Infectious Disease 2 Flashcards
- What are the 5 main organisms that cause infections of the cervix and the vagina?
- Which ones are not sexually transmitted?
- Which ones are sexually transmitted?
- Gardnerella vaginalis in bacterial vaginosis (BV): not ST
- Candida albicans in vulvovaginal candidiasis: not ST
- Trichomonas vaginalis in trichomonas infections: ST
- Neisseria gonorrhoeae in gonorrhea infections: ST
- Chlamydia trachomatis in chlamydia infections: ST
Which infection is often associated with a foul amine odor and can be passed from female to female during sex and is not typically tested or treated in med?
gardnerella vaginalis (BV)
Which infection rarely causes symptoms in men as yeast but causes vaginitis with thick, curd-like consistency and can also cause intense vaginal and vulvar pruritis?
candida albicans
Which infection(s) causes urethritis, dysuria and other urinary symptoms in men and can cause vaginitis and cervicitis in women?
- trichomonas vaginalis
- neisseria gonorrhoeae
- chlamydia trachomatis
How can you test for gardnerella vaginalis?
- female pelvic exam with wet mount test (done in office)
- DNA hybridization probe testing (Affirm VPIII) (done in office but sent to lab for evaluation)
How can you test for candida albicans?
- female pelvic exam with wet mount test (done in office)
- DNA hybridization probe testing (Affirm VPIII) (done in office but sent to lab for evaluation)
- vaginal culture (rare-done in office but sent to lab or eval)
How can you test for trichomonas vaginalis?
- female pelvic exam with wet mount test (done in office)
- DNA hybridization probe testing (Affirm VPIII) (done in office but sent to lab for evaluation)
- nucleic acid amplification tests (in office, sent to lab for eval)
- vaginal culture
How can you test for neisseria gonorrhoeae?
- nucleic acid amplification testing NAAT
- bacterial culture (rare)
How can you test for chlamydia trachomatis?
- nucleic acid amplification testing NAAT
- bacterial culture (rare)
What is the purpose of doing a wet mount?
determining causative agent in vaginitis or cervicitis:
- vulvovaginal yeast infection
- bacterial vaginalis
- trichomoniasis
(immediate result)
What test is the only one where you can you a cotton swab to perform a test as we don’t need sterility in this instance?
wet mount
How many mL of normal saline are mixed with the swabs during a wet mount?
0.5 mL
- In a wet mount, you can formulate one or two slides, one with (…) and one without (…)
- What does this (substance you add) do?
- with KOH, without KOH
- lyses cell walls of bacteria, trichomonads, WBCs, and RBCs may be present; makes it easier to see bacteria
Describe the whiff test?
- prior to performing wet mount, place KOH on slide
- evaluate for an amine or fishy odor
- if present = bacterial vaginosis
- may also be present in trichomonas infections
What can you also do to test for infections other than the wet mount for cervical infections?
- vaginal pH
- What is the normal vaginal pH?
- If it is higher than 4.5, what does this indicate?
- If it is lower than 4.5, what does this indicate?
- 3.8-4.5
- bacterial vaginosis
- vulvovaginal candidiasis
On a wet mount, if the edges of epithelial cells are covered by coccobacilli or “clue cells”, what does this indicate?
bacterial vaginosis
What is this wet mount of?
vulvovaginal candidiasis
What is this a wet mount of, and is associated with looking like a balloon with string attached?
trichomonas vaginalis
- What 3 causes of vaginitis does DNA hybridization probe testing test for?
- This test is only approved in what individuals?
- BV
- candidiasis
- trichomonas
- only approved in females
What test can detect trichomonas rapidly (10 mins) and is only approved in females?
OSOM trichomonas rapid test
When testing for gonorrhea and chlamydia, what is preferred over culture of specimens?
nucleic acid amplification tests
What are the pros of using NAAT?
- can identify low amounts of DNA
- highly sensitive and specific
- can also use urine in most cases
What are the collection sites of NAAT for gonorrhea and chlamydia in men and women?
men: urethra (use urine, don’t swab)
women: vaginal or endocervical swab (higher sensitivity than urine)
In women (…) samples for NAAT have higher sensitivity than (…)
- vaginal samples
- urine
What are the testing options in males for BV, candida, gonorrhea, trichomonas, and chlamydia?
- gonorrhea/chlamydia: NAAT testing using NAAT swab on urine or urethral sample
- trichomonas (1 of 2 ways): perform culture using urine container (send out for G/C and trich testing)
- BV/candida: not tested
What are the testing options in females for BV, candida, gonorrhea, trichomonas, and chlamyda?
- gonorrhea/chlamydia: NAAT testing using NAAT swab on urine or urethral sample
- trichomonas/BV/candida: wet mount or BD-affirm (DNA hybridization)
- What are the 2 types of HIV?
- Which is more commonly found in US and Europe?
- Which one is more common in West Africa?
- Which one is more transmissable?
- HIV-1 and HIV-2
- HIV-1
- HIV-2
- HIV-1
What test is the earliest marker and can detect HIV as early as 10-12 days after initial infection?
HIV DNA viral load
Why is viral RNA not usually recommended as initial screening?
- less sensitive than serologic
- false-positives are possible
Viral load for HIV is often used as what? What does a low viral load mean?
measurement of response to treatment; viral load undetectable=untransmissible