202/203: Reporductive Impact and Microbiology of STIs Flashcards
Which organisms are most commonly associated with urethritis in people with a vagina? (5)
- Chlamydia
- Gonorrhea
- HSV
- Trichomonas vaginalis
- Gardeneralla
Which pathogens can be transmitted to a neonate via breastmilk? (2)
HIV
HBV
Which of the following maternal and neonatal outcomes is NOT increased by maternal infection with clamydia?
- Ectopic pregnancy
- Spontaneous abortion
- Chronic pelvic pain
- Infertility
- Neonatal pneumonitis
b. Spontaneous abortion
All of the following may cause lesions on the genitalia except:
- HSV
- Treponema pallidum
- Haemophilus ducreyi
- Nesseria gonorrhoeae
- HPV
d. Nesseria gonorrhoeae
All others cause legions
Notably, treponema (syphilis) and HPV will be painless, HSV and ducreyi will be super painful
How does hormonal status affect chlamydia transmission?
Chlamydia target cells = endocervical cells
- Younger women tend to have more endocervical cells due to increased estrogen/progesterone
Name a parasite (1) and a bacteria (1) likely to cause vaginitis
Parasite: Trichomonas vaginalis
Bacteria: Gardenerella vaginella
What is the most important determinant in whether an HIV(+) mother will transmit HIV to the fetus?
How can risk of transmission be reduced?
Maternal viral load
HAART is highly effective in reducing transmission
C-section also plays a role, if mother has high viral load
Remember, HIV can be tranmitted transplacentlaly but also transvaginally during birth
Is chlamydia more likelty to be asymptomatic (and therefore undiagnosed) in men or women?
Women
Rank the following STIs in order from most to fewest new cases/year
- HPV (most)
- Chlamydia
- HIV
Why are women more susceptible to the acquisition of HIV than men through receptive vaginal/penile intercourse?
Women are exposed to more body fluids over a greater surface area for a long period of time
Young women are more likely to have a cervical ectropion -> target cells are more exposed to HIV
(Cervical ectropion = columnar cervical epithelium is present on the ectocervix)
Which STI is most strongly associated with cervical, vaginal, and vulvar cancer?
HPV
(High-risk = HPV-16, 18, 31, 33)
6 and 11 are low risk, cause genital warts
Which STI can be transmitted both transvaginally and transplacentally during gestation?
HIV
- Chlamydia, HSV, HBV are only transvaginal*
- Syphilis, Zika are only transplacental*
How is syphilis (treponema) diagnosed?
BOTH of the following tests:
- Non-trepomenal serologic assay (VRDL)
- Measures things associated with syphilis infection
- Sensitive, but not specific
- Treponemal serologic test (FTA-ABS)
- Detects treponema
- Specific
How has the strategy behind STI prevention efforts changed?
(Think “then vs. now”)
- Then: Aimed at reducing shared body fluids
- Abstinence
- Condom use
- Generally, relies on behavior change and not very successful
- Now: Goal is to reduce infectivity of infected individuals
- Test and treat
- PreP
- PeP
- Microbicides (ex: tenovofir gel)
- Circumcision (Fewer Langerhans cells on penis -> fewer target cells for HIV)
Which STI is most likley to present with swollen, painful joints and a sore throat?
Gonorrhea
(Especially if acquired through oral-genital contact)