Genito-urinary Infections Flashcards

Question

Main organisms

Answer 1

``` Gonorrhoea Chlamydia Syphilis HIV virus Genital herpes Hepatitis B ```

Answer 2

Fully virulent human pathogen - not a commensal Asymptomatic carrier state Acute urethritis - in 95% males, only 50% females suffer discharge and dysuria Ascend to fallopian tubes - acute salpingitis, pelvic inflammatory disease - endometritis - cophoritis (ovaries) - sterility Ophthalmia neonatorum - infant blindness Oral gonorrhoea - very rare but can result from oral sex with infected man

Answer 3

AEROBIC Surface pili - bundle forming Opa proteins Lipo-Oligosaccharide sialylated - complement resistance - host mimicry and release sialic acid Por proteins - nucleate actin aiding cell invasion Possesses IgA protease - aids survival inside host cells Antigenic variation hinder vaccination development Release into bloodstream disseminates infection to other sites, arthritis, endocarditis

Answer 4

In 1980s, fear of HIV infection and increased condom usage (barrier methods) decreased infection in developed countries Very recently, number of cases increasing again due to promiscuity, travel (including sex trade) and use of oral contraceptives over barrier methods Co-infection of HIV and N. gonorrhoeae increases transmission of HIV by 500% (WHO) Infection with N. gonorrhoeae also increases likelihood of contracting HIV 5x

Answer 5

1. urethral swab - sub-culture on chocolate agar - oxidase positive - gram -ve diplococcus Antibiotic prophylaxis of contacts Historically treated with penicillin and tetracyclines Ceftriaxone and azithromycin recommended 3rd world strains are penicillin and tetracycline resistance

Answer 6

Major venereal disease for at least last 600 years "French disease" Treatment with mercury - ‘ A night in the arms of Venus leads to a lifetime on Mercury’

Answer 7

Treponema pallidum Exclusively human 3rd most frequent STD in USA Sexual contact via minute skin abrasions Vertical transmissions - cross placental congenital syphilis 1. primary chancre at site of infection 2. enlarged inguinal nodes 3. flu like illness, headache, fever, myalgia, mucocutaneous rash, spontaneous resolution 4. tertiary syphilis - neurological issues, paralysis, aortic lesions, heat failure, progressive destructive disease, splenomegaly Teeth can be malformed

Answer 8

With HIV Hinders tx Increases infectivity and spread of HIV

Answer 9

Transmitted cross placenta - still birth - congenital infection - birth deformities, silent infection, presents as facial and dental deformities at 2 years of age

Answer 10

Most common STI in the UK Often asymptomatic in females 50% symptomatic in males Re-infection common as immunity weak 7-14 day incubation Disease due to direct damage to cells and immunopathology causing fibrosis and scarring Can cause conjunctivitis - common co-occurence Trachoma biggest cause of preventable blindness

Answer 11

``` Common cause of conjunctivitis Also in neonates- infection in birth Major cause of blindness worldwide with 6 million cases of blindness due to trachoma -not STI in true sense ```

Answer 12

``` Asymptomatic infection ~ 50% Non specific urethritis Strong associations with: Acute epididymitis Prostatitis Male infertility ```

Answer 13

Asymptomatic infection ~ 70 % Mucopurulent cervicitis Urethral infection Pelvic inflammatory disease in up to 40% - ascending infection involving uterus, fallopian tubes, and other pelvic structures Complications include chronic pelvic pain, ectopic pregnancy and infertility

Answer 14

homosexual men mainly men - acute onset urethritis - genital swelling - knees ankles and toes - REITER'S syndrome Neonates infected during birth --> 20% conjunctivitis +/or peumonia

Answer 15

``` Small Obligate intracellular parasite Small genome Enters through minute abrasions Specialised life cycle Avoid but not stimulate immune responses ``` Prefers to infect non-ciliated columnar and cuboidal epithelium - genital tract from urethra up to fallopian tubes and rectum also respiratory and conjunctival cells