MICRO Flashcards
T/F: garnderella vaginalis will elicit a whiff test with 10% KOH
False, pure G. vaginalis will not; a sample of bacterial vaginosis will though
What agar can you grow Candida on?
Sauboraud dextrose
Describe the appearance of Trichomonas vaginalis
4 flagella at the top of the head with one intracellular flagellum giving it a ruffled appearace (or just 4 flagella with ruffled appearance)
What will you see on microscopy with: A) BV B) Candida and C) Trichomonas
A) clue cells B) hyphae and pseudohyphae and C) MOTILE trichomonads (4 flagella, ruffled body d/t intracellular flagellum)
What mutation may occur in a person to confer immunity to HIV? What mutation may occur in the virus to lead to a long term survivor?
CCR5 (homozygous = best); nef mutation, since nef is needed to be infectious; NOTE the person is not immune to HIV they can still get superinfection and die. However, the particular strain of HIV they are infected with happens to be noninfectious
What is the best Tx for chlamydia?
Azithromycin and (for the likely Gonorrhea coinfection) ceftriaxone
Why culture Gonorrhea on Thayer-Martin agar when you can do NAAT?
To test for antibiotic resistance
What is the treatment for gonococcus?
Ceftriaxone and (for Chlamydial coinfection) Azithromycin or Doxycycline
What do you add to a vaginal sample to elicit a whiff test?
10% KOH
Perianal ulcers from chlamydia would be most likely from which serovars?
L (not D-K)
What type of virus is HPV?
naked (hearty) dsDNA
Tx of A) BV B) Yeast and C) Trichomonas
A) Metronidazole B) Fluconazole and C) Metronidazole
2 bugs suggested by a dysuria/pyuria presentation that has low bacterial count
staphylococcus saprophyticus and Chlamydia trachomatis
This is the HIV fusion protein
Gp41
Reservoir for HSV
MAN (lol)
Which bacteria is predominately responsible for the low pH of the vagina?
lactobacillus
Buzzword for clinical S/S of trichomonas
Strawberry cervix
Host for Trichomonas
HUMANS
Which aspect of N. gonorrhea is responsible for fallopian tube damage?
LOS
Why aren’t there many AE with acyclovir?
It only kills/works in cells that are expressing VIRAL thymidine kinase
What is one important way in which (a nuance, really) of the treatments for BV and Trichomonas differ?
No need to treat the partner for BV but need to for trichomonas because often asymptomatic
What is the cause of most head and neck cancers?
Smoking but HPV causes a good amount
Most common cause of bacterial vaginosis
Garnderella vaginalis
How is HPV spread?
direct contact
What will you find when you check liver enzyme tests for Fitz-Hugh-Curtis?
NORMAL FINDINGS (apparently gonorrhea has some abnormalities but chlamydia wont)
What is the difference in the reasons that you use 10% KOH to Dx candida vs. BV/Trich?
BV and trich will elicit a whiff test; candida it will kill off the normal flora and only show the hyphae
Which bug causes Fitz-Hugh-Curtis syndrome?
BOTH gonorrhea and the clap
How is HPV spread? How is herpes spread?
DIRECT CONTACT
Which bug that causes PID is most likely to cause a fever?
Gonococcus
What does latency really mean, molecularly?
In a latent period of infection, viruses are “living” inside infected cells but there is NO DNA replication and there is NO protein expression
How is Gardasil dosed?
1st dose, then 2 months, then at 6 mos
What is the relationship of estrogen and glycogen?
The higher the the estrogen, the higher the glycogen; so as one ages, there will be less glycogen
What is the epithelial cell receptor for gonorrhea?
CD66
This is the HIV attachment protein
Gp120
What are the oncogenic proteins of HPV?
E6 binds to p53, and E7 binds to Rb
Where does HSV-1 go latent?
Trigeminal ganglion
What is unique about the strain of gonococcus responsible for Diseminated gonoccocal infection?
it contains low molecular weight protein A1 and it grows on Auxotype AHU agar
2 reasons that antibodies in AIDS patients are usually IgM?
1) the virus undergoes a lot of antigenic drift so that new antibodies (i.e. IgM) need to be produced; 2) the lack of functioning T cells leads to the inability to class-switch when they have AIDS (i.e. later in the course) and so they have a functional Hyper-IgM syndrome
T/F: BV results in many PMN’s
false it is not a true infection
What are the top 3 (in that order) causes of vaginitis?
