Bacterial sexually transmitted infections II

Question 1

How is syphilis acquired?

Answer 1

Direct contact of mucous membranes

Question 2

How many people are infected with syphilis every year?

Answer 2

50,000

Question 3

What is the causative agent of syphilis?

Answer 3

Treponema pallidum

Question 4

Is treponema pallidum gram negative or gram positive?

Answer 4

Gram negative

Question 5

What is the shape of treponema pallidum?

Answer 5

Spirochete

Question 6

Is treponema pallidum sensitive or insensitive to oxygen?

Answer 6

Extremely sensitive

Question 7

What kind of microscopy is used to visualize treponema pallidum?

Answer 7

Darkfield (or direct fluorescence Ab test)

Question 8

How is the syphilis lesion described?

Answer 8

1. Painless ulcerated papule 2. Indurated (hardened)

Question 9

When does secondary syphilis manifest?

Answer 9

2-8 weeks post-chancre

Question 10

What are the symptoms of secondary syphilis?

Answer 10

1. Flu-like - sore throat, headache, fever, myalgia, muscle ache, anorexia, lymphadenopathy 2. Prominent skin lesions all over body - highly infectious 3. Possible raised lesions condylomata lata - in skin folds

Question 11

How are condylomata lata lesions described?

Answer 11

Soft, flat, moist, pink-tan, papules and nodules

Question 12

Gummas (granulomatous lesions) are indicative of what stage of syphilis?

Answer 12

Tertiary

Question 13

What are symptoms of congenital syphilis?

Answer 13

Rhinitis and maculopapular rash developing after birth

Question 14

What is the diagnosis for syphilis?

Answer 14

1. Darkfield / direct fluorescence microscopy 2. Ab detection / serology (most common) 3. Culture not available

Question 15

What are nontreponemal tests for syphilis?

Answer 15

Measures antibody directed against cardiolipin

Question 16

What are treponemal tests for syphilis?

Answer 16

Detect antibody specific to T. pallidum

Question 17

If a patient with syphilis is treated and then administered a nontreponemal test, will it be positive or negative?

Answer 17

Negative (treponemal test will still be positive)

Question 18

How is syphilis treated?

Answer 18

1. Penicillin 2. Doxycycline or azithromycin if allergic to penicillin

Question 19

All patients with urethritis should be tested for what other infections?

Answer 19

Gonorrhea and chlamydia

Question 20

What are some major symptoms of non-gonococcal urethritis in males?

Answer 20

Blood in urine or semen, dysuria, discharge from penis, pain with intercourse

Question 21

What are some major symptoms of non-gonococcal urethritis in females?

Answer 21

Abdominal pain, dysuria, fever and chills, pelvic pain, vaginal discharge

Question 22

What is the most common cause of non-gonococcal urethritis?

Answer 22

Chlamydia

Question 23

What are the minor players involved non-gonococcal urethritis?

Answer 23

Mycoplasma genitalium and ureaplasma urealyticum

Question 24

Do mycoplasma and ureaplasma have a cell wall?

Answer 24

No

Question 25

What is contained in the plasma membrane of mycoplasma and ureaplasma?

Answer 25

Sterols stolen from host cell

Question 26

Which bacteria have a fried egg appearance?

Answer 26

Mycoplasma

Question 27

M. genitalium is resistant to what drug?

Answer 27

Doxycycline

Question 28

Men with non-gonococcal urethritis (suspected ureaplasma) should be treated with what drug?

Answer 28

Doxycycline

Question 29

Recurrent non-gonococcal urethritis in men should be treated with what drug?

Answer 29

Azithromycin or quinolones

Question 30

What is the causative agent of chancroid?

Answer 30

Haemophilus ducreyi

Question 31

Is haemophilus gram negative or gram positive?

Answer 31

Gram negative

Question 32

What is the shape of haemophilus?

Answer 32

Pleomorphic coccobacillus

Question 33

What is the oxygen requirement for haemophilus?

Answer 33

Facultative anaerobe

Question 34

What is the catalase rating for haemophilus?

Answer 34

Catalase positive

Question 35

What does haemophilus require for growth?

Answer 35

X and V factors

Question 36

What is the presentation progression for H. ducreyi?

Answer 36

1. 5-7 days post exposure a tender papule with an erythematous base develops on genitalia or perianal area 2. Within 2 days lesion ulcerates and becomes PAINFUL 3. Inguinal lymphadenopathy commonly present

Question 37

How is chancroid treated?

Answer 37

Macrolide: azithromycin, erythromycin

Question 38

What is the diagnosis for H. ducreyi?

Answer 38

1. Slow growth on chocolate agar 2. Syphilis and HSV must be excluded

Question 39

What is the causative agent of donavanosis / granuloma inguinale?

Answer 39

Klebsiella granulomatis

Question 40

What is the gram staining for klebsiella granulomatis?

Answer 40

Gram negative

Question 41

What is the shape of klebsiella granulomatis?

Answer 41

Rod

Question 42

Is klebsiella granulomatis encapsulated?

Answer 42

Yes

Question 43

What is the appearance of klebsiella granulomatis lesions?

Answer 43

Wartlike, painless, bleed easily (NOT ulcerated)

Question 44

What is the diagnosis for klebsiella granulomatis?

Answer 44

1. Rule out other causes 2. Presence of Donovan bodies in pathological specimens

Question 45

What is the treatment for klebsiella granulomatis?

Answer 45

Prolonged treatment with tetracycline, sulfamethoxazole, gentamycin, ciprofloxacin, or erythromycin