Internal Medicine_Infectious Diseases_12

Question 2

What is the morphology of Chlamydia spp.?

Answer 2

Chlamydia spp. are obligate intracellular, gram-indeterminate bacteria that lack muramic acid in their cell walls.

Question 3

What are the two developmental forms of Chlamydia spp.?

Answer 3

Elementary bodies: Extracellular, infectious, non-replicating form.

Reticulate bodies: Intracellular, replicating form.

Question 4

How are Chlamydia spp. detected in the lab?

Answer 4

Intracellular inclusion bodies on microscopy (visualized with Giemsa stain).

Nucleic Acid Amplification Tests (NAATs) are the gold standard for detection.

Question 5

Which serovars of Chlamydia trachomatis cause STIs?

Answer 5

Serovars D-K and L1-L3.

Question 6

What clinical features are associated with Chlamydia trachomatis serovars D-K?

Answer 6

Watery or mucopurulent vaginal or urethral discharge.

Pelvic inflammatory disease (PID).

Vertical transmission causing neonatal conjunctivitis or pneumonia (staccato cough).

Question 7

What is lymphogranuloma venereum (LGV), and which serovars cause it?

Answer 7

LGV is caused by serovars L1-L3 of Chlamydia trachomatis and is characterized by tender inguinal or femoral lymphadenopathy.

Question 8

What is the most common cause of infectious blindness worldwide?

Answer 8

Trachoma, caused by Chlamydia trachomatis serovars A-C.

Question 9

How is Chlamydia trachomatis associated with reactive arthritis?

Answer 9

Reactive arthritis (Reiter’s syndrome) involves a triad of symptoms:

Uveitis
Urethritis
Arthritis

Question 10

Which Chlamydia spp. are associated with atypical pneumonia?

Answer 10

Chlamydophila pneumoniae.

Chlamydophila psittaci (from bird feces exposure).

Question 11

What is the standard treatment for Chlamydia trachomatis infections?

Answer 11

Macrolides (e.g., azithromycin).
Tetracyclines (e.g., doxycycline).

Question 12

Why is ceftriaxone often co-administered in cases of chlamydial infection?

Answer 12

To treat possible Neisseria gonorrhoeae co-infection.

Question 13

What is the most common bacterial STI in the U.S.?

Answer 13

Chlamydia (Chlamydia trachomatis).

Question 14

What is the causative organism of Gonorrhea?

Answer 14

Neisseria gonorrhoeae, a gram-negative diplococcus.

The second most common cause of bacterial STI in the United States.

Question 15

What are common risk factors for Chlamydia and Gonorrhea?

Answer 15

New sexual partners.
Multiple partners.
Inconsistent condom use.
History of STIs.
Men who have sex with men.

Question 16

What are the clinical presentations of Chlamydia in men and women?

Answer 16

Men: Urethritis (mucoid discharge/dysuria), and epididymitis.
Women: Cervicitis, Pelvic Inflammatory Disease (PID).
Asymptomatic: Common, especially in men.

Question 17

What are the common extragenital manifestations of Gonorrhea?

Answer 17

Proctitis (rectal infection).
Pharyngitis.
Disseminated gonococcal infection (e.g., septic arthritis, tenosynovitis).

Question 18

Asymptomatic Gonorrhea is most common in men, women, or both?

Answer 18

Often asymptomatic in both.

Question 19

What are symptoms of disseminated gonococcal infection (DGI)?

Answer 19

Polyarthritis or septic arthritis.
Tenosynovitis.
Skin pustules.

Question 20

What diagnostic test is used for Chlamydia and Gonorrhea?

Answer 20

Nucleic Acid Amplification Test (NAAT).

Test from vaginal canal, urine, or anal/pharyngeal sites.

Question 21

What are the clinical presentations of Gonorrhea in men and women?

Answer 21

Men: Urethritis (mucoid discharge/dysuria), rare prostatitis or epididymitis.
Women: Urethritis, Cervicitis, Pelvic Inflammatory Disease (PID).
Asymptomatic: Common, especially in men and women.

Question 22

A gram stain indicating _______ and ________ from the urethra, usually indicates a gonococcal infection.

Answer 22

A gram stain indicating gram-negative diplococci and PMNs from the urethra, usually indicates a gonococcal infection.

Ceftriaxone: To cover Neisseria gonorrhoeae.

Question 23

Will Chlamydia be seen on a gram stain?

Answer 23

No

Azithromycin or Doxycycline: To cover potential Chlamydia trachomatis co-infection (unless NAAT is negative).

Question 24

How is Chlamydia treated?

Answer 24

Azithromycin: Single 1,000 mg dose.

Doxycycline: Alternative.

Question 25

What are possible complications of untreated Chlamydia or Gonorrhea in women?

Answer 25

Pelvic Inflammatory Disease (PID).
Infertility.
Ectopic pregnancy.

Question 26

Why are Chlamydia and Gonorrhea often treated together?

Answer 26

They commonly co-infect, and treating both ensures full coverage.