Infections and STDs (2) Flashcards
clinical vignette for vulvovaginitis from bacterial vaginosis
adherent yellowish discharge; pH > 5; fishy amine odor in KOH; clue cells; gram neg dominate
clinical vignette for vulvovaginitis from Candida spp
vulvoaginitis, pruritis; erythema;
discharge w/ consistency of cottage cheese
clinical vignette for vulvovaginitis from Trichomonas vaginalis
“Strawberry cervix”;
foamy purulent discharge;
many PMNs and motile trophozoites micro (corkscrew motility)
Pathogenesis of vulvovaginitis from bacterial vaginosis
overgrowth of Gardnerella vaginalis;
anaerobes
Pathogenesis of vulvovaginitis from candida spp
antibiotic use => overgrowth, immunocompromised
Pathogenesis of vulvovaginitis from trichomonas vaginalis
vaginitis w/ discharge
diagnosis of vulvovaginitis from bacterial vaginosis
clue cells, gram neg rods
diagnosis of vulvovaginitis from candida spp
germ tube test;
gram pos yeasts in vaginal fluids
diagnosis of vulvovaginitis from trichomonas vaginalis
pear-shaped trophozoites w/ corckscrew motility
Case vignette and key clues for PID
adnexal tenderness, bleeding, dyspareunia;
vaginal discharge, fever;
chandelier sign
onset follows menses
pathogenesis for PID caused by Neisseria gonorrhoeae
pili and IgA protease production
pathogenesis for PID caused by chlamydia
intracellular in mucosal epithelia;
TYPE 4 HYPERSENSITIVITY DAMAGE
diagnosis for PID caused by Neisseria gonorrhoeae
Gram neg diplococci in PMNs;
culture on Thayer Martin
diagnosis for PID caused by Chlamydia tachomatis
tissue culture;
intracytoplasmic inclusion bodies in mucosal cells
Case vignette and key clues for Condyloma acuminatum (genital warts)
lesions are papillary/wart-like lesions;
may be sessile or pedunculated;
koilocytotic atypica is present;
anogenital
most common cause for condyloma acuminatum (genital warts)
HPV
Pathogenesis for condyloma acuminatum (genital warts)
HPV proteins E6, E7 inactivate cellular antioncogene;
associated w/ cervical CA
Diagnosis for condyloma acuminatum (genital warts)
dsDNA, naked, icosahedral;
intranuclear inclusion bodies
case vignette or key clues for genital herpes
multiple, painful, vesicular, coalescing;
recurring
most common cause of genital herpes
HSV
pathogenesis for genital herpes
latent virus in sensory ganglia reactivates
Diagnosis fo genital herpes
virus culture, intranuclear inclusion bodies; syncytia (Tzanck smear) dsDNA enveloped (nuclear), icosahedral
case vignette and key clues for primary syphilis
painless chancre forms on glans penis (or vulva/cervix) and heals w/in 1-3 months
case vignette and key clues for secondary syphilis
local or generalized rash lasting 1-3 months;
involves palms and soles
case vignette and key clues for tertiary syphilis
affects central nervous system, hear and skin;
characteristic lesion is gumma;
single or multiple;
most common in liver, testes, and bone
case vignette and key clues for chancroid
nonindurated, painful ulcer;
suppurative w/ adenopathy;
slow to heal
most common cause of syphilis
treponema pallidum
most common cause of chancroid
haemophius ducreyi
case vignette and key clues for lymphogranuloma venereum
soft, painless papule heals;
lymph nodes enlarge and develop fistulas;
genital elephantiasis may develop
most common cause lymphogranoma venereum
chlamydia trachomatis serotypes L1-3
Pathogenesis of primary syphilis
3 week incubation during which spirochetes spread throughout body
pathogenesis of secondary syphilis
develops 1-2 months after primary stage
pathogenesis of tertiary syphilis
develops in 1/3 of untreated patients;
NEUROSYPHILIS =>including meningovascular, tabes dorsalis and general paresis;
obliterative endarteritis of vasa vasorum of aorta can lead thoracic aneurysm
pathogenesis of chancroid
unknown
pathogenesis of lymphogranuloma venereum
obligate intracellular
Diagnosis of primary syphilis
biopsy/scarping viewed w/ dark-field microscopy shows spirillar organisms
Diagnosis of secondary syphilis
serology => VDRL positive (nonspecific);
FTA-Abs (specific)
diagnosis of tertiary syphilis
serology=> FTA-abs; non-specific tests may be negative
diagnosis of chancroid
gram neg rods;
chocolate agar => requires NAD and hemin
diagnosis of lymphogranuloma venereum
cell culture;
glycogen containing inclusions
