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Bacterial STIs II Flashcards

1
Q

What the pH of vaginal secretions caused by bacteria?

A

>4.5

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2
Q

What are the characteristics of vagional discharge in bacterial vaginosis?

A

Bacterial vaginosis

  1. homogeneous vagional discharge
  2. release of an amine-like odor when discharge is mixed with 10% KOH
  3. Clue cells present on wet mount/gramstain
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3
Q

What is the most common etiologic agent of Bacterial Vaginosis?

A

BV is defined as a disruption of the ecology of the vaginal microflora and is characterized by a shift in microbial species from Lactobacillus species to Gardenerella vaginalis and anaerobic commensals

**This is not aquired sexually

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4
Q

What are the risk factors for developing Candida Vulvovaginitis?

A

Candida Vulvovaginitis

  1. Diabetes melitus
  2. Antibiotic use
  3. increased estrogen levels (oral contraceptives, pregnancy, etc.
  4. immunosuppression
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5
Q

What is the clinical presentation for Candida Vulvovaginitis

A

Candida Vulvovaginitis

  1. Vulvar puritis, burning, soreness, irritation
  2. dysuria
  3. dysparenuria
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6
Q

What would we see on a physical exam on a pt with Candida Vulvovaginitis?

A

Candida Vulvovaginitis

  1. Physical exam
    1. erythema
    2. edema of vulva
    3. little or no discharge
      1. if present, discharge is white, thick, adherent, and clumpy (curd-like)
      2. Little or no odor
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7
Q

what are the two most common causitive agents of Candida Vulvovaginitis?

A

Candida Vulvovaginitis

Candida albicans (80%)

Candida glabrata

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8
Q

Trichomoniasis

Clinical presentation

A

Trichomoniasis

  1. Clinical Presentation
    1. malodorus, frothy discharge
    2. Burning, itching, and chafing
    3. diffuse vaginal erythema
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9
Q

Trichomoniasis

treatment

A

Trichomoniasis

Metronidazole

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10
Q

What is the sexually transmitted form of Treponema?

what disease does this cause?

A

Treponema pallidum

Syphillis

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11
Q

Syphilis: Treponema pallidum

features

A

Syphilis: Treponema pallidum

  1. Gram-negative, spirochete, obligate intracellular parasite
  2. lacks endotoxin
  3. can not be cultured
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12
Q

Syphilis: Treponema pallidum

painful/painless ulcers

A

Syphilis: Treponema pallidum

painless ulcers

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13
Q

what are the characteristics of the primary stage of syphilis?

A

Primary syphilis is characterized by a single chancre that develops after 3 weeks at the site where T. pallidum entered the body.

The chancre lasts about one month. If left untreated, primary syphilis may progress to secondary

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14
Q

What are characteristics of secondary syphilis?

A

Secondary syphilis

skin rash

infectious lesions

the rash will resolve with or without treatment.

about 2/3 of cases will develop latent syphilis

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15
Q

What is tertiary syphilis?

A
  1. tertiary syphilis develops in about 20% of latent syphilis cases
  2. gummas develop in skin or other tissues
    1. granuloma formation (cellular hypersensitivity reaction)
  3. CV lesions
  4. CNS degeneration
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16
Q

How do we test for syphilis?

A

testing for syphilis

  1. screening
    1. serology- non-specific: measures non-treponemal or wasserman antibody
      1. RPR
      2. VDRL
  2. confirmatory
    1. serology- specific: treponemal antibody
      1. Fluorscent Treponemal Antibody (FTA)
17
Q

A pt. presents with a “soft chancre” that is painful and necrotizing.

A

Chancroid (haemophilus ducreyi)

  1. Small G-neg, rod, facultative anaerobe
18
Q

who is at risk for developing chancroid (Haemophilus ducreyi)?

A

chancroid (Haemophilus ducreyi)

Endemic in Asia, Africa, and the carribbean

Sex trade workers, travelers

*Women are more likely to be asymptomatic carriers

19
Q

chancroid (Haemophilus ducreyi)

diagnosis

A

chancroid (Haemophilus ducreyi)?

  1. Gram stain from genital lesion
  2. culture to confirm
    1. growth below 35 C
    2. vancomycin enhances
20
Q

chancroid (Haemophilus ducreyi)

Treatment:

A

chancroid (Haemophilus ducreyi)

  1. Azithromycin
  2. Ceftriaxone
  3. Ciproflozacin
  4. Erythromycin base
21
Q

Mycoplasma genitalium

buzzwords

A

Mycoplasma genitalium

  1. pleomorphic
  2. cell membrane with sterols
  3. Terminal Tip-Like structure
  4. clinical symptoms are a result of immune response
  5. Fried egg appearance
22
Q

Mycoplasma genitalium

Diagnosis

A

Mycoplasma genitalium

  1. specimin:
    1. men- 1st void urine
    2. women- vaginal swab.
    3. grow very slowly in anaerobic conditions
23
Q

Ectoparasites

Diagnosis

A

Ectoparasites

Pubic lice- hair follicle and shaft

Scabies- burrow into upper dermis

  1. Diagnosis
    1. examine hair follicle for nits or adult lice
    2. Skin scrapings and KOH wet mount for scabes
24
Q

Ectoparasites

treatment

A

Ectoparasites

  1. Lice:
    1. Permethrin/Pyrethrin
    2. Malathion/Ivermectin
  2. Scabes:
    1. Permethrin or Ivermectin

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