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Microbiology Midterm 2 > Lecture 13: Sexually Transmitted Infections > Flashcards

Lecture 13: Sexually Transmitted Infections Flashcards

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1
Q

What structure of Gonorrhea have

A

Gram-negative diplococcus (coffee beam shape)

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2
Q

What is Gonorrhea’s causative agent

A

Neisseria gonorrhoeae

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3
Q

What age group is gonorrhea most common in

A

20-25

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4
Q

How is Gonorrhea transmitted

A

through contact of mucous membranes (sexually or perinatally)

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5
Q

Is Gonorrhea better or worse than the 1990s

A

getting worse

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6
Q

what does Gonorrhea require for culture

A

enriched medium (so it doesn’t dry out) and CO2

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7
Q

How is Gonorrhea most commonly detected

A

PCR

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8
Q

What are the clinical manifestations of Gonorrhea in men and women separately

A

Men: Mucopurulent urethritis (drainage or milk discharge in men from urethra)

Women: Mucopurulent cervicitis (inflammation of the cervix),
Pelvic inflammatory PID, which can lead to reduced fertility

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9
Q

What are the clinical manifestations of Gonorrhoea in both males and females

A

Pharyngitis (inflammation of the throat)

Conjunctivitis (inflammation of the eyes)

Disseminated gonococcal infection (spread throughout body) especially joint pain

Gonorrheal ophthalmia neonatorum (bacterial eye infection in new borns)

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10
Q

How is gonorrhea diagnosed

A

Nucleic acid amplification testing (NAAT) like PCR

Culture of urethral or cervical swabs

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11
Q

Is NAAT or culture more sensitive and specific in Gonorrhea testing

A

Sensitive: NAAT is more sensitive than culture as molecular methods can also detect dead organisms

Specific: Very specific because if you grow gonorrhea on a plate there is no mistaking what it is

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12
Q

What medication is used to treat Gonorrhea

A

Cerfixime (cephalosporin, beta lactam) administered orally
or
Ceftriaxone (cephalosporin, beta lactam) administered intramuscularly through injection

With azithromycin for possible Chlamydia co-infection

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13
Q

What medication is now not used with Gonorrhea

A

Ciprofloxacin (fluoroquinolione) because of resistance

Many guidelines dont use Cerfixime anymore because it is becoming resistant so go straight to Ceftriaxone

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14
Q

What drug is given to someone who travelled or has multiple partners

A

Ceftriaxone

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15
Q

What STI is considered A-typical

A

Chlamydia

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16
Q

What is the causative agent of Chlamydia

A

Chlamydia trachomatis

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17
Q

Why is Chlamydia Atypical

A

Obligate intracellular bacteria with no cell wall, so cant be gram-stained

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18
Q

What STI has different serotypes

A

Chlamydia

Lymphogranuloma centrum (LGV) not in Canada

Eye diseases (trachoma) found in newborns and found in tropics

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19
Q

How is Chlamydia detected

A

cannot be grown on artificial media, requires culture in cultured cells (human or animal cells to grow)

Molecular amplification testing (panther)/ NAAT

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20
Q

What is the reticulate body

A

actively replicating form found within cells

When mature, it causes cell rupture and fragments into many elementary bodies

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21
Q

What is the elementary body

A

Inert infectious form found on the surface of cells, invades cells (Transmitted form)

Don’t replicate within themselves they transfer to new hosts and bodies turn into reticulate bodies so they can replicate in the new host

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22
Q

What form of Chlamydia infects and how

A

Elementary bodies

Infects urethral, cervical, and conjunctival epithelial cells (eyes)

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23
Q

What form of Chlamydia infects and how

A

Elementary bodies

Infects urethral, cervical, and conjunctival epithelial cells (eyes)

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24
Q

How is Chlamydia transported

A

through sexual contact or perinatally, direct contact to conjunctiva (eye)

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25
Q

What age group is most common to have Chlamydia

A

15-25 years old, females tend to younger than males

26
Q

What does nongonococcal mean

A

See nothing on a gram stain, Chlamadia

27
Q

What are the clinical manifestations of Chlamydia in men and women separately

A

Men:
- Mucopurulent urethritis (drainage or milk discharge in men from urethra)
- Epididymitis (inflammation of an area in the back of the testicle)

Women:
- Mucopurulent cervicitis (inflammation of the cervix)
- Pelvic inflammatory disease, complications include ectopic pregnancy and sterility secondary to scarring

28
Q

What are the clinical manifestations of Chlamydia in men and women both

A

Reactive arthritis (formally Reiter’s syndrome)

Urethritis: inflammation of the urethra

Proctitis: inflammation around rectum or anus

Conjunctivitis: pink eye, espically in new borns

Trachoma: severe form of conjunctivitis in the tropics

29
Q

How are Chlamydia specimens obtained

A

Men:
urine samples (Now)
Urethral swabs (Past)

