Diebel: STDs Flashcards
1
Q
Urethritis
cervicitis
vaginitis
vaginosis
A
Inflammatory infections
2
Q
Urethritis
A
N. gonnorrhea
C. trachomatis
3
Q
Cervicitis
A
C. trachomatis
4
Q
Vaginitis
A
T. Vaginalis
C. albicans
5
Q
Vaginosis
A
Gardnerella
6
Q
Sypilis herpes chancroid lymphogranuloma venereum genital warts
A
Genital ulcers (non exudative)
7
Q
Syphilis
A
T. pallidum (no pain)
8
Q
Herpes
A
HSV1
HSV2
9
Q
Chancroid
A
H. ducreyi
10
Q
Lymphogranuloma venereum
A
C. tranchomatis
11
Q
Genital warts
A
HPV
12
Q
STI
A
AIDS
PID
13
Q
AIDS
A
HIV1
HIV2
14
Q
PID
A
N. gonorrhea
C. trachomatis
15
Q
Cancer
A
cervical carcinoma
KS
16
Q
Cervical carcinoma
A
HPV
17
Q
Kaposi
A
KSHV (HHV 8)
18
Q
22 y/o small raided lesions on cervix asymptomatic (no pain) Many partners labial veneral warts and friable erythematous cervix
A
HPV caused genital warts
19
Q
Single best screening procedure available for cervical cancer
A
Pap smear
20
Q
Tests used to test samples from a pelvic exam for presence of dangerous HPV TYPES in women >30 years
A
PCR
21
Q
Is HPV curable?
A
No
Genital warts can be removed but virus causing them remains with you. It’s possible for virus to resolve itself but it’s unpredictable.
22
Q
VF of HPV
A
Oncogenes in malignant types (16 and 18)
23
Q
DS DNA virus w/ a circular genome
A
HPV (Papovaviridae)
24
Q
infects epithelial cells of host that are in S phase>
local replication>
benign outgrowth of cells into GENITAL WARTS
A
HPV
25
cervical cancer associated w/ HPV
cervical carcinoma
26
48 hr painful urination
yellowish penile discharge
multiple partners
N. Gonorrhoeae
*typically has purulent discharge
27
Testing for N. gonorrhoeae?
Gram stain of urethral discharge*
DNA probes for PCR tests
ELSA- protein/Ab against bacteria
28
Gram - diplococci that is OXIDASE + and a glucose oxidizer
N. Gon
29
Specialized pilli for attachment to mucosal surface
Endotoxin
IgA protease
N. Gonn
30
Antigenic variation specialized pilli allows this bacteria to evade host host defenses and prevents killing by phagocytosis
N. Gonn
31
How does N. Gon cause urethritis in men and cervicitis in women?
```
N. gon attches via pili to mucosal cells or urethra or vagina>
evades mucosal Abs w/ IgA protease>
endocytosed>
kills ciliated cells>
Inflammatory response>
Urethritis/cervicitis
```
32
N. Gonn that progresses to uterus, fallopian tubes or ovaries
PID> increased risk of ectopic preg
33
N. Gonn that progresses from fallopian tubes to peritoneal cavity and leads to peritonitis and infection of the liver capsule
Fitz- Hugh Curtis Syndrome
34
N. Gonn that invades the submucosa, enters the blood stream, collects in synovial fluid
septic arthritis
35
Need for prophylactic erythromycin eye drops in neonates
```
neonates inoculate conjunctiva during passage through birth canal>
opthalmia neonatorum (neonatal conjunctivitis)>
increased risk for blindness
```
36
Mensturation and IUD
Higher incidence of infection w/ N. Gon
37
MCC cause of septic arthritis in sexually active ppl
N. Gon
38
Chocolate sheep's blood media that kills ALL other bugs: vanco, colistin, nystatin, SXT
Thayer Martin media
39
Treatment for N. Gon
ceftriaxone (+ doxy for probably concurrent chlamydia)
40
why is it difficult to develope a vaccine for N. gonn?
antigenic variation
41
```
Painful, itchy blisters on penis of 24 y/o M
Low grade fever, malaise, mild HA
Has had unprotected sex w/ new partner
CLEAR discharge
INGUINAL lymphadenoapathy
```
Herpes Simplex
42
Testing/dx of herpes simplex?
