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(Duluth) HRM Final Review > Diebel STDs > Flashcards

Diebel STDs Flashcards

1
Q

What organisms most commonly produce urethritis?

A

N gonorrhoeae, C thrachomatis, M hominis

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2
Q

What organisms most commonly cause cervicitis?

A

C trachomatis, M. Genitalium

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3
Q

What organisms most commonly cause vaginitis?

A

T gavinalis, C albicans

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4
Q

What organisms most commonly cause vaginosis?

A

Gardnerella spp. Mobiluncus spp.

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5
Q

What organism is responsible for lymphogranuloma venereum?

A

C trachomatis

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6
Q

What organisms most commonly cause PID?

A

N gonorrhoeae, C trachomatis

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7
Q

What cells are seen on pap smear in an individual infected with HPV?

A

Koilocytes - abnormal giant cells

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8
Q

What strains of HPV are most common?

A

6, 11

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9
Q

What strains of HPV are most dangerous?

A

16, 18, 31, 33, 35

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10
Q

What type of screening test is done in order to identify the serotype of HPV?

A

PCR based screening test

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11
Q

What is the genetic classification of HPV?

A

DsDNA, group I, circular genome, icosahedral, nonevelopoed, papovaviridae, papillomavirus

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12
Q

What cells does HPV infect first? Why?

A

The basal cells - more likely to be undergoing replication and therefore would have host DNA polymerase

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13
Q

What does the host cell provide to the HPV virus?

A

DNA polymerase

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14
Q

In HPV, the E6 viral protein is responsible for what?

A

Ubiquinating p53 for degradation

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15
Q

What is the normal function of p53?

A

Senses DNA damage and triggers cell cycle arrest

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16
Q

In HPV infection, the viral protein E7 is responsible for what?

A

Interacts with and binds Rb, thereby releasing E2F; E2F can then go act as a transcription factor

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17
Q

What is the normal function of Rb protein?

A

Holds onto E2F and keeps it in cytosol so proliferation cannot occur

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18
Q

How is E2F normally released from Rb protein?

A

Cycline D and E phosphorylate Rb, resulting in the release of E2F

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19
Q

What organism typically causes a purulent discharge in males?

A

N gonorrhea

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20
Q

What microorganisms will typically cause clear discharge?

A

C trachomatis, M hominis, Ureaplasma urealyticum

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21
Q

What is the gram stain and morphology of N gonorrhea? Other characteristics?

A

Gram negative, diplococci; oxidase +, oxidizes glucose only

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22
Q

What type of media does N gonorrhea grow on?

A

Thayer Martin Media

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23
Q

What is in Thayer Martin Media?

A

Chocolate sheep’s blood, beef infusion, casein, starch, Vanco, Colistin, Nystatin, SXT

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24
Q

What is the effect of adding colistin to thayer martin media?

A

Kills most G - bacteria

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25
Q

What is the importance of adding SXT to thayer martin media?

A

G - organisms, particularly swarming proteus

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26
Q

What virulence factors does N gonorrhea have?

A

Specialized pili, endotoxin, capsule, IgA protease

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27
Q

What is the treatment for N gonorrhea urethritis?

A

Ceftriaxone (+ azithromycin for probable concurrent Chlamydia infections)

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28
Q

Prophylactic erythromycin drops can be given to a neonate to prevent what STI?

A

N gonorrhea

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29
Q

STI that is gram - diploccoi, oxidase +, oxidizes only glucose

A

N gonorrhea

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30
Q

What is the importance of the specialized pili found on N gonorrhea?

A

Allows attachment to mucosal surface, antigenic variation to evade host, prevents killing by phagocytosis

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31
Q

If PID is not treated, what could it progress to?

A

Fitz-hugh-curtis syndrome - involvement of liver capsule; also increases risk for ectopic pregnancy and infertility

32
Q

What population of women have a higher incidence of N gonorrhea infection?

A

During menstruation or IUD

33
Q

What serovars of Chlamydia trachomatis are responsible for conjunctiva?

A

A-C

34
Q

What serovars of chlamydia are responsible for GU infections?

A

D-K

35
Q

In a chlamydia trachomatis infection with serovars D-K, what cell type is the infection initiated at?

A

Columnar epithelium

36
Q

Serovars L1-L3 of chlamydia trachomatis is responsible for what?

A

Lymphogranuloma venereum

37
Q

How does lymphogranuloma venereum present?

A

Painless genital ulcer at site of infection; followed by painful inguinal LAD (formation of buboes)

38
Q

What is the leading cause of blindness globally?

A

Trachoma serotypes A-C

39
Q

What are seen on LM in infections of chlamydia trachomatis?

A

Intracellular inclusion bodies

40
Q

What is the treatment for chlamydia trachomatis?

A

Azithromycin; consider ceftriaxone for gonorrhea

41
Q

What are the two forms of C trachomatis? Which is infectious? Replicative?