1) BV 2) Candida (monilial) and 3) Trichomonas vaginalis
What is the main reservoir for HIV (in the body)? What is the early reservoir?
CD4 T cells; MO
Aside from Herpes, what other major virus family leads to syncytia or giant cells?
paramyxovirus
Gp120 attaches to this co-receptor on macrophages
CCR5
Which bug mostly has a watery discharge?
da clap
What is the CD4:CD8 ratio in a healthy adult?
2:01
T/F: you can kill Gardnerella vaginalis with metronidazole
False, you can treat bacterial vaginosis with it but it does not actually kill pure G. vaginalis
Odor in candida vaginitis
NONE just looks like a nightmare
pH in monilial vaginitis
NORMAL (diff from trich and BV)
What bug uses Opa proteins to enter cells? What receptor is it binding to?
Gonorreah; CD66
This genital infection is Tzank positive?
Herpes
What happens to people with heterozygous CCR5 mutations? Homozygous?
If heterozygous it is a slower course to AIDS with an HIV infection, if homozygous it is IMMUNITY; this is because of the difficulty for HIV to enter the MO
T/F: herpes can only be spread from a vesicle
false, herpes can be spread when it is latent/ no clinical s/s
Where does HSV-2 go latent?
Sacral ganglia
Why do they call ‘em cold sores?
HSV 1 and 2 both tend to reactivate when the immune system is depressed, i.e. during a cold with zee rhinovirus (attach at ICAM-1, if you remember)
T/F: HIV is a haploid virus
ACTUALLLYYYY, no. It has 2 copies of ssRNA
What does lactobacillus use to create lactic acid (don’t say pyruvic acid)
GLYCOGEN
Describe the normal discharge of the vagina
clear to white, odorless and high viscosity
Tx of herpes
acycovir or prodrug valacyclovir = better oral admin
Umbilicated lesions are essentially pathognomonic for ___________
Poxviruses (MCV-1 and MCV-1, and smallpox but we don?t care about that)
Screening and diagnostic tests for AIDS
Screen: ELISA; Diagnostic = Western blot
What is the Chandelier response in PID?
When you palpate the cervix and they shoot their arms up as if to grab a chandelier because apparently that?s what you grab when you are in pain
How is the structure of herpes virus different from HPV?
HPV = dsDNA and NAKED; Herpes = dsDNA and enveloped
What is the Tx of molluscum?
curettage and liquid nitrogen
What is the laboratory diagnosis of Chlamydia?
Nucleic Acid Amplification Test
Tx of Candidal vaginitis
FLUCONAZOLE
What is the neonatal ophthalmic ointment for Chlamydia infections?
Erytrhomycin droplets
What is the structure of the poxviruses?
DS DNA genome
What are the obstetric complications of BV?
preterm labor and therefore, low birthweight infants
What antigen is detected earliest in HIV infections?
P24 , antibodies are made very early to it, it is the capsid protein
Gp120 attaches to this co-receptor on CD4 T-cells
CXCR4
What will you see when you gram stain for chlamydia?
nothing, just PMNs
What is a major clinical characteristic of herpes viruses?
LATENCY
Microscopy for bacterial vaginosis =
clue cells
T/F: both HPV and herpes remain in the host for the entirety of his/her life
false, herpes stays for life and HPV will eventually (usually) be taken care of by host CMI
What are 5 risk factors for BV?
Recent antibiotics, bubble baths, decreased estrogen production, and douching
What 2 bugs have a postive whiff test?
Bacterial vaginosis (multiple) and Trichomonas vaginalis (protist)
How do you treat BV?
Metronidazole
What herpes viruses go latent in WBC’s?
EBV (via CD21) and CMV
Why would a newborn have laryngeal HPV?
aspirated from delivery
Which HPV types are associated with warts? With cancer?
6 and 11; 16 and 18
What is the pH of both BV and trichomonas infections?
greater than 4.5
Why are young females more susceptible to gonococcal infections than older females?
they have more stratified columnar epithelial cells which is the cell that gonorrhea infects
Characteristic cell from HPV on pap smear?
Koilocyte
