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Infectious diseases > 9- STI > Flashcards

9- STI Flashcards

1
Q

The immediate goal of screening for STI’s is to

A

identify and treat infected people before they develop complications, and to identify, test and treat their partners to prevent transmission and reinfections

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2
Q

T. pallidum is what kind of bacteria, and how is it detected?

A

order spirochaetales, cannot be seen by direct microscopy, needs darkfield microscopy (has rotary motion with flexing movement which are considered sufficiently characteristic to be diagnostic

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3
Q

transmission of T pallidum is via

A

direct contact with an infectious lesion (primary chancre, mucous patches, condyloma lata) during sex, it readily crosses the placenta, not through blood transfusions bc it cannot survive longer than 24-48 hours under storage conditions

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4
Q

which syphilis stages are considered contagious

A

those with early latent syphilis

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5
Q

which type of syphilis has serological evidence but no symptoms

A

latent syphilis

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6
Q

early syphilis includes

A

primary and secondary syphilis (occur weeks to months after initial infection), and early latent syphilis (which is an asymptomatic infection that was acquired within the previous 12 months)

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7
Q

when do pts enter late latent syphilis , and does it have symptoms

A

when pts are untreated during the early syphilis stages

no this stage is asymptomatic

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8
Q

what is teritary syphilis

A

when pts are not treated for early syphilis and they develop major complications

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9
Q

when do events due to late syphilis occur

A

they can occur anytime from 1-30 years after primary infection and can involve a variety of different tissues

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10
Q

when can pts get neurosyphilis

A

any time during the course of the infection

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11
Q

pathology of a chancre

A

the lesion starts 21 days after initial infection; it begins as a papule (painless) at the site of inoculation, then ulcerates, 1-2 cm in size with a raised indurated margin

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12
Q

T/F chancres heal spontaneously within 3-6 weeks without treatment

A

T (note that as the chancre disappears, the infections disseminates)

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13
Q

what % of people develop secondary syphilis

A

25%

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14
Q

T/F the acute manifestations of syphilis resolve spontaneously, except in cases of severe cutaneous ulceration called lues maligna

A

T

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15
Q

common findings in secondary syphilis

A
  • rash (maculo-papular also on palms and soles)
  • lymphadenopathy
  • condyloma lata (in moist regions where a previous chancre was)
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16
Q

alopecia type in secondary syphilis

A

moth eaten alopecia (is reversible with treatment)

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17
Q

T/F most pts with ocular syphilis develop diminished visual acuity, secondary to posterior uveitis

A

T (other manifestations are retinal necrosis, and optic neuritis)
note that involvement of the eye should be considered manifestation of neurosyphilis

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18
Q

most common clincal manifestations of late syphilis

A
  • aortitis (CV syphilis)
  • gummatous syphilis (granulomatous, nodular lesions in skin and bone)
  • CNS involvement (general paresis, and tabes dorsalis)
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19
Q

who gets tertiary syphilis

A

pts with late syphilis who have symptomatic manifestations involving the cardiovascular system or gummatous disease

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20
Q

why do you need to know the difference between early and late latent syphilis

A

to know the risk of transmission; pts with late latent dx are not infectious, but pts with early latent dx are
- pregnant women with late latent syphilis can transmit T. pallidum to their fetus for upto 4 years

21
Q

T/F like all herpes virus strains, HSV has a latent state followed by viral reactivation and recurrent local disease

A

T

22
Q

T/F perinatal transmission of HSV can lead to significant fetal morbidity and mortality

A

T

23
Q

define primary HSV

A

the infection in a pt without preexisting antibodies to HSV1 or HSV2

24
Q

define non primary HSV

A

getting genital HSV1 in a pts with pre existing antibodies to HSV2 or the acquisition of genital HSV2 ina pt with pre existing abs to HSV1

25
Q

define recurrent HSV

A

the reactivation of genital HSV in which the HSV type found in the lesion is the same as the antibodies in serum

26
Q

T/F subclinical HSV infection with no symptoms can still be infectious

A

true, transmission can occur in cases of subclinical viral shedding

27
Q

manifestations of primary HSV

A

p severe painful genital ulcers, dysuria, fever, tender local inguinal lymphadenopathy, headache. Note that it can also be asymptomatic

28
Q

T/F there is no clear difference in clinical presentation of HSV1 or HSV2

A

T

29
Q

Manifestations of non primary infection HSV

A

fewer lesions, and less systemic symptoms than primary infection (maybe bcuz abs against one HSV offer protection against the other)

30
Q

manifestation of recurrent HSV

A

they are less severe than non/primary infection
duration of lesions is shorter than time of primary lesions
duration of viral shedding is 2-5 days

31
Q

T/F the likelihood of recurrence of HSV is much higher for HSV2

A

T (recurrence is also more common in immunocompromised)

32
Q

DX of HSV

A

lab testing PCR or serological test

33
Q

tx of HSV

A

acyclovir or famiciclovir or valacyclovir (dose depends on stage)

34
Q

T/F different HPV types has a propensity to infect different body sites and are associated with different diseases

A

T

35
Q

T/F HPV 6, 11 causes 90% of genital warts

A

T

36
Q

T/F HPV 16, 18 cause 90% of anal cancers and precancerous anal lesions

A

T

37
Q

T/F HPC plays a role in the pathogenesis of SCC of the head and neck

A

T

38
Q

most common benign laryngeal tumor in children

A

recurrent respiratory papillomatosis due to HPV 6, 11 acquired during passage through the birth canal of infected mother

39
Q

dx of HPV

A

cytology, or HPV testing of cervical specimens or cytology of anal specimens

40
Q

what is trichomaniasis

A

a genitourinary infection with the protozoan trichomonas vaginalis (it is the most common non viral STD worldwide)

41
Q

dx of trichomaniasis

A

cervical cytology, culture, nucleic acid amplification test, microscopy

42
Q

tx of trichomaniasis

A

metronidazole, tinidazole

43
Q

should you treat sex partners of trichomaniasis pts

A

yes

44
Q

T/F majority of people with chlamydia are asymptomatic

A

T

45
Q

dx of chlamydia

A

nucleic acid amplification testing PCR

46
Q

whom to test for chlamydia

A

symptomatic and at risk asymptomatic pts
pts with recent exposure
pts with persistent symptoms
recurrence of symptoms

47
Q

tx of chlamydia

A

tetracycline, macrolides (alternate therapy is quinolones)

48
Q

chlamydia coinfection with gonorrhea

A

give single injection of ceftriaxone (250 MG) for uncomplicated gonococcal urogenital anorectal and pharyngeal infections

49
Q

ceftriaxone can be used in preganancy

A

true

Infectious diseases (36 decks)

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