Lect 21

Question 1

Chlamydia Trachomatis can cause what 4 infections

Answer 1

• trachoma
• lymphogranuloma venereum
• inclusion conjunctivitis
• NGU (nongonococcal urethritis)

Question 2

Chlamydia Trachomatis

• gram status
• requirements

Answer 2

• obligate intracellular bacteria, require host derived ATP
• gram negative

Question 3

Chlamydia Trachomatis exists in what 2 forms

Answer 3

1. elementary body: infectious
2. reticulate body: intracellular

Question 4

list the 3 main causes of nongonococcal urethritis

Answer 4

• Chlamydia Trachomatis
• ureaplasma urealyticum
• mycoplasma genitalium

Question 5

main reservoir of ureaplasma urealyticum and mycoplasma genitalium

Answer 5

genital tract of sexually active person

Question 6

NGU from C. trachomatis has highest prevalence in what patient population

Answer 6

• teenagers

Question 7

ascension of C. trachomatis in females can cause

Answer 7

• salpingitis
• PID

Question 8

presentation of NGU C. trachomatis in males

Answer 8

• urethritis and epididymitis
• water, odorless discharge

Question 9

toxin of C. trachomatis

Answer 9

• toxin similar to Toxin B in C. Diff
  
  • causes
    
    • chronic inflammation
    • sloughing of mucosal cells

Question 10

how is C. trachomatis diagnosed

Answer 10

1. isolation of cell culture: gold standard
2. nucleic acid probes

Question 11

Tx: C. trachomatis

Answer 11

azithromycin or tetracycline

Question 12

Trichomonas vaginalis

• in what form does it exist

Answer 12

• exists as a trophozoite
  
  • flagellated protozoan
  • extracellular anaerobe

Question 13

how is Trichomonas vaginalis transmitted

Answer 13

sexual intercourse

Question 14

clinical presentation

• males: asymptomatic, scant, clear to mucupurulent d/c
• females: profuse vaginal d/c, frothy and malodorous

Answer 14

Trichomonas vaginalis

Question 15

Trichomonas vaginalis in women can lead to what co-condition

Answer 15

bacterial vaginosis

Question 16

how is Trichomonas vaginalis diagnosed

Answer 16

• wet mount exam
• culture

Question 17

tx Trichomonas vaginalis

Answer 17

metronidazole

Question 18

what is bacterial vaginosis

Answer 18

• not an STI
• caused by overgrowth of opportunistic pathogen in vagina due to changes in pH

Question 19

differentiate between vaginal pH in normal vs vaginosis

Answer 19

• normal: PH < 4.5
• vaginosis: pH: 5-6

Question 20

List the criteria that are present to diagnose bacterial vaginosis

Answer 20

1. presence of CLUE CELLS
2. fishy odor when 10% KOH added
3. pH > 4.5

Question 21

where are Candidiasis spp normally found

Answer 21

• normal flora of skin and mucous membranes
• opportunistic fungal infections

Question 22

vulvovaginal candidiasis is normally caused by what species

Answer 22

candida albicans

Question 23

clinical presentation

• thick, white, frothy d/c in women (no odor)
• itching, irritation
• burning sensation with intercourse or urination
• vaginal pain

Answer 23

vulvovaginal candidiasis

Question 24

candida albican parent yeast can turn into what 3 forms

Answer 24

1. budding yeast
2. pseudohypha
3. germ tube -> hypha

Question 25

which form of candida albican is the most adhesive

Answer 25

germ tube

Question 26

how is candida albican diagnosed

Answer 26

1. direct microscopic exam * large G+ cells (will stain purple) * yeast cells, true hyphae, pseudohyphae 2. Culture -\> chromagar

Question 27

tx of vulvovaginal candidiasis

Answer 27

* topical cream: miconazole * oral fluconazole

Question 28

Haemophilus * gram status * motile

Answer 28

* gram negative * non motile

Question 29

Haemophilus Ducreyi leads to formation of what lesion

Answer 29

chancroid

Question 30

clinical presentation * develops 3-5 days post infection * vesicle or papule that quickly progresses to pustulation and ulceration * lesion: tender papule on genitalia that lacks induration, bleeds readily,

Answer 30

soft chancre of chancroid -\> Haemophilus Ducreyi

Question 31

how is Haemophilus Ducreyi diagnosed

Answer 31

1. required identification of Haemophilus Ducreyi from genital ulcer or swollen lymph node 2. PCR

Question 32

tx: Haemophilus Ducreyi

Answer 32

3rd gen cephalosporin \*\*needs susceptibility testing

Question 33

Pelvic inflammatory disease is usually caused by what two pathogens

Answer 33

1. Neisseria gonorrhoeae 2. chlamydia trachomatic

Question 34

what increases risk of developing PID

Answer 34

* STD present * prior episode of PID * sexuall active adolescent * mult sex partners * frequent douching

Question 35

clinical presentation * low abd pain * abnormal vaginal discharge * painful intercourse * increased pain with menstruation * scarring * irregular menstruation * fever and chills

Answer 35

PID

Question 36

how is PID diagnosed

Answer 36

* clinically * evidence of inflammation * fever, leukocytosis, elevated ESR