Exam #6: STD II Flashcards

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1
Q

What causes syphilis?

A

Treponema pallidum (spirochete)

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2
Q

List the characteristics of Treponema pallidum.

A

Thin Gram (-) spirochete
Motile
Microaerophilic

*Does NOT grow in cell free culture, very difficult to grow

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3
Q

Describe the structure of Treponema pallidum.

A

Gram (-) cytology, but DOES NOT gram stain
Flexible
Peptidoglycan surrounds axial fibrils
Wound endoflagella
Cell wall & axial fibrils are covered by an outer bilayered membrane

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4
Q

How is syphilis diagnosed?

A

Dark-field micrscopy
Direct fluorescence
Antibody/ serology is most common

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5
Q

How is primary syphilis characterized?

A

1+ skin lesions (chancres)
Hard
Indurated
Painless

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6
Q

What causes the lesion & how long does it last?

A

Inflammation causes the lesion
Onset is 10-90 days post initial infection
Lasts 2 weeks–>2 months

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7
Q

How is secondary syphilis charactertized?

A

Disseminated disease

  • Flu-like syndrome
  • Prominent skin lesions on plams & soles
  • “Condylomata lata”
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8
Q

What are Condylomata lata?

A

Raised lesions in skin folds associated with secondary syphilis

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9
Q

How is latent syphilis characterized?

A

Asymptomatic period

  • Lasts years to decades
  • Can relapse into secondary syphilis
  • Transmission possible esp. from mother to child
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10
Q

How is tertiary syphilis characterized?

A

Diffuse, chronic inflammation
Can cause devastating destruction of virtually any organ/ tissue
Gumma

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11
Q

What is a gumma?

A

Granulomatous lesions that may be found in bone, skin, & other tissues i.e. brain & heart associated with tertiary syphilis

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12
Q

What were the outcomes of the Tuskegee syphilis experiment?

A

IRB

Informed consent

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13
Q

What is congenital syphilis?

A

Mother-to-child transmitted syphilis

  • Often terminates pregnancy, but when it doesn’t:
  • Chronic rhinitis–>saddle nose
  • “Condylomata lata”
  • Teeth & bone malformation, blindness, deafness, & cardiovascular syphilis
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14
Q

What is Hutchinson’s triad?

A

Small
Malformed
Widely spaced teeth

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15
Q

What are the serologic tests for syphilis? What are their targets?

A

Treponemal test= detects antibody specific to T. pallidum

Nontreponemal= measures antibody directed against cardiolipin

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16
Q

When will a person start to exhibit a positive response to serologic tests through the infectious process?

A

Four weeks

17
Q

How is syphilis treated?

A

PCN

18
Q

What is NGU?

A

Non-gonococcal urethritis

i.e. when Gonorrhea & Chlamydia don’t cause urethritis

19
Q

What are the most common causes of NGU?

A

Mcoyplasma genitalium & Ureaplasma urealyticum

20
Q

List the characteristics of Mcoyplasma genitalium & Ureaplasma urealyticum.

A

DO NOT have a cell wall
Not stained
Pleomorphic

Plasma membrane contains sterols

21
Q

What is the characteristics morphology of Mycoplasma genitalium?

A

“Fried-egg” appearance

22
Q

What is Mycoplasma genitalium resistant to?

A

Doxycycline

23
Q

What is Mycoplasma genitalium susceptible to?

A

Azithromycin

24
Q

How is Ureaplasma treated?

A

Doxycycline

25
Q

What is Chancroid caused by?

A

Haemophilus ducreyi

26
Q

List the characteristics of Haemophilus ducreyi.

A

Gram (-) pleomorphic coccobacillus

27
Q

What is required for the growth of Haemophilus ducreyi ?

A

X & V factor

28
Q

What are the symptoms of Chancroid?

A

Genital ulcers

  • Painful chancre (vs. painless)
  • Soft (vs. hard)
  • Multiple vs. 1 lesion
  • Lymphadenopathy

“You do cry with ducreyi”

*Note that diagnosis is challenging because labs are NOT set up to detect b/c of low prevalence

29
Q

How is Haemophilus ducreyi i.e. Chancroid treated?

A

Macrolides

30
Q

What causes Donovanosis or Granuloma inguinale?

A

Klebsiella granulomatis

31
Q

What are the symptoms of Donovanosis?

A
  • Primary lesion is ulcerated
  • Lesions are painless & bleed easily
  • Significant genital damage can occur
  • Hard
32
Q

How is Donovanosis diagnosed?

A

Donovan bodies

33
Q

Describe the medical decision making process when a patient presents with a genital ulcer.

A

1) Syphilis vs. Genital Herpes?

2) IF NOT, then chancroid or donovanosis

34
Q

M. genitalium vs. Ureaplasma & doxycycline?

A

M. genitalium is resistant!

Ureaplasma is susceptible