eruption
 Encephalitis

70. 1. Oral anti-viral drugs such as
acyclovir, famciclovir or valvacyclovir.
2. Personal hygiene.
3. Restoration of fluid and electrolyte
balance.
4. Isolation of clients.
5. Practice of universal precaution and
through handwashing.

71. EBV
Kissing, blood transfusion

72.  Pharyngitis
 Lympadenopathy
 Splenomegaly

73. Serologic test for EBV
Avoid kissing to a stranger

74. AIDS
Acquired Immune Deficiency
Syndrome, it is acquired, which
means it is neither hereditary nor
inborn. It involves immune
deficiency; hen a persons immune
system breaks down

75. Human Immunodeficiency virus (HIV)
1. Sexual contact
2. Injection of infected blood
products
3. Perinatal or vertical transmission
4. Stages of HIV infection

76. CLINICAL STAGE 1:
ASYMPTOMATIC
 General Lympadenopathy
CLINICAL SATGE 2: EARLY (MILD)
 Weight loss greater than 10% of
body weight
 Minor mucocutaneous manifestation,
like:
 Seborrheic dermatitis
 Fungal nail infection
 Recurrent oral ulceration

77. CLINICAL STAGE 1:
ASYMPTOMATIC
 General Lympadenopathy
CLINICAL SATGE 2: EARLY (MILD)
 Weight loss greater than 10% of
body weight
 Minor mucocutaneous manifestation,
like:
 Angular cheilitis
 Recurrent respiratory infection
(rhinitis, tonsilophayrngitis)

78. CLINICAL STAGE 3:
INTERMEDIATE (MODEERATE)
 Weight lost greater than 10%
 Chronic unxpalined diarrhea for
more than one month
 Oral candidiasis (thrush)
 Oral hairy leukoplakia
 Severe bacterial infection like
pneumonia

79. CLINICAL STAGE 4: LATE (SEVERE
AIDS)
 HIV wasting syndrome
 Pneumocystis Carini pneumonia
 Toxoplasmosis of the brain
 Crytosporidosis with diarrhea for
more than one month
 Herpes simplex viruis infection
 Progressive multifocal
leukoencephalopathy
 Disseminated endemic myoscosis

80. AIDS
Chronic Illness
Acute illness
(fever, rash, joint and muscle pain, sorethroat)
HIV Infection

81.  Memory loss
 Altered gait
 Depression
 Sleep disorders
 GIT symptoms:
 Chronic diarrhea AIDS related
complex

82.  Persistent cough for one month
 Generalized pruritic dermatitis
 Recurrent herpes Zoster infection
 Oropharyngeal candidiasis
 Chronic disseminated herpes simplex
infection
 Generalized lymphadenopathy

83.  Loss of weight 10% of body weight
 Chronic diarrhea for more than one
month
 Prolonged fever for one month

84. 1. Depression
2. Diarrhea
3. Thrush
4. Weight loss
5. Lipodystrophy (fat redistribution
syndrome)
6. Sinus infection
7. Nausea and Vomiting
8. Lactic Acidosis Lactic acid builds up
in the clients

85. 9. Burning and tingling of the feet and
hands ( peripheral neuropathy.

86.  A. Mac – Mycobacterium avium
complex a TB like manifestation that
usually occurs when the patient cd
count is below 50
 Tuberculosis
 Salmonillosis

87.  Herpes
 B. Hepatitis
 Genital warts
 CMV
 Molluscumcontaiosum
 candidiasis
 Cryptococcal meningitis
 Hystoplasmosis

88.  Bacterial
 Pneucystiscarinii pneumonia (PCP)
 V. CANCERS
 KaposisSarcopma
 Cervical dysplasis and cancer
 Non Hodgkins Lymphoma

89.  Toxoplasmosis
 Cryptosporidiosis

90. 1. Watery diarrhea
2. Abdominal cramps
3. Low grade fever
4. Weight loss due to persisitent
diarrhea

91.  Wash hands thoroughly after contact
with feces
 Practice safe sex
 Be careful not to swallow water when
swimming
 Wash and or cook food properly
 Drink safe water

92. 1. EIA or ELISA – Enzyme-Linked
Immunosorbent Assay
2. Practice Agglutination (PA test)
3. Western blot analysis confirmatory
diagnostic test
4. Immunofluorescent test
5. Radio immune-precipitation assa
(RIPA)
6. HIV antibody test

93. REVERSE trancriptase inhibitors
1. A. Zedovudine- Retrivir
2. Zalcitabine _HAVID
3. Stavudine – ZERIT
4. Lamivudine- Epivir
5. Nevirapine – Viramine
6. Didanosine – VIDEX
Protease inhibitors
1. Saquinavir
2. Ritinovir
3. Indinavir

94. 1. Health Education
2. Practice universal / standard
precaution
3. Prevention
The FOUR Cs in the Management of
HIV/AIDS
1. Compliance
2. Counseling /education
3. Contact tracing
4. Condoms

95. “The man who does
not read good
books has no
advantage over the
man who can’t read
them…”
~Mark Twain