1. Tzank smear (GMNC), and Cowdry type A inclusion bodies
2. Viral cultures from base of vesicles
3. PCR to confirm virus type
43
Ds DNA virus w/ a liner genome belonging to the alpha herpes viridae fmaily
Herpes simplex
1: above waist
2: below waist
44
Latency of HSV 1/2
neuron
45
Reactivation of HSV 1/2 in immunosuppressed
leads to shingles> fomration of lesions over entire dermatome
46
What is needed to control HSV infections?
cell mediated immunity
47
Treats HSV, VZV, encephalitis and disseminated herpes
Acyclovir
48
MOA of acyclovir
requires VTK to activate acyclovir (prodrug) to acyclovir 3 phosphate which blocks viral DNA Pol and is a CHAIN TERMINATOR
49
Viral thymidine kinase is only effective in..
lytic infections/active viral infection
50
Does gancyclovir work to treat HSV?
NO, mainly used for B viruses because requires a different kinase
51
Endephalitis, keratoconjunctiviits, pharyngitis, esophagitis
HSV1
52
meningitis, encephalitis, pharyngitis, neonatal HSV
HSV2
53
25 y/o woman w/ profuse yellow, foamy, vaginal discharge w/ a foul odar
vulvular irritation and itching
ahs had multiple partners
Strawberry cervix
Trichomonas vaginalis
54
Elevated vaginal pH (above 4.5) is suggestive of...
trichomoniasis or bacterial vaginosis
55
Foul smelling fish odor d/t presence of amines + clue cells on gram stain
bacterial vaginosis
56
Low pH + large motile flagellated micro-organisms seen on low powered fields
trichomonas vaginalis
57
Clue cells
epithelial cell covered in bacteria
58
Small pear shaped protozoa with 4 anterior flagella + 1 and an undulating membrane
Trichomonas vaginalis
59
Bacteria that is a common biota of most people, exhibits NO opportunistic shift, and is transmitted through sexual contact
Trichomonas
60
Treatment for trichomonas
Metronidazole for pt and partner
61
22 y/o F w/ vulvular itching and thick, white vaginal discharge lasting for several days
Not currently sexually active
just completed course of antibiotics
Candida Albians
62
Testing for Candida?
Wet prep> shows yeast cells and pseudohyphae
Gram stain
63
Causes of candida albicans?
disruption of normal bacterial biota> over growth
64
Presence of pseudohyphae in a c. albicans wet prep?
yeast is growing rapidly and causing a yeast infection
65
Who is predisposed to yeast infections?
diabetics and pregnant women (menstruating women adn HIV +)
OPPORTUNISTIC infection
66
MCC of vaginitis
c. albicans
67
Treatment for candida?
topical and oral azoles
68
What types of cells does HIV infect?
T cells and macrophages (need CD4 and CxCR4 and CCR5)
69
HOw does HIV replicate?
reverse transcription
70
What are RF for HIV?
unprotected sex
| contaminated blood
71
How can HIV be treated?
HAART
NNRTI+ 2NRTI
PI + 2 NRTI
72
What other opportunistic infections is a pt w/ HIV susceptible to?
TB
candida
etc.
73
Female presents w/ low grade fever, malaise and a rash. She also recalls having painless ulcers that seemed to resolve on their own, and now, 6 weeks later, has a generalized rash on her palms and soles.
Secondary syphillis
74
gram - Spirochete bacteria
treponema pallidum (the syph)
75
Painless chancre (a small, hard red bump with firm margins) often occuring on internal and external genitalia
Primary syphilis
76
Lymphadenopathy and red/brown rash on all skin surfaces (including hands and feet) Appears 3-6 mos after chancre heals.
secondary symphillis
| type III hypersensitivity- Ab binds ag, gets attacked by complement, collateral damage> rash
77
Gummas
Painful swollen tumors indicative of tertiary syphilis
78
Argyll robertson pupil
Sign of neurosyphilis:
| adhesions along hte inner edge hte iris fix the pupil's position into a small irregular circle
79
"bark like" appearance of small arteries in aortic wall than can lead to aortic rupture
Tertiary syphillis
80
detect bacterium in syphillitic lesions during primary and secondary stages with...
WET MOUNT
*bacteria is VERY transmissable at thsis time
81
Anti-cardiolipin Abs
Sign of syphillis
82
Treatment for syphillis
Penicillin G> goal is to maintain blood level lethal to spirochete for at least 7 days
**impt to monitor for successful clearance of spirochete
83
Saber shins, saddle nose, CN 8 deafness, hutchinson teeth, and mulberry molars
Signs of congenital syphilis (MC in 2nd and 3rd trimesters)
84
How do you prevent congenital syphilis?
treat mother early in pregnancy as placental transmission typically occurs in first trimesteer
