L51 STD Flashcards
Bacteria causing
- syphilis
- gonorrhoea
- chancroid
- bacterial vaginosis
- Treponema pallidum
- Neisseria gonorrhoeae
- Haemophilus ducreyi
- Gardnerella vaginalis
Chlamydia trachomatis servora
- D-K
- L1-L3
will cause?
- D-K
- Non-specific urethritis (NGU)
- Pelvic inflammatory diseases - L1-L3
- Lymphogranuloma venereum (a disease!)
Ureaplasma urealyticum is a mycoplasma causing?
Non gonorrhoeal urethritis
Mycoplasma hominis causes?
Pelvic inflammatory disease
Post partum fever
Genital herpes is caused by?
Herpes simplex virus (mostly type 2)
Genital warts is caused by?
Papilloma virus
HPV6, 11
Molluscum contagiosum is caused by?
Pox virus
Trichomonas vaginalis is a bacteria/fungi/protozoa?
What does it cause?
Protozoa
- vaginitis
- urethritis
Genital scabies is caused by?
Sarcoptes scabiei
Pubic lice = Pediculosis pubis is a disease caused by?
Phthirus pubis
Which of the following is correct about Treponema palladium?
A. It is a spirochete
B. It is visualised by dark-field microscopy
C. It is cultivable in lab
D. It causes venereal syphilis
E. It causes painless genital ulcer - Chancre
All except C
Primary syphilis - painless genital ulcer (chancre)
Secondary syphilis - constitutional symptoms, rash, hepatitis, osteitis, nephritis, uveitis (wide spread dissemination)
Latent syphilis
Tertiary syphilis: Cardiovascular (aortitis), CNS (general paresis, tabes dorsalis)
Dark ground microscopy for Treponema palladium may cause false negative as the organisms cannot survive long once outside the host.
- Apply glass slide onto the ulcer lesion (chancre)
- observed for motile spirochetes
What tests are done for confirmation instead? (2)
What are the drawbacks for the tests? (2)
- VDRL (Venereal Disease Research Laboratory)
- measure total IgM and IgG (> e.g. 1:16 titre of antibody)
- for screening
- for treatment monitoring
- false positivities: pregnancy, rheumatoid factors with Ab as well
> need to do Treponemal test as confirmatory test
- FTA-ABS - Fluorescent treponemal antibody absorption
- TPPA T. Pallidum particle agglutination assay
- costly
How to diagnose Neisseria gonorrhoeae infection?
It is a GN diplococci with attachment facilitated by pili to columnar epithelial cells
Bedside inoculation
- Urethral discharge for Gram stain and culture for male
- Endocervical swab (columnar cells) for female
(NOT vaginal swab: squamous cells)
*Only male is symptomatic with urethral discharge
females are asymptomatic
Hemophilus ducreyi is
A. small GN bacilli
B. requires special enriched medium to grow, difficult to culture
C. causes painful ulcer of genitalia (chancroid)
D. causes enlargement and suppuration of inguinal lymph nodes
E. enahnces HIV transmission
F. cannot be clinically diagnosed
All except F
Gram stain of urethral discharge shows non-gonorrheal urethritis.
What is the possible causative organism?
Chlamydia trachomatis
Serovar D-K
(For Serovar A,B,C there causes trachoma)
List possible causative organism(s) causing neonates with sticky eye. What is the diagnosis?
Diagnosis: Neonatal conjunctivitis
- Neisseria gonorrhoeae (1st 5 days after birth, purulent discharge)
- Chlamydia trachomatis (3 days to 2 weeks, less purulent)
What is lymphogranuloma venereum? (LGV)
It is caused by?
Lymphoproliferative reaction, lymphangitis
- Inguinal nodes enlarged, painful, rupture (bubo)
- Chlamydia trachomatis serovars L1-L3
Typical lesion for HSV genital infection?
- Cluster of vesicles
- Painful ulcers
- Recurrent
- facilities HIV transmission
- neonatal disseminated herpes - herpetic encephalitis in primary maternal infection at delivery
How is HSV genital infection diagnosed? (2)
Treatment? (2)
Diagnosed
- Fluid from vesicles for viral culture
- Antigen detection
Treatment
- Oral acyclovir
- Suppressive therapy for recurrent infections
- Pox virus
- Transmission: direct contact, fomites, sex
- Shining, pearly white, hemispherical umbilicate papules.
- Self limiting within 6-9 months
- Clinical diagnosis
Organism?
Molluscum contagiosum
Human papilloma virus (HPV) A. has >200 types B. transmitted through abrasion in skin and sexual contact C. has tropism D. can be oropharyngeal
All of the above
C
- Cutaneous warts
- plantar warts - Anogenital
- genital warts
- cervical cancer!
Causative organisms for vaginitis? (3)
- Candida albicans (fungus)
- Trichomonas vaginalis (protozoan)
- Bacterial vaginosis
Candida albicans
A. not always sexually transmitted
B. curd cheese discharge
C. pruritus vulvae
D. vulvovaginitis and balanoposthitis in men if STD
E. vaginal swab for fungal culture for diagnosis
All of the above
A: pregnancy, antibiotics, immunosuppression, diabetes
hormonal imbalance
Trichomonas vaginalis is a flagellate protozoan. It is sexually transmitted.
What are the symptoms in male and female. Diagnosis?
Male: asymptomatic
Female: malodorous vaginal discharge
Diagnosis
- Vaginal swab for Trichomonas culture
Patient /F complains of vaginal discharge with fishy smell, and vaginal swab for Gram stain is done, with clue cell found.
What is clue cell?
What is the diagnosis?
Clue cell is the vaginal squamous epithelial cell packed with dense coccobacilli (polymicrobial)
- Diagnosis: Bacterial vagniosis
- with overgrowth of anaerobes (peptostreptoccocus, Prevotella), and Gardnerella vaginalis due to hormonal imbalance
Name 2 arthropod infestations in STD.
- Scabies by Sarcoptes scabiei
2. Pubic lice by Phthirus pubis
Patient with intense irritating and itchy sensation on webs between fingers, flexor surfaces od wrist, lower buttock, penile shaft and scrotum.
Mite is found. Name?
Diagnosis by?
Sarcoptes scabiei
- Clinical
- Skin scrapping: mites, eggs in lab
Patients with pediculosis pubis = public lice by Phthirus pubis usually complains of?
- Itchiness
- Mobile tiny insects on hair
diagnosed by demonstration of dark nits (eggs) and white empty eggs, lice
