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Clinical Science > Lecture 16 Infectious Disease > Flashcards

Lecture 16 Infectious Disease Flashcards

1
Q

What do STIs include?

A

syphilis, gonorrhea, HIV, genital herpes, genital warts, chlamydia and trichamoniasis

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2
Q

What do STIs include?

A

syphilis, gonorrhea, HIV, genital herpes, genital warts, chlamydia and trichamoniasis

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3
Q

What are the two test that can be done to test an infection of the cervix and vagina?

A

wet mount and gonorrhea/chlamydia

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4
Q

What are the five organisms that can cause an infection in the cervix and vagina?

A

bacterial vaginosis, candida vulvovagintis, trichomonas vaginitis, gonorrhea, chlamydia

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5
Q

What is the most implicated bacteria that causes bacterial vaginosis?

A

Gardnerella vaginalis

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6
Q

What is the most common reason for vaginitis?

A

bacterial vaginosis

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7
Q

What does bacterial vaginosis present with?

A

off white, thin, homogenous discharge with “fishy” odor

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8
Q

Vaginal Candidiasis

A 
Represents vaginal infection by Candida species
Results in irritation and itching
Discharge is white, thick and clumpy
Often adheres to vaginal wall
May be minimal discharge in some cases
No odor and NOT sexually transmitted
Second most common reason for vaginitis
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9
Q

Trichomonas Vaginalis

A

Can be asymptomatic or present with thin, frothy, green malodorous discharge in some, but not all, cases
Can be difficult to distinguish from other causes of vaginitis
Sexually transmitted

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10
Q

Chlamydia

A

Infection caused by Chlamydia trachomatis
Can be asymptomatic (85%) or present with vaginal discharge, pelvic pain
Can also be difficult to diagnose visually
Sexually transmitted disease

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11
Q

Gonorrhea

A

Infection caused by bacteria Neisseria Gonorrhea
Can be asymptomatic or cause vaginal discharge
Again, difficult to ascertain causative organism visually upon exam
Sexually transmitted organism

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12
Q

What are the 3 parts in a wet mount when determining vaginitis or cervicitis?

A

Vulvovaginal yeast infection- symptoms include vulvar pruritis, irritation, erythema, dysuria, dyspareunia
Bacterial vaginosis- symptoms include no symptoms to vaginal discharge that is thin and has a “fishy” odor
Trichomonas- symptoms include no symptoms to thick, purulent vaginal discharge with burning, pruritis, urinary frequency/burning, abdominal pain

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13
Q

What is characteristic of a clue cell?

A

edges of epithelia cells covered with coccobacilli

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14
Q

What is characteristic about the volvovaginal candiasis wet mount?

A

the evil eye

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15
Q

What is the whiff test?

A

placing a drop of 10% potassium hydroxide (KOH) onto the slide and smelling… if there is a fishy odor this indicates likely bacterial vaginosis

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16
Q

What is the normal vaginal pH?

A

3.8-4.2

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17
Q

What is the pH with BV/Trichomonas?

A

> 4.5

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18
Q

What is the pH with candidiasis?

A
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19
Q

What is now the preferred and recommended method of testing gonorrhea and chlamydia?

A

nucleic acid amplification test

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20
Q

What are the material used for a NAA urethral swab test

A

One package with tube and swab prepared
Swabs should have a plastic or wire shaft and a rayon, dacron, or cytobrush tip
Do NOT use a standard Q-tip.
Blue swab breaks off into tube after collection

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21
Q

What are the collection sites for NAA testing?

A

women: vaginal or endocervical swab
men: urethra

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22
Q

Which type of HIV is more prevalent in the US and Europe?

A

HIV-1

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23
Q

What is measured in an HIV virologic test?

A

HIV RNA

HIV p24 antigen

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24
Q

What is measured in a HIV serologic test?

A

IgM

IgG

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25
Q

Why is testing for HIV RNA not usually recommended as initial screening?

A

Less sensitivity when compared to serologic testing
FDA-approved test only tests for HIV-1
False-positives are possible on this test

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26
Q

When is HIV RNA viral load used as a measurement?

A

as a measurement in response to treatment

27
Q

When is HIV RNA detected?

A

its presence in found earliest and is measurable as early as 10-12 days after initial infection

28
Q

What are the two test that can be done to test an infection of the cervix and vagina?

A

wet mount and gonorrhea/chlamydia

29
Q

What are the five organisms that can cause an infection in the cervix and vagina?

A

bacterial vaginosis, candida vulvovagintis, trichomonas vaginitis, gonorrhea, chlamydia

30
Q

What is the most implicated bacteria that causes bacterial vaginosis?

A

Gardnerella vaginalis

31
Q

What is the most common reason for vaginitis?

A

bacterial vaginosis

32
Q

What does bacterial vaginosis present with?

