Why STIs are called 'silent infections'

In the following paragraphs I will be discussing why sexually transmitted diseases are called silent infections. I will also be discussing the topic of urinalysis and its components and how these components may reveal if the body is functioning normally or abnormally. . The information pertaining to these subjects relates to the knowledge I have gained through my readings of The Human Body in Health & Disease, as well as personal knowledge and opinion.

Explain why sexually transmitted diseases are often called “silent infections”, and discuss why this is especially true for women.

The reason sexually transmitted diseases are called silent infections is that many of them are asymptomatic infections which produce no visible or immediate physical symptoms, thus an individual may be infected with an STD and not know it for days or weeks, even up to years because there are no symptoms present. The bacterium called Chlamydia trachoma, which produces the disease Chlamydia, can be asymptomatic for months and up to years. When symptoms occur they may be very minor at first in women, such as: vaginal discharge, frequent urination that may be painful, pain during sex, vaginal itching and burning. Since a yeast infection (candida albicans) can produce these same symptoms in a woman they may just treat it as a yeast infection and not see a doctor till the symptoms progress or are not relieved by current treatment for some time. This may not be the case with men, since the most common symptoms of a yeast infection in men are extreme itching of the penis glands and red sores on the penis, but they may also experience burning while urinating and uncommonly have discharge from the penis. With Chlamydia, a man that shows symptoms will most likely also have burning while urinating and penis discharge. Yeast infections in men are not as common and these kinds of symptoms usually causes a man to go straight to the doctor instead of the drug store. The disease Chlamydia is very common, and if diagnosed early it can be treated very effectively, but left untreated it can cause a number of health issues such as: conjunctivitis, which is an eye infection or pinkeye; urogenital infections such as yeast infections; systematic infections which are infections that are spread throughout the body, and also progress to pelvic inflammatory disease (PID), which causes infertility and sterility, and if untreated may cause death through septic shock. The bacterium syphilis (treponema pallidum) is another good example of a STD that takes a number of months to cause any visible or physical symptoms and has three stages that it may progress through if left undiagnosed and untreated. The first stage, primary syphilis is highly contagious and produces chancre sores on the outside and inside of the vagina, the penis and scrotum and also the mouth. This stage can be treated with antibiotics, and if left untreated it may resolve itself within a month or so, but if this disease is not treated in the first stage it is possible that it will recur later as the second stage. The second stage, is secondary syphilis, is also highly contagious and at this point the disease has spread throughout the body and its organ systems. In this stage the symptoms may include sore throat, fever, headaches and a skin rash on the hands and feet. Also, the individual may develop wart-like sores on the penis or vagina areas. Besides the wart-like sores, all other symptoms may not be recognized as caused by a possible STD since these symptoms are similar to the common cold and allergic rash. So once again, the disease may be silent in it diagnosis and goes untreated so it can progress to the next stage, as well as most likely infecting others. The third stage is called tertiary syphilis and the disease is still affecting the body and its organ systems (systematic stage) throughout. By now many of the organ systems may be showing signs of the disease, and may be developing problems which can cause many serious health issues and possible death. The STD HIV and trichomoniasis are also asymptomatic in most individuals for some time. These are just a few of many STDs an individual may contract that may show no immediate symptoms and can go untreated, and can continue to spread from individual to individual.

The reason STDs are especially silent diseases for women is that they may move to other parts of the body and cause damage of secondary infections/diseases without producing any symptoms. If some symptoms do develop they may present themselves as a common infection, such as, yeast infection or urinary tract infection. STDs that go undiagnosed in women can spread through the reproductive system (cervix, uterus and uterine/fallopian tubes) as well as the blood and other organ systems. The two STDs I discussed above, syphilis (treponema pallidum) and Chlamydia trachoma, are good examples of silent STDS, and both can produce few or no symptoms and are very commonly undiagnosed or untreated, thus causing secondary diseases like pelvic inflammatory disease (PID), which can cause infertility, chronic pelvic pain, ectopic pregnancy and increase the risk of contracting HIV if exposed to the virus; This why I believe that STDs are especially silent diseases for women.

