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Clinical Micro > Bacterial STI > Flashcards

Bacterial STI Flashcards

1
Q

What are 4 consequences of untreated STIs in women?

A
  1. Pelvic Inflammatory Disease (PID)
  2. Infertility
  3. Ectopic pregnancy
  4. Cervical cancer
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2
Q

What are 2 consequences of untreated (vertically transmitted) STIs in infants?

A

Eye infections: result in blindness and sepsis

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3
Q

What are 2 consequences of untreated STIs in men?

A

Infertility and narrowing of the urethra

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4
Q

What are 5 risk factors for chlamydia/gonorrhoea?

A
  1. Age < 25 years
  2. Street youth, homeless
  3. New sexual partners
  4. > 2 sexual partners / year
  5. Non-barrier contraception
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5
Q

What is a classic symptom of gonorrhoea in males and females that is absent from chlamydia? What is a typical clinical manifestation of it in men and women?

A

Considerable amounts of discharge

Acute urethritis (males) / cervicitis (females)

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6
Q

Where are two other areas that gonorrhoea can show symptoms?

A

Ano-rectal gonorrhea

Pharyngeal gonorrhea

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7
Q

What are two possible outcomes if gonorrhoea is ;eft untreated?

A
  1. Pelvic inflammatory disease (PID)

2. Septic arthritis

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8
Q

What is the risk of transmission from an infected woman to a man?

A

about 20 percent

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9
Q

What is the risk of transmission from an infected man to a woman?

A

about 50 %

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10
Q

Is there a risk risk of transmission of gonorrhoea from anal sex?

A

yep

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11
Q

Where does a gonorrhoeal infection typically manifest in an infant after perinatal transmission?

A

in the eyes

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12
Q

What are two major virulence factors of gonorrhoea that also mediate attachment?

A
  1. Pili

2. Outer membrane

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13
Q

What is the role of pili in the virulence of gonorrhoea?

A

Allows them to attach to mucosal surfaces and evade killing by macrophages

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14
Q

What is the role of the OM in the virulence of gonorrhoea? (2 things)

A
  1. proteins (OMP’s) facilitate invasion of epithelial cells

2. lipooligosaccharides (LPS) possess endotoxin activity, results in ciliary death

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15
Q

What two cell types are primarily infected by N. gonorrhoea?

A

columnar or cuboidal epithelium

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16
Q

How long does it take for the epithelial cells to be penetrated by N. gonorrhoea?

A

20-24 hours

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17
Q

What is the first line defense/first symptoms of a gonorrhoeal infection?

A
  1. Aggressive neutrophil response results in sloughing off of epithelial cells
  2. Exudation of pus/discharge
18
Q

What is sensitivity a measure of?

A

A measure of the proportion of actual positive tests that are correctly identified

19
Q

What is specificity a measure of?

A

A measure of the proportion of negative tests that are correctly identified

20
Q

What is the positive predictive value? What is the value dependent on?

A

the proportion of patients with positive test results who are correctly diagnosed.

Its value is dependent on the prevalence of the disease.

21
Q

What is the negative predictive value ?

A

The proportion of patients with negative test results who are correctly diagnosed

22
Q

What are the preferred forms of specimens for a gonorrhoeal test for men and women?

A

Women: vaginal swab
Men: 1st voided urine

23
Q

What kinds of media will gonorrhoea grow on? Which will it not? What are the growth conditions required? How long?

A

TMA, MLA, NYCA
- nutritious media with lots of antibiotics

WON’T grow on SBA

needs 5% CO2, 35ºC, 24-72 hours

24
Q

What are 3 common forms/types of resistance that gonorrhoea has developed?

A
  1. ß-lactamases on plasmids
  2. Fluoroquinolone resistance
  3. tetracycline resistance
25
Q

What are the two current drug recommendations for treatment of gonorrhoea? When do you use either?

A
  1. 800 mg Cefixime (orally) - uncomplicated urogenital
    - this is the only oral agent available
  2. 250mg Ceftriaxone (intramuscular injection)
    - can be used to treat all forms of gonorrhoea (anal, pharyngeal..)
26
Q

What class of drugs do the gonorrhoea drugs belong to?

A

the cephalosporins

27
Q

What are the 3 species of chlamydia?

A

C. psittaci, C. pneumoniae, C. trachomatis

28
Q

What kind of lifecycle does chlamydia have? What are the two forms and what do they infect?

A

Biphasic life cycle

The elementary body is the infectious form that enters host cells

Develops into the reticulate body which undergoes binary fission

29
Q

How long is the incubation period for chlamydia in men?

A

7-21 days

30
Q

What % of men are asymptomatic? Women?

A

about 25% of men and 80% of women

31
Q

What makes controlling PID difficult in women with chlamydia?

A

The majority of women with cervicitis (80%) are asymptomatic and have normal cervical exam

32
Q

What is a classic symptom of chlamydia in women?

A

urethritis

33
Q

What is the go to lab test to detect chlamydia?

A

PCR of specimen

34
Q

What is the first line treatment of chlamydia?

A

1 gram Azithromycin (oral, single dose)

35
Q

What is the second line treatment for chlamydia?

A

100mg BID doxycycline (oral, 10 days)

36
Q

What bacteria causes chancroid?

A

Haemophilus ducreyi

37
Q

What are chancroid lesions?

A

Tender non indurated irregular ulcers

38
Q

What is the spread of infection from Haemophilus ducreyi?

A

Infection is localized, however frequently spreads to regional lymph nodes
Lymph nodes enlarged and painful
- tend to be in the groin area

39
Q

What is the morphology like for Haemophilus ducreyi? Intra or extracellular?

A

Intra or extracellular depending

pleomorphic cocco-bacilli or short rods.

40
Q

What does a gram stain of Haemophilus ducreyi look like?

A

gram stain variable

Bipolar staining

Arranged in parallelchains = school of fish or rail road trackappearance

41
Q

How do you culture H. ducreyi? What are the media requirements?

A

Gonococcal agar-based or a Mueller–Hinton-based medium is best
- can use a mixture of two media bases best

Need to add:

  1. 1% IsoVitalex
  2. 5% chocolatized horse blood or 1% hemoglobin
  3. 5% fetal calf serum (FBS)
  4. Vancomycin

Clinical Micro (28 decks)

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