202, 203 STIs

Question 1

Why are women (esp. young women) more susceptible to the acquisition of HIV than men through heterosexual intercourse?

Answer 1

there is disproportionate exposure to more body fluids over a greater surface area for a longer period of time

young women are also more likely to have an ectropion, which may increase exposure of target cells

Question 2

How do STIs act synergistically to influence acquisition?

Answer 2

genital tract inflammation from syphilis, BV, chlamydia, or gonorrhea that causes recruitment of inflammatory cells which increase the likelihood of acquiring HIV if it is present

Question 3

List the long term consequences of gonorrhea on women’s reproductive health.

Answer 3

PID - can lead to chronic pelvic pain, tubo-ovarian abscess, tubal occlusive disease, infertility, and ectopic pregnancy

Question 4

List the effective prevention strategies for interrupting the sexual transmission of syphilis.

Answer 4

use of condoms to prevent the spread of syphilis from infected partners to uninfected partners, screening high risk individuals, screen and treat other STIs to reduce susceptibility

Question 5

Which one of the following maternal and neonatal outcomes is NOT increased by maternal infection with chlamydia?

a) ectopic pregnancy
b) spontaneous abortion
c) chronic pelvic pain
d) infertility
e) neonatal pneumonitis

Answer 5

b) spontaneous abortion

Question 6

What modern techniques are used to prevent HIV transmission?

Answer 6

microbicides, PreP, diagnosis and early treatment, male circumscision

Question 7

What STIs can be passed to fetuses?

Answer 7

syphilis, gonorrhea, chlamydia, HIV

Question 8

Rank HPV, HIV, and chlamydia in order of most to least new cases per year.

Answer 8

HPV > chlamydia > HIV

Question 9

List three major causes of urethritis in males

Answer 9

chlamydia trachomatis, neisseria gonorrhoeae, HSV

Question 10

List three major causes of epididymitis

Answer 10

chlamydia trachomatis, neisseria gonorrhoeae, urinary tract pathogens

Question 11

What are major causes of cervicitis/cystitis/urethritis/vaginitis

Answer 11

chlamydia trachomatis, neisseria gonorrheae, HSV, trichomonas vaginalis, bacterial vaginosis (gardnerella, etc.)

Question 12

What are major causes of PID?

Answer 12

neisseria gonorrhoeae, chlamydia trachomatis, vaginal flora

Question 13

What are the risk factors for PID?

Answer 13

IUD, vaginal douching, past history of PID

Question 14

What are the symptoms of PID?

Answer 14

mucopurulent vaginal discharge followed by midline abdominal pain and abnormal vaginal bleeding

later leads to bilateral lower abdominal and pelvic pain with nausea and vomiting

can sometimes leads to inflammation of the liver capsule (Fitz-Hugh-Curtis)

Question 15

What is the newborn disease associated with gonorrhea?

Answer 15

gonococcal ophthalmia after contact with birth canal

Question 16

What is the pathogenecity factor of chlamydia trachomatis?

Answer 16

type III secretion system

Question 17

What are the laboratory tests for syphilis?

Answer 17

VDRL, RPR, dark field microscopy

Question 18

What is the shape of trichomonas vaginalis?

Answer 18

pear-shaped protozoa with flagella and motility

Question 19

What are the symptoms of trichomonas vaginalis infection?

Answer 19

malodorous yellow-green vaginal discharge, vulvar itching, dysuria, frequent urination, dyspareunia

Question 20

What is the treatment for trichomonas vaginalis?

Answer 20

oral metronidazole or tinidazole for both sexxual partners

Question 21

What are the symptoms of bacterial vaginosis?

Answer 21

malodorous white discharge, irritation, itching

can lead to PID or premature labor

Question 22

What are the symptoms of haemophilus ducreyi?

Answer 22

painful genital chancroid with tender inguinal adenopathy

Question 23

What are the high risk subtypes of HPV?

Answer 23

16, 18, 31, 33

Question 24

You treat a patient for chlamydia urethritis with a seven-day course of doxycycline. Three weeks later, the patient returns with a chlamydial infection. What are several possible explanations?

Answer 24

noncompliance with medicine, re-infection by a sexual partner

resistance is highly unlikely

Question 25

All of the following may cause lesions on the genitalia EXCEPT:

a) HSV
b) treponema pallidum
c) haemophilus ducreyi
d) neisseria gonorrhoeae
e) HPV

Answer 25

d) neisseria gonorrhoeae

Question 26

Which of the following is a parasite that causes vaginitis?

a) gardnerella vaginella
b) HSV
c) trichomonas vaginalis
d) candida albicans
e) treponema pallidum

Answer 26

c) trichomonas vaginalis