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Clinical Pathology > 50 HIV and STDs > Flashcards

50 HIV and STDs Flashcards

1
Q

Differentiate between an STI, STD and GID:

A

STI: infection transmitted by sexual contact.
STD: STI + symptoms.
GTD: not all acquired via sexual contact.

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2
Q

Which bacteria commonly cause STIs? (6).

A 
Neisseria gonorrhoea.
Chlamydia trachomatis.
Ureaplasma.
Mycoplasma.
Gardnerella vaginalis.
Anaerobes.
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3
Q

Which virus’ commonly cause STIs? (3).

A

Herpes simplex virus (HSV).
Human papilloma virus (HPV).
Pox virus.

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4
Q

Which protozoa commonly causes STIs?

A

Trichomonas vaginalis.

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5
Q

Which fungus commonly causes STIs?

A

Candida albicans.

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6
Q

Which ectoparasites commonly cause STIs? (2).

A 
Pthirus pubis (crabs).
Sarcoptes scabiei.
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7
Q

What is the most common STI in England?

A

Chlamydia.

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8
Q

Which organism causes gonorrhoea?

A

Neisseria gonorrhoea.

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9
Q

Which characteristic of Neisseria gonorrhoea makes it more likely to infect columnar/cuboidal epithelium?

A

Pilli on cell surface increases ability to attach to mucosal epithelia.

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10
Q

What are the symptoms of gonorrhoea?

A

60% are asymptomatic.

Urethral discharge, dysuria.

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11
Q

What are the local complications of gonorrhoea? (6).

A 
Epididymitis.
Prostatitis.
Barthonilitis (Bartholin's gland)
Salpingitis (fallopian tubes)
Peritonitis.
Fitz-Hugh-Curtis syndrome.
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12
Q

What are the systemic complications of gonorrhoea? (4).

A

Disseminated Gonococcal Infection.

Bacteraemia, arthritis, dermatitis, meningitis.

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13
Q

What can gonorrhoea cause in pregnancy and neonates?

A

Preg: spontaneous abortion, premature labour.
Neo: ophthalmia neonatorum (purulent conjunctivitis that may cause blindness).

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14
Q

What is the recommended treatment of gonorrhoea?

A

Ceftriaxone and azithromycin.

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15
Q

Which antibiotics in gonorrhoea commonly resistant to? (3).

A

Tetracycline.
Penicillin.
Ciprofloxacin.

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16
Q

Which organisms cause non-gonococcal urethritis? (2)

A

Chlamydia trachomatis.

Ureaplasma urealyticum.

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17
Q

How is non-gonococcal urethritis treated?

A

Doxycycline, + azithro/erythromycin.

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18
Q

What is the lifecycle of chlamydia trachomatis?

A

Extracellular infectious form: Elementary body.

Intracellular replicative form: Reticulate body.

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19
Q

Which tissues does chlamydia trachomatis target? (5).

A

Endocervix/upper genital tract (f)
Conjunctiva, urethra, rectum (m+f)
Infant respiratory tract (infants)

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20
Q

Describe the national chlamydia screening program:

A

All sexually active under 25’s yearly or on change of partner.
Opportunistically.
If +ve, 3 months post Rx.

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21
Q

What are the clinical features of chlamydia? (5).

A

Women > men asymptomatic.
Urethritis and mucopurulent cervicitis.
Dysuria.
Cause of sterile pyuria.

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22
Q

What are the complications of chlamydia infection? (5)

A

Pelvic inflammatory disease.
Tubal infertility.
Neonatal conjunctivitis/pneumonia.
Reiter’s syndrome.

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23
Q

What is Reiter’s syndrome? (4).

A

Arthritis.
Conjunctivitis.
Urethritis.
Skin lesions.

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24
Q

How is chlamydia treated?

A

Azithromycin or doxycycline.

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25
Q

How is chlamydia treated in neonates?

A

Erythromycin.

26
Q

Which infections cause pelvic inflammatory disease?

A

Neisseria gonorrhoea.

Chlamydia trachomatis.

27
Q

What commonly causes genital warts?

A

Human papilloma virus.

Types 6 + 11.

28
Q

How are genital warts treated?

A

Burn: podphyllin, salicylic/ tirchloracetic acid.
Freeze: liquid nitrogen.
Cut.
Imiquimod.

29
Q

Which type of genital herpes is more common in women than men?

A

HSV 2.

30
Q

What are the features of primary genital herpes infection? (5).

A

Pain, itching, dysuria, vaginal/urethral discharge.

