GU system Flashcards
Treponema pallidum
- gram negative spirochete
- obligate internal parasite
- Rabbits used as animal model
The syph
Great imposter, signs and sx look like a lot of other things
Virulence of treponema pallidum
(syphilis)
- Fibronectin coat is antiphagolytic
Lesions are primarily the result of the inflammatory response
Chancre appears
Local multiplication and dissemination to nearby lymph nodes
Primary syphilis
-Syphilis chancre is the principal lesion of primary syph
Maculopapular rash
Mucosal warty lesions - condylomata lata in 1/3 of pts
Immune complexes form in anteriolar walls
Secondary syphilis
Neurosyphilis (cortical degen, etc)
Cardiovascular syphilis (AAA)
Granulomata (gummas) in any tissue
Tertiary syphylis
Hutchinson’s Triad
-Notched incisors
Interstitial keratitis
8th nerve deafness
Congenital syph
can also cause lesions, nasal obstruction, osteitis of nasal bones
How to dx syph
Treponemal test (specific serology) Nontreponemal test (nonspecific serology test, screening for cardiolipin flocculatio) Darkfield microscopy
Virulence factor of neisseria gonorrhea
gram neg diplococcus w/ kidney bean cells
Plasmid - chromosome mediated resistence to penicillins, tetracylcines, spectinomycin, fluoroquinolones
Critical step in gonarrhoeae pathogensis
attachment of epithelia pili and surface proteins
Complications of gonnorhea
1) Various local effects (cervicitis, urethritis and d/c)
2) Acute salpingitis or pelvic inflammatory disease (PID)
3) Disseminated Gonococcal Infection (DGI) - arthritis/purulent arthritis, dermatitis
Gold standard to dx gonarrhea
Nucleic acid amplification
Chlamydia trachomatis
can also cause PID
Obligate intracellular bacteria
gram neg, require host ATP, elementary body, reticulate body
Lymphogranuloma venerum
Caused by serotype of Chlamydia trachomatis
Gold standard of dx of chlamydial infections
isolation in cell culture
-Noncultural test avail: nucleic acid probes are very sensitive
Main resevoir is genital tract of sexually active
Present in >80% of people who boned more than 3 people
Responsible for 50% of nongonococcal, nonchlamydial urethritis in men
Cause of chorioamnionitis and postpartum fever in women
Ureaplasma urealyticum
Categories of vaginitis:
Trichomonas tenax
commensal in the mouth
Categories of vaginitis:
Trichomonas hominis
Commensal in the intestine
Categories of vaginitis:
Trichomonas vaginalis
yellow-grey d/c
Cause of STD
(flagellated protozoan)
Extracellular anaerobe
Bacterial Vaginosis
pH 5-6 w/ presence of CLUE CELLS
NOT AN STI
Caused by overgrowth of opportunistic pathogen
Fishy odor, homogenous secretions (grey d/c)
Haemophilus ducreyi
CHANCROID
Odor-less, thick, WHITE, frothy d/c
Itching, burning during vag activities
Vaginal candidiases
-treat with Miconazole or oral fluconazole
Candida albicans virulence
Germ tube is more adhesive than yeast cell
Dx of candida
-Direct microscopic exam:
Large gram + cells
Hyphae, pseudohyphae, yeast
-Culture to see germ tubes
Soft chancre of Chancoid
-bleeds readily, lacks induration
3-5 days post infection
Vesicle/papule that progresses quickly to pustulation and ulceration
Progressive enlargement and multiple ulcers
