GU infxn Flashcards
treatment herpes
famciclovir nucleoside anlogs
(processed by viral but not host DNA polymerase leading to chain termination)
congenital syphyllis does not damage fetus until ____
4th month (Abx can prevent)
treatment mollucscum contagiosum
scraping, liquid N, iodine
ritonavoir or cidofovir in immunocompromised patients with dleayed clearance
viral mophology mollucum contagiosum (pox virus)
ovoid to brick shaped
linear doubled standed DNA
rep;icate exlcuisvely in cytoplasm (carries all necessary proteins)
transmits via direct contact
treatment Chlamydia trachomatis
single dose IM ceftriaxone (to taget N gonorrhoeae)
7d course oral doxycycline or 1 oral dose azithromycin
presentation, dx and treatment candida albincans
vaginal itching and thick copious discarhge
increased incidence in antibiotic, new OBC, menses, pregnancy
dx via KOH prep
treatment Imidazole suppositories or single dose fluconazole
morphology gardnerella vaginalis
pleomorphic gram neg rods
not dependent on X factor or V factor for growth (as the simular haemophilus ducreyi is)
Jarisch Herxheimer Phenom
worsening of symptoms of T pallidum infxn after starting ABx due to pyrogen release by killed organism
Chalmydia tachomatis mrophology
cell target
gram negative
oblligate intracellular
ATP/ADP ranslocator usurbs host energy
tiny, not easily seen on gram stain
targets columnar epithelia cells at mucous membranes
presentation and diagnosis molluscum contagiosum
nodular wart like lesions
begin as papules and become ubillicated with central caseous plug
clusters of 5-20 nodules
Dx based on lesions and histology of large eosinopihllic cystoplasmic inclusions (mollluscum bodies)
Dx treponema pallidum
VDRL and RPR - abs against cardiolipin and lecithin release during bacterial damage (non-specific)
FTA-ABS - IFA to detect abs agasint T pallidum
PCR
Tertiary treponema palllidum:
Gummatous syphyllis =
cardiovascualr syphillis:=
neurosyphillis =
Gummatous syphyllis = - localied granulamouts lesions in skin/bones, noninfectious
cardiovascualr syphillis:= aneurysm in ascending aorta or arch, due to destruction of small arterioles supplying aorta
neurosyphillis = asymptomatic, subactue with fever, stiff neck, headache. Meningovascular with infarction due to ceerebral vessel damage. Tabes dorsales if spinal cord affected
presentation and dx, trichomonas vaginallis
most males asymptomatic, urethrtitis, prostatitis rare
scant watery discharge in females, posssible vaginitis+ painful urination
Dx via microscopy
dx chlamydia trachomatis
by elcusion
cytoplasmic inlcusions on giemsa stain or scarpings
PCR for DNA can be obtained from urine
presentation and dx garnerella vaginallis
part of normal flor
vaginitis,
prurititis, dysuria
prulent discharge with fishy ordor
dx with clue cells (multple pleomorphic bacterira in discharge)
Whiff test - amine odor when KOH added to sample
high PH
presentation and diagnosis haemophilus ducreyi
chancroid - tender papule with ertyhtmatous base
progresses to painful ulceration with assocd. LAD (unilateral)
dx based on culture, PCR of ulcer of lymph node aspiarates
ureaplasma urealyticum morphology
mycoplasma family - no cell wells, (beta lactams and gram stain don’t work)
pleomorphic shape
urease breaks down urine into amonia > alakaline urine
disease presentations Chlamydia trachomatis (5)
- *Non gonococcal urethritis** - most commom STI, dysuria, mucoid discharge
- *PID** - abnl vaginal discahrge, bloeeding, intense lower Adb pain
- *chlamydial epididymitis** - unilateral scotal swelling, tenderness, pain
- *lymphogranuloma venereum** - painless papule > heals. invades unilateral inguinal lymph nodes > drainprulent exudate through sinus tracks
- *Reiter’s syndrome-** complication - arthritis, conjuncitivits, blanitis circinata, keratodermia blenorrhagia (scaly rash on palms and soles)
Neisseria gonorrhea morphology
Gram neg dipplococci
oxidase positive
pili, outer membran porins (for invasion to epithelal)
opa proteins
iga proteast
LPS mediated destruction of cilia on neighboring cells
treatment Ureaplasma urealyticum
erthromycin
tetracycline
dx + presentation herpes simplex
HSV 1 or 2 specific antibodies
fevere
headaces
malaise
myalgias
LAD
Diease presentation neisseria gonorrheae
dx
urethritis with painful urination
purulent discharge
epididiymiiis, prostatitis, urethral strictures
endocervictis, PID
bacteriemia +septic arthritis > extremity lesions, fever
dx via gram stain on Thayer Marter VCM
presentation adn ddx ureaplasma urealyticum
carried by 60% healthy women
due to infection of lower UT
dyruria, yellow mucoid discharge
dx via pCR or culture (requires cholesterol and urea for growth)
tiny colonies (T-strain)
treatment hameophilus ducreyi
azithromycin
ceftriaxone,
ciprofloxacin
morpohlogy treponem a pallidum
gram negative spirochete
extra out membrane
perplasmic flagella
treatment gardernella vaginallis
metronidazole (flagyl)
clindamycin)
haemophilus decryi morphology
coccobacilli
facultative aneraobes
often associated with mucous membranes
trichomonas vaginallis morphology
four flagella, undulating membrane
trophozoite only form
treatment trichomonas vaginalis
metronidazole (flagyl)
tinidazole if resistant
pathophys of PHV integration events
disrupt expression of viral E2 gene - negative regulato of viral e6 and 37 oncogenes
HPV morphology and significant strains
papovirus, small circular DS DNA,
icosahedral, capsid, not eveloped
most genital caused by HPV 6 and 11
high risk 16 18 31 46
treatment T pallidum
penicillin
ethrythromycin
doxycycline
treatment Neisseria gonorrheae
IM ceftriaxone
(erthromycin eye drops prophylatic at birth)
infection stages treponema pallidum
primary - chancre, highly infectious, painless
secondary - hematogenic sprea, rash, feve LAD,alopecia, highy contagious *condyloma latum * at moist sites
;atent - asymptomatic, noninfectious (except fetal)
tertiary - slow inflammaition driven damage to organs
