43 - STDs I - Chlamydia and Gonorrhea

Question 1

Most common Chlamydia infection

Answer 1

Chlamydia trachomatis

Question 2

Chlamydia and Chlamydophila features

Answer 2

Small cocci
Obligate intracellular pathogen
Gram-negative-like wall (NO peptidoglycan)

Question 3

Chlamydia forms

Answer 3

Elementary body

Reticulate body

Question 4

Chlamydia elementary body features

Answer 4

Rigid cell wall
Infectious

Extracellular survival

Question 5

Chlamydia reticulate body features

Answer 5

Fragile cell wall
Non-infectious

Intracellular growth

Question 6

Clinical presentation for Chlamydia trachomatis

Answer 6

Eye infections

UG infections

Question 7

C. trachomatis diseases

Answer 7

Trachoma
Inclusion conjunctivitis

STI/UG infections

LGV

Infant pneumonia

Question 8

C. trachomatis serovars

Answer 8

Many, based on Ag differences in MOMP

Question 9

C. trachomatis serovars that cause trachoma

Answer 9

A, B, Ba, C

Question 10

C. trachomatis serovars that cause UG tract disease

Answer 10

D-K

Question 11

C. trachomatis serovars that cause LGV

Answer 11

L1, L2, L2a, L2b, L3

Question 12

What is the leading cause of preventable blindness in the world?

Answer 12

Chronic Chlamydia conjunctivitis

Question 13

What is the most common STD in the U.S.?

Answer 13

C. trachomatis

Question 14

C. trachomatis UG infections in men

Answer 14

Symptomatic
Dysuria

Mucopurulent discharge

May progress to Reiter syndrome

Question 15

Reiter syndrome

Answer 15

Urethritis
Conjunctivitis

Polyarthritis

Question 16

C. trachomatis UG infections in women

Answer 16

Mostly asymptomatic
Mucopurulent discharge

PID

Question 17

LGV symptoms

Answer 17

Painless lesion
Inguinal lymphadenopathy

Proctitis

Question 18

C. trachomatis diagnosis

Answer 18

Iodine staining for RBs
Immunofluorescence of EBs

NAAT from urine/urethral discharge

Question 19

C. trachomatis treatment and prevention

Answer 19

Doxycycline or macrolides

Infection does NOT confer immunity

Question 20

Mechanism of action for macrolides and doxycycline

Answer 20

Inhibition of protein synthesis

Question 21

Neisseria features

Answer 21

Gram-negative
Diplococci

Oxidase +

Catalase +

Non-spore forming

Non-motile

Question 22

Differences between N. meningitidis and N. gonorrhoeae

Answer 22

N. meningitidis oxidized maltose

Question 23

N. gonorrhoeae virulence factors

Answer 23

Pilin
Porin

Opa protein

LOS

Outer membrane blebs

IgA1 protease

Beta-lactamase

Question 24

Porin function

Answer 24

Promote intracellular survival

Question 25

Opa protein function

Answer 25

Attachment to eukaryotic cells

Question 26

LOS function

Answer 26

Lipid A
Core oligosaccharide

NO O Ag

Endotoxin

Question 27

Outer membrane blebs function

Answer 27

Contains LOS and proteins
Enhance toxicity

Absorb Abs

Question 28

Pathogenesis of N. gonorrhoeae

Answer 28

Attach to mucosal cells
Multiply within cells

Establish infection in subepithelial space

LOS stimulates inflammation

Question 29

Gonorrhea disease in both men and women

Answer 29

Mucopurulent discharge

Dysuria

Question 30

Gonorrhea disease in men

Answer 30

Almost always have acute symptoms

Epididymitis, prostatitis, periurethral abscesses

Question 31

Gonorrhea disease in women

Answer 31

Only about half are symptomatic
Salpingitis

Tuboovarian abscesses

PID

Question 32

Gonococcemia

Answer 32

Disseminated N. gonorrhoeae disease
Septicemia and infection of skin and joints

Purulent arthritis

Question 33

N. gonorrhoeae diseases

Answer 33

Purulent conjunctivitis
Anorectal gonorrhea

Pharyngitis

Question 34

N. gonorrhoeae diagnosis

Answer 34

Gram-negative, d iplococci IN neutrophils
Culture

NAAT

Question 35

N. gonorrhoeae treatment and prevention

Answer 35

Ceftriaxone (gonorrhea) PLUS doxycycline or macrolide (chlamydia - assumed)
Patient education/condoms