NU 545 Unit 3 Study Guide (PDF) | (2026/2027) | Advanced Pathophysiology | University of South Alabama

NU 545
Unit 3 Study Guide
Advanced Pathophysiology
University of South Alabama.

This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-minute
review. The guide is structured to help students
reinforce understanding, identify weak areas, and prepare
confidently for the assessment.

, Exam 3 Study Guide

1. Know all STIS: pathophysiology, etiology, clinical manifestations,
diagnostic tests, treatment, and complications. How is each transmitted
during pregnancy to the fetus? Know the different stages of syphilis;
what organism causes each STI and is it viral, bacterial etc.? Do you treat
both partners and why? What age group has the greatest risk of STIs and
why? What causes cervical cancer? Pg.867 ch.27



 Infections can be transmitted directly through touch, or infectious agent can
be transmitted by object known as fomite
 Syphilis, gonorrhea, chlamydia, hepatitis, human immunodeficiency (HIV)
can be transmitted from mother to child from pregnancy and birth --->
vertical transmission
 STI risk prevalent in urban and lower income
 Age
i. Half of those infected with STI are younger than 25 y/o
ii. Due to risk taking behavior, adolescents have the greatest risk for STI
exposure and infection

Bacterial STI
Gonorrhea p.867 ch 27
 Pathophysiology
o Humans are natural host
o Hair-like filaments on gonococci (pili) help microorganisms attach
themselves to host cells (epithelial cells of mucous membranes)
o Columnar, transitional, and stratified squamous epithelial cells most
often infected
o Gonococci attach to plasma membranes (cell wall) then they invade
cells and begin to damage mucosa --> quick leukocytic (inflammatory)
response and exudate occurs at site of infection
o Women
 Endocervical canal (inner cervix) common infection site
 Urethral colonization & infection of paraurethral (skene) glands
and greater vestibular (Bartholin) glands are common
 Gonococci in uterus and fallopian tubes can cause PID
1. Disintegration of mucous plug w/ increase vaginal pH >4.5
during menstruation
2. Uterine contractions cause retrograde menstruation into
fallopian tubes/uterine tubes
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, 3. Various microbes that possess virulent potentiating factors for
chlamydia or gonococcal PID
 Bacteria can adhere to sperm & transport to fallopian/uterine
tubes
 When at tubes, sloughing of normal ciliated tubal
epithelium and marked inflammatory response causing
tubes to have exudate
o Men
 Gonococci infect urethra or rectum
 Untreated cause epididymitis and can lead to urethral stricture,
fistula formation, and sterility
 Maintain asymptomatic infections for long periods of time
o Concurrent or isolated oropharyngeal and anorectal infection is found
in men and women --> difficult to detect w/ common testing
 This site greater w/ abx resistance than urethral or vaginal->
additional treatment and monitoring
o Hypothesis for increase resistant strains
 Oral and rectal mucosae contain Neisseria bacteria and are often
exposed to abx for other non STI conditions --> instead of
elimination they develop resistance
 Gonococci share plasmids and DNA across species (conjugation)
facilitating transfer of abx resistance
 Etiology
o Caused by Neisseria gonorrhoeae, aerobic, non spore-forming, oxidase-
positive, gram-negative diplococci, organisms that usually appear in
pairs w/ adjacent, slightly flattened sides
o Risk of developing from intercourse w/ infected male partner is 50%-
80% for women
 Infected female it is 20%-30% for men
 Men who have sex with men have greater risk of contracting
gonorrhea if they are the receptive partner
o Usually require direct contact of epithelial (mucosal) surfaces (vaginal,
oral, or anal intercourse)
o Infection can be maintained in vagina, rectum, oropharynx, or urethra
 Clinical Manifestations
o Higher in men than women
o Categorized as local or systemic and uncomplicated and complicated
o Uncomplicated local infection
 Urethral infection in men


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,  Can be asymptomatic but can cause painful urination or
purulent penile discharge (both) within a week of infection
 Slight discharge or urethral itching (pruritus)
 5%-10% men no s/s
 Untreated resolve spontaneously after several weeks
 95% men asymptomatic by 6 months after infection
 Urogenital infection in women
 Symptoms manifest within 10 days of exposure or 1-2 days
after next menstrual period
 Symptoms dont often appear until after the spread to
upper reproudctive tracts (uterus, fallopian/uterine tube,
and ovaries)
 Dysuria, vaginal discharge, abnormal menses,
dyspareunia, lower abd/pelvic pain, fever
 Cervix= red and friable w/ mucopurulent discharge from
cervical os
 Discharge of glands if involved
o Isolated finding w/ coexisting urogenital gonorrhea
 Anorectal gonorrhea
 Commonly in MSM but found in women
 Symptoms: mild anal puritis, mucopurulent rectal d/c,
slight rectal bleeding to severe rectal pain, tenesmus
(painful and ineffectual straining at stool), constipation
 Erythema and d/c, mucosal damage to anus and rectum,
friability, edema, purulent exudate
o Gonococcal pharyngitis
 Oral contact
 Fever, lymphadenopathy, tonsillitis
 60% asymptomatic
 Clinicians neglect test for oropharyngeal gonorrhea bc dont
screen for unprotected oral sex
 Cure rate lower bc inadequate abx concentration of oral tissue
o Sites of uncomplicated local infection
 Eyes -> conjunctivitis predominately in NB from mother
 Primary cutaneous infection
 Localized ulcer of genitalia, perineum, proximal lower
extremity, or fingers
o Complicated gonococcal infection
 Prostatitis, epididymitis, lymphangitis, and urethral stricture


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