Bilateral ulcers.

31
Q

Where does genital herpes lie dormant?

How is it reactivated? (3).

A

Sensory neuron cels - sacral nerve ganglia.

Trauma, menstruation, stress.

32
Q

What is the treatment for genital herpes?

A

Aciclovir.

33
Q

What are the complications of genital herpes? (4).

A

Meningitis.
Encephalitis.
Sacral nerve parasthesiae.
Urinary retention.

34
Q

What is syphilis caused by?

A

Treponema pallidum.

35
Q

Why is syphilis hard to detect?

A

Too small for light microscopy.

Can’t be cultured in vitro.

36
Q

What is the characteristic histology of syphilis?

A

Obliterative endartertitis.

Concentric endothelial/fibroblast proliferation.

37
Q

What is the incubation period of syphilis?

A

21 days.

38
Q

What is the 1o phase of syphilis?

A

Chancre: painless indurated lesion.

Heals spontaneously in 3-6 weeks.

39
Q

What is the 2o phase of syphilis? (5).

A 
2-8 wks post chancre onset.
Maculopapular rash.
Condylomata lata.
Fever, malaise, weight loss.
Lymphadenopathy.
Headache + meningismus in 40%.
40
Q

What are condylomata lata?

A

Highly infectious, grey erythematous plaques that occur in warm bodies areas during 2o syphilis.

41
Q

What are the features of the 3o phase of syphilis? (3).

A

Neurosyphilis.
Cardiovascular.
Late benign gummas.

42
Q

What are the features of neurosyphilis? (7).

A

Hemiplegia.
Seizures.
Personality changes, Argyll-Roberton pupils.
Ataxic, wide based gait, loss of position/vibratory sense.

43
Q

What are the features of cardiovascular syphilis? (2).

A

Aortitis: aortic regurgitation and saccular aneurysm.

44
Q

What are the signs of congenital syphilis? (6).

A 
Rash.
Hepatosplenomegaly.
Frontal bosses.
Saddle nose.
Sabre shins.
Hutchinsons incisors.
45
Q

How is syphilis monitored?

A

Microscopy and PCR.
Antitreponemal antibodies for diagnosis.
Non-specific tests for monitoring.

46
Q

How is syphilis treated?

A

Penicillin.

47
Q

What is the Jarish-Herxheimer reaction?

A

Occurs during syphilis treatment.
Fever, chills and myalgia.
Hypersensitivity to protein released during organism lysis.

48
Q

What is trichomoniasis caused by?

A

Trichomonas vaginalis.

49
Q

What is the symptom of trichomoniasis?

How is it treated?

A

Profuse, green, frothy vaginal discharge.

Metronidazole.

50
Q

What is bacterial vaginosis caused by?

A

Reduced vaginal lactobacilli.

Increased Gardnerella vaginalis + anaerobes.

51
Q

What are the clinical features of bacterial vaginosis?

A

Watery discharge.
+ve KOH test (fishy smell).
Vaginal pH >4.5.

52
Q

What are the treatments for bacterial vaginosis? (3).

A

Metronidazole.
Amoxycillin.
Topical clindamycin.

53
Q

What are the three causative factors of candidiasis?

A

Oral contraceptives.
Poorly controlled diabetes.
Antibiotics.

54
Q

What are the features of candidiasis? (5).

A 
Erythema.
Itching.
Thick discharge.
White plaques.
Fissuring lesions.
55
Q

How is uncomplicated candidiasis treated?

A

Topical co-trimazole.

Oral fluconazole.

56
Q

How was AIDs first recognised?

A

Pneumocystis jirovecci pneumonia.

Kaposi’s sarcoma.

57
Q

How does the HIV virus enter CD4 cells?

A

Viral glycoprotein gp120 interacts with cell receptor CD4 and chemokine receptor CCR5 to gain host cell entry.

58
Q

What is the common primary infection after HIV? Symptoms? (4).

A

Acute retroviral syndrome.

Fever, pharyngitis, lympadenopathy, rash.

59
Q

What are the early symptoms/infections in HIV? (5).

A 
Pulmonary TB.
Persistent oral candidiasis.
Chronic diarrhoea.
Persistant fever.
Severe bacterial infections.
60
Q

What tests are used in HIV diagnosis?

A

Antibody testing.
PCR.
CD4 cell count.

61
Q

What are the five types of HIV drugs?

A 
NRTIs.
NNRTIs.
Protease inhibitors.
Viral entry inhibitors.
Integrase strand transfer inhibitors.

Clinical Pathology (66 decks)

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