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Repro/GU by Minnie: AH > 202/204: Microbiology of STIs and Reproductive Impact > Flashcards

202/204: Microbiology of STIs and Reproductive Impact Flashcards

1
Q

Which organisms are most commonly associated with urethritis in people with a vagina? (5)

A
  • Chlamydia
  • Gonorrhea
  • HSV
  • Trichomonas vaginalis
  • Gardnerella (anything that causes bacterial vaginosis)
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2
Q

Which pathogens can be transmitted to a neonate via breastmilk? (2)

A

HIV

HBV

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3
Q

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

  1. Ectopic pregnancy
  2. Spontaneous abortion
  3. Chronic pelvic pain
  4. Infertility
  5. Neonatal pneumonitis and conjuctivitis
A

b. Spontaneous abortion

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4
Q

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

  1. HSV
  2. Treponema pallidum
  3. Haemophilus ducreyi
  4. Nesseria gonorrhoeae
  5. HPV
A

d. Nesseria gonorrhoeae
* No lesions, just lots of inflammation and discharge*

All others cause legions

Notably, treponema (syphilis) and HPV will be painless, HSV and ducreyi will be super painful

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5
Q

How does hormonal status affect chlamydia transmission?

A

Chlamydia target cells = columnar epithelium of the cervix

  • Younger women tend to have more exposed endocervical cells due to increased estrogen/progesterone
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6
Q

Name a parasite (1) and a bacteria (1) likely to cause vaginitis

A

Parasite: Trichomonas vaginalis

Bacteria: Gardenerella vaginella

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7
Q

What is the most important determinant in whether an HIV(+) mother will transmit HIV to the fetus?

How can risk of transmission be reduced?

A

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 and through breastmilk!

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8
Q

Is chlamydia more likelty to be asymptomatic (and therefore undiagnosed) in men or women?

A

Women

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9
Q

Rank the following STIs in order from most to fewest new cases/year

Chlamydia, HIV and HPV

A
  • HPV (most)
  • Chlamydia
  • HIV
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10
Q

Why are women more susceptible to the acquisition of HIV than men thorugh vaginal/penile intercourse?

A

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)

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11
Q

Which STI is most strongly associated with cervical, vaginal, and vulvar cancer?

A

HPV

(High-risk = HPV-16, 18, 31, 33)

  • 6 and 11 are low risk, cause genital warts*
  • Thank you @Will Schwartz!*
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12
Q

Which STIs can be transmitted both transvaginally and transplacentally during gestation?

A

HIV, HBV

(also CMV, not an STI)

Transvaginal only: chlamydia

Transplacental only: Syphilis

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13
Q

How is syphilis (treponema) diagnosed?

A

BOTH of the following tests:

  • Non-trepomenal serologic assay
    • Measures things associated with syphilis infection, but not trepona directly
    • Can be used to measure treatment response
  • Treponemal serologic test (FTA-ABS)
    • Detects antibodies against trepona
    • Stays positive forever (can’t be used to track treatment response)
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14
Q

Which STI is most likley to present with swollen, painful joints and a sore throat?

A

Gonorrhea

(Especially if acquired through oral-genital contact)

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15
Q

What factors increase liklihood of HIV infection following an exposure? (3)

A
  • More virus particles introduced to the lumen
    • Semen has the most HIV particles of any body fluid
  • More target cells (Langerhans cells = specific type of macrophage that have HIV coreceptor)
    • There will be more of these cells if there is an existing STI
  • Disrupted epithelial surface
    • Vaginal and anal epithelium are at baseline most susceptible to infection
    • Progesterone and spermicide (nonoxyol-9) can increase breaks in mucosa
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16
Q

Which perinatal infections can be transmitted transplacentally?

STIs and non-STIs

A

Must cross syncytiotrophoblasts

  • STIs
    • HIV
    • Syphilis
    • HBV
  • Non-STIs
    • CMV
    • Rubella
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17
Q

Which STIs can cause neonatal conjunctivis after perinatal transmission? (2)

A
  • Chlamydia
    • Delayed, milky discharge
  • Gonorrhea
    • Very soon after birth, thick/waxy discharge

chlamydia also causes neonatal pnemonitis!

