GONORRHEA and GENITAL WARTS a sweet and small presentation to learn and refer........

1. Gonorrhea is the sexually transmitted disease that can
affect both men and women . It can cause infection in the
genitals , rectum & throat . It is very common infection ,
especially among young people ages 15-24 years .
Gonorrhea is known as the clap.

2. ‘Gonorrhea is caused by NEISSERIA gonorrhea,
gram negative DIPLOCOCCUS.

3.  Age that is 15-24 years age group.
 Anyone who is sexually active can get gonorrhea.
 A pregnant women can give the infection to her
baby during childbirth.
 Early onset of sexually activity.
 A new sex partners.
 Multiple sex partners.
 Previous gonorrhea diagnosis.
 Having other sexually transmitted infection.
 Drugs use , prostitution & previous history of
gonorrhea , & sexually transmitted infection.

4. About 50% of patient with gonorrhea are asymptomatic &
even the symptoms are present , they are non specific.
 Strong smelling vaginal discharge that may be thin &
watery or thick and yellow/ green.
 Irritation or discharge from the anus.
 Abnormal vaginal bleeding / abnormal mensus.
 Pain or burning sensation when passing urine.
 Possible some low abdominal or pelvic tenderness.
 Low abdominal pain sometimes with nausea.
 Pain during sexual intercourse.
 Labia may be swollen & look inflamed.
 Bartholin gland may be enlarge or palpable tender
with fluctuation , suggestive of formation of abcess.

6. The incubation period is 3-7 days.

7.  SWAB TESTS– Culture from infection mucus
membranes {cervix , rectum or throat}
 URINE EXAMINATION– First voiding
morning urine sample or at least one hour since
the last void sample should be tested.
 Gram staining & NAAT( Neucleic acid
amplification test ) should be done.

9.  Acute pelvic infection leads to chronic pelvic
inflammatory disease.
 Infertility.
 Ectopic pregnancy.
 Dyspareunia.
 Chronic pelvic pain.
 Tubo -ovarian mass.
 Bartholin gland abcess.

10. 1. PREVENTION
 Use condom.
 Get tested: Be sure that you & your partners
are tested for sexual transmitted infection. Talk
to each other about your test result before you
have sex.
 Be monogamous: Having sex with
just one partner can lower risk for sexually
transmitted infection.
 To avoid multiple sex partners.

11. 2. MEDICAL MANAGEMENT.
Gonorrhea is treated with antibiotics such as
according to recommended drugs in acute gonorrhea
{CDC 2006}.
a) CEFTRIAXIONE – 125 mg IM.
b) CIPROFLOXACINE– 500mg.
c) OFLOXACIN--- 400mg.
d) CEFIXIME—400mg.
e) LEVOFLOXACIN—250mg
f) In combination with either azythromycin or
doxycycline.

12. 3.NURSING MANAGEMENT
 Advice the patient to practice abstinence.
 Advice the patient to limit the number of sexual
partners.
 Patient should use condoms for barrier protection.
 Advice the pregnant women about important of
routine screening.
 Administer prescribed medication.
 Advice the patient to maintain good personal
hygiene habits.

14. Genital warts small, benign growth
caused by a viral infection that is HUMAN
PAPILLOMA VIRUS typically HPV6 & HPV11.
 A female with genital warts is at an increase risk
for developing cervical cancer.
 Genital warts often occur in clusters & can be very
tiny or can spread into large masses on genital
tissues.
 Females & males in 9-26 years age.
Genital warts are highly contagious
sexually transmitted disease. Genital warts can
travel from one part of the body to another.

15. 1. Cervix.
2. Vagina.
3. Urethra.
4. Perineum.
5. Perineal skin.

16. ‘Genital warts is caused by HPV6 &HPV11.

17. 1. Human papilloma virus 6&11.
2. To some extent , excessive use of the tobacco & alcohol may
lead to formation of genital warts.
3. Pre-malignant or malignant cervical cancer in women also
increase the changes of the occuring of genital warts.
4. A person with sexually transmitted diseases are more prone
to get affected by genital warts.
5. Genital warts most commonly occur in a person undergoing
stress condition.
6. In some cases, use of birth control pills, increased sexual
contact without use of barrier protection , multiple sex
partners & genital warts.
7. About two-third of people who have sexual contact with
someone already having genital warts genital very easily

18.  Difficulty in passing urine.
 Itching or burning sensation around the sex organs.
 Abnormal vaginal bleeding after sexual intercourse.
 Small fluid- filled blister may occur , which can be very
painful , with the first infection they can even take
around 2-4 weeks to heal properly.
 Vaginal discharge.
 A flu like illness - backache , headache, swollen glands
, fever.
 The small white /yellow/ gray bumps spots may occur
on the sex organs & anus.
 In some chronic cases, cervical cancer may also occur in
genital wart.

19. ‘The incubation period is 2 weeks to 8 months’.

20.  Visual inspection.
 Biopsy.
 Cervical screening : It is used to detect the
potentially pre-cancerous and cancerous
process in the cervix.
 Conventional pap smear.
 Tin prep test slide.

21.  Rarely it can become malignant.
 Genital warts can proliferate & become more
fiberable during pregnancy.

22.  Direct contact : It can transfer from one person
to another through sexual contact.
 It transfer from one part of the body to another.

23. PREVENTION
 Vaccination – Gardasil vaccine , it is
quadrivalent vaccine against HPV6,11,16,18.
 Don’t sex when you have visible warts, even
with condoms.

24. TREATMENT
 CRYOTHERAPY: It is very suitable remedy for
genital warts. In this treatment, doctor freez the
warts with liquid nitrogen.
 ELECTROCAUTERY OR DIATHERMY: It is
physically destroys the warts by burning them
local or general anesthesia can be used.
 PODOPHYLLIN: It is chemical compound that
must be applied by doctor or nurse to the
affected area of the skin.

25.  PODOFILOX CREAM OR GEL: This is self applied
treatment for external genital warts. It is easy to use
& is safe and should be applied for about 4 weeks.
 FLUOROCIL CREAM: It is used mainly to get rid of
pain that occur during intercourse .
 SURGICAL EXCISION: The doctor may use special
tools to cut off warts. Local anesthesia is needed for
this treatment.
 TCA{TRICHLORACETIC ACID}: It is another
chemical applied to the surface of the warts by a
doctor or nurse.
 LASER THERAPY: During this treatment , warts are
destroyed by introducing the laser light to the
affected area. This is used for lager or extensive
warts.