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Repro > GU infections > Flashcards

GU infections Flashcards

1
Q

Double stranded DNA
Enveloped
Space between envelope and capsid is packed with tegument proteins

A

Alpha-Herpesvirus

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2
Q

Two life cycles of HSV

A
  1. Quiescent latent infection = limited to neurons (sacral ganglion), not associated with clinical symptoms
  2. Lytic replication = active, many infectious viruses are produced, happens at the mucosa/skin at the site of initial inoculation
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3
Q

Can HSV be transmitted if there are no lesions present?

A

Yes - on any given day have 25% chance of shedding virus even without lesions

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4
Q

Diagnosis of HSV

A

Clinical presentation - vesicles
Detection of virus in lesions – culture, IFA, PCR
Detection of HSV-1 or HSV-2 specific antibodies

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5
Q

Treatment of HSV

A

Famciclovir, Acyclovir – antivirals, nucleotide analogs that specifically target viral DNA polymerase and inhibit replication

NO TREATMENT for latent infection and no vaccine

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6
Q

Very large linear double stranded DNA fused at both ends – Poxvirus family

A

Molluscum Contagiosum

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7
Q

Where does Molluscum Contagiosum replicate?

A

In the cytoplasm of infected cells – unique for DNA virus

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8
Q

How is Molluscum Contagiosum diagnosed and treated?

A

Diagnosis based on presentation of lesions and histology (large eosinophilic cytoplasmic inclusions)

Treated with scraping, liquid nitrogen, or iodine
More severe disease in immunocompromised patients can be treated with ritonavir or cidofovir. No vaccine.

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9
Q

Small double stranded DNA virus
Papovavirus family
Icosahedral capsid, not enveloped

A

Human Papillomavirus

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10
Q

How does HPV lead to disease?

A

Replicates in the upper level of epithelium – virus DNA has to be maintained as an episome for productive replication
Replication stimulates cellular division– etiology of HPV-induced genital warts

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11
Q

How can HPV lead to cancer?

A

Accidental integration of broken viral DNA terminates virus replication –> abortive infection or cancer

Viral DNA integration that disrupts E2 gene increases risk of cancer along with expression of E6 and #7

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12
Q

Treatment of HPV

A

Wart destruction in office by cryotherapy, or application of acid or removal with laser
Vaccine against high-risk strains (6, 11, 16, 18)

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13
Q

Pleomorphic gram negative rods (coccobacilli)

A

Haemophilus ducreyi

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14
Q

What does haemophilus ducreyi infection lead to?

A

Painful, ulcerated lesion with lymphadenopathy

Uncommon in US

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15
Q

How is H. ducreyi diagnosed?

A

Culture or nucleic-acid based detection

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16
Q

How is H. ducreyi treated?

A

Azithromycin, ceftriaxone, ciprofloxacin

17
Q

Pleomorphic gram negative rods

Part of normal vaginal flora in many sexually active women

A

Gardnerella vaginalis

18
Q

How does G. vaginalis cause disease?

A

Disturbance of normal flora leads to outgrowth, causing disease
Vaginal lactobacillus keeps G. vaginalis in check
Can synergize with anaerobes to cause disease

19
Q

How does G. vaginalis present?

A

Vaginitis, pruritis, dysuria, foul smelling copious vaginal discharge with fishy odor

20
Q

What is the diagnostic criteria of bacterial vaginosis?

A 
Amsels criteria = 
Vaginal pH greater than 4.5
Presence of clue cells in vaginal fluid
Milky, homogeneous vaginal discharge
Release of amine (fishy) odor after addition of 10% NaOH
21
Q

Treatment for BV?

A

Nitroimidazoles (metronidazole and tinidazole) or clindamycin

Recurrence is common regardless of therapy

22
Q

Smallest free-living bacteria
Has no cell walls – gram stain and B-lactams are useless
Slow rate of growth

A

Ureaplasma urealyticum

23
Q

Treatment for ureaplasma urealyticum

A

Erythromycin

Doxycycline

24
Q

Gram negative spirochete
Extra outer membrane
Periplasmic flagella

A

Treponema pallidum

25
Q

What are the stages of sphyillis caused by Treponema pallidum?

A

Primary stage = painless chancre at inoculation site – highly infectious
Secondary stage = systemic spread to multiple organs and CNS
Latent = asymptomatic and noninfectious, can relapse to secondary or remain asymptomatic
Tertiary = immune system driven damage to multiple organs (skin, bones, vessels, nerves)

26
Q

How is syphilis diagnosed?

A

Cannot be cultured on conventional medium or seen on light microscopy

Darkfield microscopy, serology and nucleic acid-based approaches

27
Q

Treatment of syphilis

A

Benthazine penicillin – modified for slow absorption and long half life, not effective against tertiary stage

28
Q

Gram negative obligate intracellular bacteria

A

Chlamydia trachomatis

29
Q

2 forms of Chlamydia

A

Elementary body = metabolically inactive, cannot replicate, but infectious and stable

Initial body = aka reticulate bodies, forms intracellular inclusions, metabolically active, intracellular non-infectious form, can divide and make more of itself

30
Q

Treatment for Chlamydia

A

Azithromycin and doxycycline

31
Q

Gram negative oxidase and catalase positive diplococci

A

Neisseria gonorrhea

32
Q

Diagnosis of Neisseria gonorrhea

A

Chocolate agar - nonselective
Thayer-Martin - selective
Culture
Nucleic acid based used more now

33
Q

Treatment of Neisseria gonorrhea

A

Ceftriaxone

34
Q

Protozoa
Trophozoite

Males asymptomatic
Females mild scant watery discharge or vaginitis with itching, burning and painful urination

A

Trichomonas vaginalis

35
Q

Diagnosis of Trichomonas vaginalis

A

Microscopic examination of vaginal or urethral discharge – usually highly motile in urine

36
Q

Treamtent for Trichomonas vaginalis

A

Metronidazole (flagyl)

37
Q

Yeast
Commonly in immunocompromised
Can cause vaginitis

A

Candida albicans

38
Q

Diagnosis of candida albicans

A

KOH prep of skin scrapping

39
Q

Treatment of candida albicans

A

Imidazole vaginal suppositories or single oral dose of fluconazole

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