18
Q

Which STI can cause neonatal pneumonia and conjunctivitis?

A

Chlamydia

Gonorrhea can cause chlamydia but not pneumonia

19
Q

What factors influence a person’s “rate of partner change” (3)

  • Context:*
  • Rate of spread = efficiency of transmission * rate of partner change * duration of infectiousness*
A
  • Total number of partners
  • Prevalence of infection in one’s social network
  • Multiple concurrent partners (vs. one after the other)
20
Q

Which cells are targeted by gonorrhoeae and chlamydia?

A

Columnar epithelial cells

  • Reproductive tract
  • Anal epithelium
21
Q

What percentage of new STIs occur in young people?

A

50% in ages 15-24

22
Q

What sequelae can occur due to gonorrhea or clamydia infection in the female reproductive tract?

A
  • Ascending infection -> Pelvic Inflammatory Disease
  • Results in tubal scarring
    • ​-> Tuboovarian abscess -> sepsis -> death
    • -> Ectopic pregnancy -> hemorrhage -> death
23
Q

According to trend data, which demographic accounts for 75% of newly diagnosed primary and/or secondary syphilis cases?

A

Men who have sex with men (MSM)

24
Q

Which STI can cause intrauterine growth restriction (IUGR) when passed transplacentally?

A

Syphilis

Can also cause stillbirth, congenital syphilis infection, death

25
Q

Which organisms are commonly associated with urethritis in people with a penis? (3)

A
  • Chlamydia
  • Gonorrhea
  • HSV

All three of these are common in people with a vagina as well

26
Q

Describe the process of HIV transmission

(Which cells are infected? How does it spread?)

A
  • HIV targets Langerhan’s cells in subepithelial
    • More of these cells will be present if there is an existing infection or inflammation
  • These cells are programmed to migrate to lymph nodes
  • In the lymph nodes, virus is transmitted to other cells
27
Q

Which non-STIs can cause intrauterine growth restriction (IUGR) when passed transplacentally?

A

CMV and Rubella

28
Q

Which infections are transmitted transvaginally?

A
  • STIs
    • HIV (also placentally)
    • Chlamydia
    • HBV
  • Non-STIs
    • CMV
    • Group B Strep
    • Possibly COVID?
29
Q

Why is somebody with an active gonorrhea infection more likely to acquire HIV?

A

Genital tract inflammation -> more inflammatory cells -> more target cells that HIV can infect

This is true for any inflammation from syphilis, bacterial vaginosis, chlamydia, gonorrhea

30
Q

What is the equation for rate of spread of an STI?

A

Rate of spread = beta * c * d

  • beta = efficiency of transmission
  • c = rate of partner change
  • d = duration of infectiousness
31
Q

What are the affects of congenital CMV?

A

Deafness, blindness, developmental disabilites

32
Q

What STI has NOT demonstrated an increased incidence trend in the last 5 years?

A

HIV

(chlamydia, gonorrhea and congenital syphillis are all increasing)

33
Q

What kind of bacteria is gonorrhea?

A

Neisseria gonorrhoeae

Gram negative diplococci

34
Q

What are the determinants of pathogenicity of gonorrhea?

A

Pili- help adhere to epithelial cells

Opa proteins- anchor bacterium

35
Q

What is the treatment for gonorrhea?

A

Ceftriaxone plus doxycycline

(doxycycline also treats chlamydia!)

Increasing antibiotic resistance for gonorreha

36
Q

What kind of bacteria is chlamydia?

A

Chlamydia trachomatis

Obligate intracellular pathogen

37
Q
A

Neisseria gonorrhoeae

Gram negative diplococci

38
Q

What kind of bacteria causes syphillis?

A

Treponema pallidum

Spirochete, very slowly dividing

39
Q

How is syphillis treated?

A

Penicillin G

No resistance!

Jarisch-Herxheimer reaction - feel worse in first 24 hours when all bacteria lyse at once

40
Q
A

Treponema pallidum

Syphillis

Repro/GU by Minnie: AH (29 decks)

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