A

Elementary body (infectious) and reticulate body (replication)

42
Q

The MOMP on elementary bodies recognizes what on columnar epithelium?

A

Sialic acid

43
Q

How does the elementary body avoid lysosomal degradation?

A

Has type III secretion system that inhibits the lysosome

44
Q

In order to undergo replication, the reticulate body needs what? What type of replication does it undergo?

A

Needs ATP from the host cell; undergoes binary fission

45
Q

What STI can cause painful ulcers?

A

Haemophilus ducreyi and HSV-2

46
Q

Donovanosis forms what type of ulcers? What is the causative organism?

A

Painless; K granulomatosis

47
Q

What is a Tzanck smear used for?

A

Herpes infected cells; will see giant multinucleated cells and Cowdry type A inclusion bodies

48
Q

What is the genetic classification of HSV-2?

A

DsDNA, group I, linear, icosahedral, enveloped, herpesviridae, alpha

49
Q

What is used for the treatment of HSV?

A

Acyclovir

50
Q

HSV DNA encodes for what?

A

Many proteins required to promote viral DNA replication; including viral DNA-dependent DNA polymerase

51
Q

What type of immunity is essential in controlling infection with HSV infection?

A

Cell mediated

52
Q

Direct microscopic examination of cells from the base of a HSV lesion will show what?

A

Tanck smear shows multinucleated giant cells and Cowdry type A inclusion bodies

53
Q

What is the MOA of acyclovir?

A

Inhibits DNA replication of viral genome as it is missing a 3’OH group

54
Q

25 yo F presents iwth profuse yellow, foamy vaginal discharge with a foul odor. Additionally she has vulvar irritation and itching and dyspareunia. Physical exam reveals vaginal discharge, vulvar erythema, diffuse erythematous lesion of cervix (“strawberry” cervix). What organism is likely responsible?

A

Trichomonas vaginalis

55
Q

What type of discharge is seen with Gardnerella?

A

Typically white to gray, moderate, malodorous

56
Q

What type of discharge is commonly seen with C albicans?

A

Itchiness present, typically white, small amount and clumped

57
Q

What is the typical discharge seen in an infection with Trichomonas vaginalis?

A

Frothy, yellow to green; foul smelling

58
Q

What vaginal infections result in a pH >4.5?

A

Trichomoniasis (Trichomonas vaginitis) and vaginosis

59
Q

The presence of volatile amines with a KOH amine test is a presumptive diagnosis for what?

A

Bacterial vaginosis

60
Q

What is seen on a wet prep for bacterial vaginosis?

A

Clue cell

61
Q

What is seen on a wet prep in trichomonas vaginitis infection?

A

Large, motile (flagellated organisms)

62
Q

Describe the appearance of Trichomonads.

A

Small, pear shaped protozoa with 4 anterior flagella

63
Q

What is the treatment for trichomonas vaginitis?

A

Metronidazole

64
Q

What is the appearance of C albicans on LM?

A

Dimorphic fungi - bud (yeast) and hyphae (mold) form; also has pseudo hyphae and can see germ tubes

65
Q

What is the most common cause of vaginitis?

A

C albicans

66
Q

The presence of what in a smear of C albicans in indication that the yeast is growing rapidly and causing yeast infection?

A

Pseudo hyphae

67
Q

Who are predisposed to vaginal infection with C albicans?

A

Diabetics, pregnant women, menstruation, HIV, disruption of normal biota (antibiotics)

68
Q

What is treatment for C albicans?

A

Oral fluconazole; topical azole for for vaginal

69
Q

Patient with CD4 count of 55, what other infections is he/she susceptible to?

A

A fumigatus; C albicans; CMV; cryptococcus neoformans (meningitis), cryptosporidium (chronic watery diarrhea), EBV (lymphoma), MAC; toxoplasma gondii

70
Q

What STDs present with painless genital ulcers?

A

Syphillis (Treponema pallidum), lymphogranuloma venereum (chlamydia trachomatis), Donovanosis (K granulomatosis)

71
Q

What are nonspecific serologic tests used for syphilis screening? If positive then what?

A

VDRL/RPR; confirm with FTA-ABS

72
Q

Having ulcer disease increases the chances of infection with what?

A

HIV

73
Q

During what stages is syphillis transmissible? And what stages is it not transmissible?

A

Primary and secondary = transmissible; latent and tertiary not transmissible

74
Q

What is the appearance of a chancre?

A

Small, red hard bump that enlarges and breaks down, leaving a shallow crater with firm margins

75
Q

If a sample was taken at the base of the chancroid, what could be done to visualize the organism? What would be seen?

A

Dark field microscopy; (gram -) spirochete

76
Q

What is the treatment for syphillis?

A

Penicillin G - parenterally in large dose with benzathine or procaine

77
Q

What are alternative drug therapies for syphillis if allergic to penicillin?

A

Tetracycline and erythromycin

(Duluth) HRM Final Review (22 decks)

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