L19+20: All the rest

Question 1

Possible causes of nongonococcal urethritis

Answer 1

Chlamydia trachomatic
Ureaplasma urealyticum
Mycoplasma genitalium

Question 2

Causes of nongonococcal urethritis that don’t have cell walls

Answer 2

Ureaplasma urealyticum

Mycoplasma genitalium

Question 3

Chlamydia trachomatis causes

Answer 3

Trachoma
inclusion conjunctivitis
lyphogranuloma venereum
nongonoccoal urethritis

Question 4

Chlamydia psittaci causes

Answer 4

psittaci

Question 5

Chlamydia pneumoniae causes

Answer 5

acute pneumonia

Question 6

Chlamydia trachomatis

Answer 6

Obligate intracellular bacteria, need host ATP
G-
elementary body (infectious)
reticular body (intracellular)

Question 7

If a pregnant women has Chlamydia trachomatis, what percent of infants will get it too?

Answer 7

more than half
inclusion conjuncitivitis
5-10% get pneumonia

Question 8

Chlamydia trachomatis discharge

Answer 8

watery

Question 9

Chlamydia trachomatis in men

Answer 9

Urethritis (asymptomatic)

epididymitis

Question 10

Chlamydia trachomatis in women

Answer 10

cervicitis
salpingitis
pelvic inflammatory disese

Question 11

lymphogranuloma venereum

Answer 11

other serotypes of Chlamydia trachomatis

nodules

Question 12

What can cause chronic inflammation in Chlamydia trachomatis?

Answer 12

toxin producing strains

functions like toxin B of c diff, collapses the protein scaffolding of infected cells

Question 13

Gold standard for diagnosis of Chlamydia trachomatis

Answer 13

Isolation in cell culture:
human immortalized cell lines
detect intracellular inclusions

Question 14

Non-culture tests for Chlamydia trachomatis

Answer 14

Antigen detection

Nucleic acid probes (very sensitive)

Question 15

Mycoplasma pneumoniae causes

Answer 15

Atypical pneumonia

Question 16

Mycoplasma hominis causes

Answer 16

Pyelonephritis

Pelvic inflammatory disease

Question 17

Mycoplasma genitalium causes

Answer 17

nongonococcal urethritis

Question 18

Ureaplasma urealyticum

Answer 18

nongonococcal urethritis

Question 19

Reservoir of ureaplasma urealyticum

Answer 19

genital tract of sexually active people
causes nongonococcal urethritis in men
causes chorioamnionitis and postpartum fever in women

Question 20

Trichomonas tenax

Answer 20

normal flora of the mouth

Question 21

Trichomonas hominis

Answer 21

normal flora of the intestine

Question 22

Trichmonas vaginalis

Answer 22

STD causing trichomoniasis

Question 23

Trichomonas vaginalis morphology

Answer 23

huge protozoan
exists only as a trophozoite
extracellular anaerobe

Question 24

Trichomonas in men

Answer 24

Asymptomatic

Scanty, clear to mucopurulent discharge

Question 25

Trichomonas in females

Answer 25

symptomatic
profuse, froth, malodorous vaginal discharge
changes pH, predisposes to bacterial vaginosis

Question 26

Diagnosis of trichomoniasis

Answer 26

Wet mount
Culture (more sensitive)
Monoclonal antibody
DNA probe test

Question 27

Bacterial vaginosis

Answer 27

an overgrowth of opportunistic pathogen due to change in pH

not an STI

Question 28

Risk for bacterial vaginosis

Answer 28

history of previous STDs
history of sexual activity
intrauterine devices
history of pregnancy/abortion

Question 29

Normal vaginal pH

Answer 29

<4.5

Question 30

bacterial vaginosis pH

Answer 30

5-6

Question 31

Diagnosis of bacterial vaginosis

Answer 31

Pick 3 criteria:
Homogenous quality of secretions
Clue cells
Fishy amine odor when 10% KOH added
Vaginal pH >4.5
Curved G- or gram variable rods

Question 32

Clue cells

Answer 32

Bacteria all over epithelial cells in bacterial vaginosis

Question 33

Candidiasis

Answer 33

normal flora, opportunistic mycoses (fungal)

thrush, diaper rash, nails, heart

Question 34

Why does candidiasis become pathologic?

Answer 34

broad spectrum abx
absence of competing normal flora
introduction to abnormal site
pathologic change in microenvironemnt (pH) 
immunodeficient

Question 35

Vulvovaginal candidiasis is most commonly caused by

Answer 35

Candida albicans

less common: c. tropicalis, c. glabrata

Question 36

Vulvovaginal candidiasis presentation

Answer 36

usually endogenous, can be an STI
thick, frothy white discharge (no odor)
itching, irritation
burning during intercourse or urination
vaginal pain and soreness

Question 37

Haemophilus ducreyi morphology

Answer 37

non motile G- coccobacillus

Question 38

Haemophilus influenzae causes

Answer 38

otitis media
epiglottitis
meningitis

Question 39

Haemophilus aegypticus causes

Answer 39

conjunctivitis

Question 40

Characteristics of chancroid

Answer 40

tender papule on genitalia that develops into a tender ulcer with sharp margins
“soft chancre” lacking induration
regional adenopathy and bubo

Question 41

Chancroid is more common in

Answer 41

tropical countries

Question 42

Chancroid in females

Answer 42

asymptomatic or nondescript lesion

Question 43

bubo

Answer 43

a swollen inflamed lymph node in the armpit or groin

Question 44

The soft chancre of chancroid develops

Answer 44

quickly: 3-5 days post infection

Question 45

The soft chancre presents

Answer 45

vesicle or papule, solitary, which pustulates and ulcerates
autoinoculation may lead to multiple ulcers
painful, tender
bleeds readily
lacks induration

Question 46

Chancroid diagnosis

Answer 46

Identify haemophilus ducreyi from genital ulcer or swollen lymph node
misleading due to presence of polymicrobial flora in ulcer
lymph is frequently sterile
media for culture requires growth supplements
PCR

Question 47

Risk of pelvic inflammatory disease

Answer 47

STD
prior episodes
sexually active adolescent
multiple sexual partners
douching

Question 48

Presentation of pelvic inflammatory disease

Answer 48

lower abdominal pain
irregular menstruation
painful intercourse
scarring
abnormal vaginal discharge
increased pain during menstruation
fever, chills

Question 49

Diagnosis of pelvic inflammatory disease

Answer 49

inflammation: fever, leukocytosis, elevated ESR

treat both infection and inflammation