Describe the different components of a urinalysis and discuss what each may reveal about the normal or abnormal functioning of the body. Give specific examples

Urinalysis is the process of examining urine through three specific methods. The three methods used are microscopic, physical and chemical examination. Through the use of these methods, a lot can be determined about how the body is functioning and be a very helpful tool in discovering problems or diseases that may be occurring within the body and its organ systems. The physical characteristics of urine that are examined are; color, odor and specific gravity. The color of urine is normally straw-colored, transparent yellow or amber. This is mainly caused by pigment (urochrome), as well as substances we regularly ingest. There are many things that can change the color of urine or cause it to be cloudy, such as certain food, vitamins, dehydration, bile, blood, bacteria and certain drugs. Thus when urine is an abnormal color it may just be from types of foods the individual is eating or vitamins or drugs, but it could also indicate developing problems such as hepatitis, cirrhosis, kidney stones, urinary tract infection and acute glomerulonephritis. Therefore, when urine appears an abnormal color during an examination, it would be further tested chemically and microscopically to confirm the findings of the physical examination. The odor of urine is normally very minor, and when this is not the case it may indicate such diseases as diabetes mellitus or a bacterial infection of the kidney or bladder. The presences of a strong odor may also just be from B vitamins or food like asparagus, garlic, and curry, so abnormal strong smelling urine would also be confirmed in the same manner as color. The urine specific gravity is the level of chemicals/substances in the urine, as well as water content. If the urine specific gravity is above or below the normal range (1.001-1.035 g/ml) it indicates that there is some type of disease or disorder present. When the specific gravity is increased it may indicate that the individual is dehydrated or has developed kidney stone. Also, diseases such as renal arterial stenosis, congestive heart failure and glycosuria can cause an increase in specific gravity. If the specific gravity is low it may be a sign of such diseases as pyelonophritis (kidney infection), renal failure and diabetes insipius-nephrogenic. It can also be caused by an individual ingesting an excessive amount of fluid. As with the other physical examination processes any abnormal findings would be confirmed through further testing before treatment was performed.

The chemical and microscopic processes are used to look for normal and abnormal substances and the concentration of these substances in the urine such as the pH level and normal and abnormal compounds. The normal compounds that will be found in urine are such things as; mineral ions (chloride, potassium and sodium), urine pigments, nitrogenous wastes (ammonia, creatinine, urea and uric acid) and suspended solids or sediment (bacteria, blood cells and casts). All these substance are normal characteristics of urine that are unneeded waste products that the kidneys have excreted during the reabsorption process. The mineral ions levels of chloride, potassium and sodium in the urine will be influenced by the individual intake of these minerals and the body’s need for them at the specific time they are consumed. The nitrogenous wastes ammonia, creatinine, uric acid and urea are also normal at certain levels. These substances are a byproduct of protein being broken down. If the kidneys do not excrete these nitrogenous waste products they will build up to a toxic level within the body at a very fast rate. If there are low levels of these substances in the urine it may be an indicator that there is a problem with renal function, such as acute or chronic renal failure. This would cause these substances to stay in the blood, instead of being cleansed out by the kidneys and excreted out in the urine. The presence of bacteria, blood cells and casts in urine is normal in some aspects. There are certain levels of hyaline cast that are normal for urine to contain; these are produced by deposits of cells and minerals that have broken free from the walls of the renal tubes into the urine. There are usually very few, if any, red blood cells in urine. The presence of very low quantities of red blood cells is possible in a perfectly healthy individual and especially in women because of menstruation. Urine will most likely contain some bacteria because of contamination during the process of giving the sample, but normally there should be no bacteria present if the sample is not contaminated by bacteria from the vagina or penis. I will be discussing the process used to examine casts, bacteria and blood cells in urine, as well as what abnormal levels of these substances may indicate later in the following paragraph.