A

off white, thin, homogenous discharge with “fishy” odor

33
Q

Vaginal Candidiasis

A 
Represents vaginal infection by Candida species
Results in irritation and itching
Discharge is white, thick and clumpy
Often adheres to vaginal wall
May be minimal discharge in some cases
No odor and NOT sexually transmitted
Second most common reason for vaginitis
34
Q

Trichomonas Vaginalis

A

Can be asymptomatic or present with thin, frothy, green malodorous discharge in some, but not all, cases
Can be difficult to distinguish from other causes of vaginitis
Sexually transmitted

35
Q

Chlamydia

A

Infection caused by Chlamydia trachomatis
Can be asymptomatic (85%) or present with vaginal discharge, pelvic pain
Can also be difficult to diagnose visually
Sexually transmitted disease

36
Q

Gonorrhea

A

Infection caused by bacteria Neisseria Gonorrhea
Can be asymptomatic or cause vaginal discharge
Again, difficult to ascertain causative organism visually upon exam
Sexually transmitted organism

37
Q

What are the 3 parts in a wet mount when determining vaginitis or cervicitis?

A

Vulvovaginal yeast infection- symptoms include vulvar pruritis, irritation, erythema, dysuria, dyspareunia
Bacterial vaginosis- symptoms include no symptoms to vaginal discharge that is thin and has a “fishy” odor
Trichomonas- symptoms include no symptoms to thick, purulent vaginal discharge with burning, pruritis, urinary frequency/burning, abdominal pain

38
Q

What is characteristic of a clue cell?

A

edges of epithelia cells covered with coccobacilli

39
Q

What is characteristic about the volvovaginal candiasis wet mount?

A

the evil eye

40
Q

What is the whiff test?

A

placing a drop of 10% potassium hydroxide (KOH) onto the slide and smelling… if there is a fishy odor this indicates likely bacterial vaginosis

41
Q

What is the normal vaginal pH?

42
Q

What is the pH with BV/Trichomonas?

43
Q

What is the pH with candidiasis?

44
Q

What is now the preferred and recommended method of testing gonorrhea and chlamydia?

A

nucleic acid amplification test

45
Q

What are the material used for a NAA urethral swab test

A

One package with tube and swab prepared
Swabs should have a plastic or wire shaft and a rayon, dacron, or cytobrush tip
Do NOT use a standard Q-tip.
Blue swab breaks off into tube after collection

46
Q

What are the collection sites for NAA testing?

A

women: vaginal or endocervical swab
men: urethra

47
Q

Which type of HIV is more prevalent in the US and Europe?

48
Q

What are the two types of HIV virologic test?

A

HIV RNA

HIV p24 antigen

49
Q

What are the two types of HIV serologic test?

50
Q

Why is testing for HIV RNA not usually recommended as initial screening?

A

Less sensitivity when compared to serologic testing
FDA-approved test only tests for HIV-1
False-positives are possible on this test

51
Q

When is HIV RNA viral load used as a measurement?

A

as a measurement in response to treatment

52
Q

When is HIV RNA detected?

A

its presence in found earliest and is measurable as early as 10-12 days after initial infection

53
Q

HIV p24

A

HIV p24 protein is encoded by the gag gene
Can be measured as early as 11-13 days after infection
Less expensive than viral RNA/nucleic acid testing

54
Q

What is the minimum time to detect IgG antibodies to HIV?

55
Q

What is the median time to detect IgG antibodies to HIV?

56
Q

What is the HIV fourth generation test?

A

First approved by FDA in June 2010
This combination test not only detects antibodies (IgG and IgM) but also the p24 antigen
This detects HIV infection 5 days earlier than third-generation tests
Indicated for both routine, perinatal screening and in high-risk individuals

57
Q

Who are considered high risk HIV individuals?

A

IV drug users
Men who have sex with men (MSM)- can test every 6 months per CDC
Prostitutes
Partners of those infected with HIV/bisexual/IV drug users
Persons who have sex with partners whose HIV status is unknown
Pregnant women

58
Q

What are the different types of methods for HIV testing?

A

Blood testing- most common test used, home testing kits available
Oraquick® (Oral fluid)- Not saliva, uses a brush held in cheeks, detects antibodies to HIV in cells of mouth and cheeks, results in 20 minutes
Urine- Detects HIV antibodies, less sensitive than blood

59
Q

What are the four stages of syphilis?

A

Acute- development of chancre within 2-3 weeks of exposure
Secondary- development of a generalized rash and other systemic symptoms
Latent- disease inactivity – up to 5 years
Tertiary- CNS, cardiac, ocular involvement

60
Q

What does syphilis testing revolve around?

A

either direct visualization of spirochetes or non-treponemal / treponemal tests

61
Q

Non-treponemal antibody test

A

Detects reaction of patient’s serum IgG and IgM antibodies with a cardiolipin-cholesterol-lecithin antigen (treponemal surface antigens cross-react with this antigen)

62
Q

What are the non-treponemal antibodies?

A

RPR,VDRL,TRUST

63
Q

What are the treponemal antibodies?

A

FTA-ABS, ELISA IgG/IgM, TP-MHA, TP-EIA

64
Q

Who should be screened for syphilis?

A

Patient with a painless genital ulcer
Patient with high-risk behavior
Routine screening (prenatal)

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