Bacterial sexually transmitted infections I Flashcards

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1
Q

What chlamydia species is the most common cause of genital infection and conjunctivitis?

A

Chlamydia trachomatis

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2
Q

Does chlamydia have peptidoglycan in its cell wall?

A

No

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3
Q

What is the shape of chlamydia bacteria?

A

Cocci

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4
Q

What is the infectious particle in chlamydia?

A

Elementary body

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5
Q

What is the replicating / metabolically active particle in chlamydia?

A

Reticulate body

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6
Q

Chlamydia inclusions are made up primarily of elementary bodies or reticulate bodies?

A

Reticulate bodies

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7
Q

The multiple chlamydia trachomatis serovars are based on what protein?

A

Major outer membrane protein

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8
Q

Chlamydia has a tropism for what type of cell?

A

Nonciliated, columnar, cuboidal, and transitional epithelial cells

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9
Q

How does chlamydia do cytotoxic damage?

A

Destruction of epithelium (cell lysis) and proinflammatory cytokine response

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10
Q

Without treatment, chlamydia can lead to what condition?

A

Fibrosis (infertility)

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11
Q

Which serovars are responsible for trachoma?

A

A, B, Ba, C

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12
Q

Which serovars are responsible for urogenital tract infection?

A

D-K

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13
Q

Which serovars are responsible for lymphogranuloma venerum?

A

L1, L2, L2a, L2b, L3

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14
Q

Why are LGV serovars more invasive than the other serovars?

A

Replication in mononuclear phagocytes

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15
Q

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

A

Chronic chlamydia conjunctivitis

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16
Q

What are the symptoms of acute conjunctivitis in sexually active adults?

A
  1. Mucopurulent discharge
  2. Keratitis
  3. Corneal infiltrates
  4. Occasional corneal vascularization
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17
Q

What can help prevent transmission of neonatal conjunctivitis?

A

Erythromycin eye drops

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18
Q

What is the presentation for male C. trachomatis UG infection?

A

Dysuria and thin urethral MUCOPURULENT discharge

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19
Q

What are the complications of male C. trachomatis UG infection?

A

Epididymitis, prostatitis

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20
Q

What is Reiter syndrome?

A
  1. Complication of male C. trachomatis UG infection

2. Urethritis, conjunctivitis, polyarthritis

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21
Q

What is the presentation for female C. trachomatis UG infection?

A

Mucopurulent discharge

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22
Q

Is UG chlamydia infection more common in men or women?

A

Women

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23
Q

What disease presents with primary (painless) lesions / papules and inflammation and swelling of lymph nodes draining the site of infection with inguinal lymphadenopathy?

A

Lymphogranuloma venereum (LGV)

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24
Q

What is a common result of lymphatic spread in LGV?

A

Proctitis

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25
Q

What are the tests for C. trachomatis?

A
  1. Giemsa stain
  2. Iodine stain
  3. Immunofluorscence
  4. PCR
26
Q

What does the Giemsa stain detect in C. trachomatis infection?

A

Cytoplasmic inclusions (need epithelial cells)

27
Q

What does the iodone stain detect in C. trachomatis infection?

A

Reticulate bodies (need epithelial cells)

28
Q

What does immunofluorescence detect in C. trachomatis infection?

A

Elementary bodies (need epithelial cells)

29
Q

What sample is needed for PCR diagnosis of C. trachomatis?

A

Urine or urethral discharge

30
Q

What is the treatment for C. trachomatis infection?

A

Doxycycline or macrolides

31
Q

Does chlamydia infection confer immunity?

A

No

32
Q

Is neisseria gram negative or gram positive?

A

Gram negative

33
Q

What is the shape of neisseria?

A

Diplococci

34
Q

Is neisseria aerobic or anaerobic?

A

Aerobic

35
Q

Is neisseria catalase positive or negative?

A

Positive

36
Q

Is neisseria oxidase positive or negative?

A

Positive

37
Q

Does neisseria form spores?

A

No

38
Q

How can N. meningitidis and N. gonorrhoeae be distinguished?

A

N. meningitidis ferments maltose, N. gonorrhoeae does not

39
Q

What are the N. gonorrhoeae virulence factors?

A
  1. Pilin
  2. Por protein
  3. Opa protein
  4. LOS
  5. Outer membrane blebs
  6. IgA1 protease
  7. B-lactamase
40
Q

What is the role of pilin in N. gonorrhoeae?

A

Attachment, anti-phagocytic

41
Q

What is the role of por protein in N. gonorrhoeae?

A

Promotes intracellular survival

42
Q

What is the role of opa protein in N. gonorrhoeae?

A

Attachment to eukaryotic cells

43
Q

What is the role of LOS in N. gonorrhoeae?

A

Endotoxin

44
Q

What is the role of the outer membrane blebs in N. gonorrhoeae?

A

Contain LOS and OM proteins, enhance toxicity and absorb antibodies

45
Q

What is the role of IgA1 protease?

A

Destroys IgA

46
Q

What is the role of B-lactamase?

A

Hydrolyzes B-lactam ring in penicillin

47
Q

Which N. gonorrhoeae virulence factors undergo antigenic variation?

A
  1. Pilin
  2. Por protein
  3. Opa protein
  4. LOS
48
Q

Neisseria infections are associated with deficiencies in what complement components?

A

Late complement components C5b-C9

49
Q

What are the late complement components responsible for?

A

Formation of the membrane attack complex (MAC) - lysis of pathogen

50
Q

What is the horizontal spread of N. gonorrhoeae?

A

Eye - mouth - genitals

51
Q

Does N. gonorrhoeae have a capsule?

A

No

52
Q

How do the gonococci attach to mucosal cells?

A

Pili, PorB, Opa

53
Q

What do gonococci do after invasion of mucosa?

A
  1. Replicate inside cells, lysis
  2. Phagocytosis by macrophage / neutrophil
  3. LOS stimulates inflammation
54
Q

What kind of discharge accompanies N. gonorrhoeae infection?

A

Mucopurulent discharge

55
Q

What are the disseminated effects of N. gonorrhoeae infection?

A

Septicemia, skin and joint infections, suppurative arthritis, pustular rash on extremities

56
Q

What always accompanies N. gonorrhoeae genital infection?

A

Pharyngitis

57
Q

What is the diagnosis for N. gonorrhoeae infection?

A
  1. Direct smear
  2. Culture
  3. PCR
58
Q

What would a gram stain for N. gonorrhoeae reveal?

A

Gram negative bean shaped diplococci in NEUTROPHILS

59
Q

How can N. gonorrhoeae be cultured?

A
  1. Chocolate agar (nonselective)

2. Thayer-Martin media (selective)

60
Q

What is the treatment for N. gonorrhoeae?

A

Ceftriaxone plus doxyclycline or azithromycin (for chlamydia since they probably have that too)