Abnormal compounds that may be found are: acetone, albumin, bile and glucose. The presence of these compounds can reveal a problem or disease in the body. For example, the presence of glucose in the urine (glycosuria) is a good indicator that the individual has diabetes mellitus. Diabetes mellitus causes the blood glucose concentration to increase beyond the renal threshold and the kidneys cannot reabsorb the excess glucose, so the excess glucose stays in the urine. Diabetes mellitus is a disorder of the pancreas islet cells that produce insulin to regulate blood glucose levels. When bile is present in the urine it may indicate the common bile duct is blocked, which may be caused by gallstones. It may also indicate other liver disorders such as hepatitis and cirrhosis. The substance albumin (protein) may normally be found in urine at low levels between 0 to 8 mg/dl. If the albumin levels exceed this level it may indicate there is a problem occurring in the kidneys, such as the glomeruli of the kidney may be damaged, causing it to allow protein to leak into the urine during the filtration process of the blood. This could be caused by kidney diseases and other contributing factors, such as diabetes or hypertension. The presence of high levels of the substance acetone in the urine can be produced by factors that involve diabetes mellitus that is not properly controlled. This may be caused by a lack of insulin secretion, which increases glucose supplies in the blood, but less entering the cells to use for fuel. Thus in the body’s attempt to create homeostasis it breaks down fat for energy, and as a result of using fat for energy it produces acetone that ends up in the urine as waste. The pH level can be an indicator of a number of problems that are occurring within the body. The normal pH level should be between 4.6 and 8.0 in urine. When pH level is low, or has increased acidity, it may indicate the individual is dehydrated or has diabetic acidosis, which is caused by uncontrolled diabetes mellitus or respiratory acidosis, which is caused by the retention of excess carbon dioxide in the body. When an individual has a high pH level, or increased alkaline, it may be an indicator of a urinary tract obstruction, which is an obstruction within the urinary tract that may be caused by kidney stone (calculi) or a tumor. Also, it may be caused by chronic renal failure, which is when the kidney starts to fail and does not properly process blood and create urine. These are just a few of the things high or low pH levels may indicate. Some compounds such as suspended solids or sediment (bacteria, blood cells and casts) are examined through the microscopic process after being spun in a centrifuge to push these substances to the bottom of the test tube. These substances at the bottom are then examined for the presence of abnormal cells, as well as high levels of blood cells, which may indicate things, such as bladder infection, kidney infection, bleeding within the urinary tract, and also prostatitis which is inflammation of the prostate gland, as well as other symptoms depending on the type of prostatitis. This process is also used to examine the urine for casts. Casts are tube-shaped particles that are composed of ether minerals, kidney cells, or red or white blood cells that have formed in the renal tubules of the kidneys. Then as the urine passes through these tubules they dislodge from the walls of the renal tubules and flow out of the body in the urine. There are many different types of casts and by examining which type that is in an individual’s urine, it may indicate if there are health issues developing such as chronic renal failure, renal tubular necrosis, bleeding within the kidney, interstitial inflammation and dehydration. As I mentioned in the previous paragraph, it is normal to have some hyaline casts in the urine, but such types as fatty casts, white blood cell casts, granular casts and waxy casts are indicators of problems occurring within the renal system or diseases in other parts of the body.

In conclusion, there are many types of STDs that show no immediate symptoms, and that if left untreated can cause a number of serious health issues and even death. However, many of these STDs are completely treatable with no lasting effects or damage if diagnosed before they progress and affect other organs system of the body. For any individual, regardless of gender, regular check-ups and screening for STDS is necessary; even if safe sex is practiced, it is very possible to contract an STD from another person just through physical contact, such as kissing or just touching their hands when certain diseases are present. It is important for every individual, no matter what age or gender, to have regular physicals to not only be screened for STDs, but also for other diseases that may be developing within the body, and a number of diseases can be diagnosed through the process of urinalysis.