Women:
Self-taken vaginal swabs
Urine
Endocervical swabs had to have a pap to have this done (past)

30
Q

Treatment for Chlamydia

A

Doxycycline: can’t use beta lactams because does have a cell wall to attack

or azithromycin or erythromycin

31
Q

What is syphilis’s structure

A

Tightly coiled spirochaete (5-15 um length, 0.09-0.5 um diameter)

32
Q

Who is syphilis most common in

A

increasing since 2000 in men with multiple male partners

33
Q

How is syphilis transmitted

A

through sexual contact or transplacemntal (to fetus)

34
Q

How is sphyilis viewed

A

Not easily cultured in lab, animal tissues are needed

Too fine to gram stain, so we use “dark field microscopy”

35
Q

What is dark field microscopy

A

Put organism on a black background and bounding light off the organism trying to encentuate its size (only done in Toronto)

used on primary chancre

36
Q

What are the congenial effects of Chlamydia

A

Bone, teeth, brain damage

37
Q

What are the clinical presentations of syphilis

A

Primary syphilis (localized)

Secondary syphilis (systemic)

Tertiary syphilis (late)

38
Q

What is latent infection

A

when you are asymptomatic and bypass the secondary stage of sypilis and go directly to the tertiary stage

39
Q

What is primary syphilis

A

Presents 1-4 weeks post infectious contact

Produces a chancre (painless ulceration)

Heals spontaneously within weeks

40
Q

What is secondary syphilis

A

Spirochactes are now in the blood

full body skin rash (doesn’t spare the palms or soles)

“flu like illness”

lymphadenopathy (swelling in lymph nodes)

41
Q

What is tertiary syphilis

A

Cardiovascular (heart failure) and neurological (dementia, seizures, paralysis)

Gumma (late cutaneous, bony, or visceral masses) in organs and soft tissues

42
Q

What is the main way syphilis is diagnosed

A

serology is the main route of diagnosis

Subdivided into
1) Nonspecific tests (non treponema tests)
VDRL
PRP

2) Specific tests (Treponemal tests)
TPPA
EIA

43
Q

What is the treatment for syphilis

A

penicillin is the treatment of choice, doxycycline as an alternative (if allergy)

Followed by PRP for response can be followed

Longer treatment if CNS is involved

44
Q

What is PRP

A

Rapid Plasma Reagin: used to follow resolution after established diagnosis

Cheap but can lead to false positives as you read with your eyes

You dilute blood serums- 1:1, 1:2, 1:4, 1:8
If you are positive at 1:2 but negative after, then you have low levels of organism

Can test RPR over treatment to see if you are getting better

45
Q

What is a common co-infection in Syphilis

A

HIV

46
Q

What is genital herpes structure

A

linear double stranded DNA virus

47
Q

Neurotropic

A

invades nerves and becomes dormant (latent) within them, regrowth with cold sores or genital sores gives reactivation of infection

48
Q

Who is genital herpes most common in

A

all

49
Q

What are the types of gential herpes

A

herpes simplex virus (HSV) type 1 or 2

50
Q

How are genital herpes transmitted

A

through contact with person shedding virus

51
Q

what is the sereoprevelance of HSV-2

A

20-80% have antibodies

52
Q

What is the clinical presentation of genital herpes

A
  1. Primary infection:
    fever, headache, malaise, myalgia

Painful lesions on genitalia

Dysuria (burning during urination) more common in women

Vaginal or urethral discharge

Tender inguinal adenopathy (groin nodes area)

  1. Latent
    Shedding of virus without any lesions
53
Q

What type of Genital herpes infection is more likely to reoccur

A

HSV-2 more than HSV-1

usually much less severe than primary infection usually localized to genital area
50% have prodromal symptoms (tingling, pain)

54
Q

What does congential herpes look like

A

localized, CNS, disseminated (especially if mother has primary infection at delivery)

55
Q

What type of diagnosis is used for genital herpes

A

Swabs of local lesions
i) NAAT
ii) culture on cells (less sensitive, laborious)

Serology rarely used

56
Q

What is the treatment for genital herpes

A

Antivirals (acyclovir, valaciclovir, famciclovir)

Longterm prophylaxis may be necessary in frequency recurrent disease

57
Q

What is genital warts caused by

A

human papillomaviruses

Many serotypes, some found at different body sites that are not all STIs

58
Q

How are genital warts transmitted

A

by direct sexual contact

59
Q

What do genital warts look like

A

Skin growths on genitalia, perianal area

May be asymptomatic
Usually transient infection, resolving in months

60
Q

How can Genital warts be removed

A

chemical means, freezing, or surgery

Microbiology Midterm 2 (15 decks)

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