Micro Intro Flashcards

1
Q

Rank the following infectious diseases in order or prevalence from most to least:

AIDS

Hep A/Hep B

TB

Chlamydia

GC

HPV

Syphilis

HSV

A

Chlamydia

GC/HPV/HSV

AIDS

TB

Syphilis

Hep A/Hep B

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2
Q

Drips

A

Chlamydia D-K

GC

Ureaplasma

Trich

Candida

Gardnerella

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3
Q

Warts

A

HPV

2 syphilis

Molluscum (pox virus)

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4
Q

Ulcers

A

HSV 2 (can be d/t 1)

Chlamydia L1-L3 (LGV)

H. ducreyi

1 syphilis

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5
Q

Which “STD”’s are caused by overgrowth of normal flora?

A

Candida

Gardnerella

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6
Q

How would you distinguish primary from recurrent HSV-2 infection?

A

You can’t!

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7
Q

Dx of HSV?

A

Tzank smear - look for multinuclear giant cells with inclusions

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8
Q

Which sexually transmitted organisms cannot be seen with a gram stain? How do you diagnose it?

A

1. Treponema pallidum

Use dark field microscopy, RPR, VDRL, FTA-Abs

2. Ureaplasma urealyticum

not discussed?

3. Chlamydia trachomatis

NAAT on urine

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9
Q

DOC for syphilis?

A

PCN

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10
Q

Which test for syphilis is sensitive? Specific?

A

Sensitive = RPR, VDRL

Specific = FTA-Abs

(FTA-Abs takes a while, so do RPR or VDRL initially)

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11
Q

DDx spots on hands and feet?

A

2 syphilis vs. RMSF

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12
Q

DDx truncal rash (if infectious)

A

2 syphilis vs. N. meningitdis

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13
Q

Characteristic lesion of 3 syphilis?

A

Gumma

(Soft necrotic, inflammed growth)

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14
Q

Causative agent of LGV?

A

Chlamydia trachomatis L1-L3

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15
Q

How does LGV present?

A

Inguinal lymphadenopathy

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16
Q

STD transmitted by haemophilus ducreyi?

A

Chancroid

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17
Q

G- diplococci

A

GC

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18
Q

Spirochetes

A

Treponema pallidum

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19
Q

Obligate intracellular organism

A

Chlamydia trachomatis

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20
Q

Flagellated protozoa

A

Trichomonas vaginalis

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21
Q

G- rod

A

Gardnerella vaginalis

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22
Q

Kissing kidney beans

A

GC

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23
Q

Yeast

A

Candida

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24
Q

Which bacterial STD is likely to recur and why?

A

GC d/t antigenic variation of the pilus

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25
Q

Pleomorphic, non-staining bacteria

A

Ureaplasma

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26
Q

Oxidase +

A

GC

(Cytochrome oxidase produced by all G- bacteria except Enterobactericaea)

27
Q

“It hurts to pee”

A

GC

28
Q

3 diseases caused by GC?

A

Urethritis

Cervicitis

PID

29
Q

Which two STD’s commonly occur together? What is the implication of such co-infection?

A

GC and chlamydia

Usually treat for both if diagnosis of one is made

30
Q

Tx of GC?

A

Cephalosporin + azithromycin or doxy to cover chlamydia

31
Q

“Cultured on chocolate agar” Dx?

A

Neisseria or haemophilus

32
Q

“Cultured on Thayer-Martin medium”

Dx?

A

Neisseria

33
Q

What is chocolate agar?

A

Agar with lysed RBC’s

Grows Neisseria or haemophilus

34
Q

What is Thayer Martin medium?

A

Chocolate agar that contains Abx that will kill off normal flora

Grows Neisseria

35
Q

Antigenic variation

A

GC

(New pilus structure)

36
Q

3 diseases caused by Chlamydia trachomatis D-K?

A

Non-gonococcal urethritis

Cervicitis

PID

37
Q

Function of elementary body? Reticulate body?

A

EB = attachment/entry

RB = replication

(Chlamydia)

38
Q

Why are beta-lactams an inappropriate treatment choice for Chlamydial infections?

A

Chlamydia lack a cell wall

39
Q

Dx of Chlaymdia trachomatis D-K? Tx?

A

NAAT on urine

Azitro or doxy + cephalosporin for GC

40
Q

A college student seeks medical attention for frothy vaginal discharge and dysuria. Her doctor prescribes her some medication and counsels her on safe sex practices. She begins treatment immediately to relieve her discomfort. Later that evening at a party, she becomes violently ill. Why?

A

She most likely has trich and was prescribed metronidazole, which produces a disulfiram-like reaction with alcohol consumption

41
Q

Presentation of trich?

A

Painful vaginitis with yellow, frothy, very productive discharge +/- dysuria

42
Q

Presentation of vulvovaginal Candidiasis?

A

Itchy, white discharge, esp in a patient on immunosuppressants, with diabetes, or during/after Abx

43
Q

Dx of Candidiasis? Tx?

A

KOH prep

Azoles or nystatin

44
Q

Clue cells

A

Epithelial cells with adherent Gardnerella

45
Q

What is the “whiff test”?

A

Add KOH to to vaginal discharge –> releases amines –> fishy smell –> Dx of vaginitis

46
Q

How does bacterial vaginitis present?

A

Fish-smell discharge, usually nonpainful

47
Q

Most common STD in US

A

Conyloma acuminatum (HPV)

48
Q

Structure of HSV vs HPV

A

Both are DNA viruses but HSV is enveloped and HPV is nonenveloped

49
Q

Implication of HPV being nonenveloped?

A

Can persist in environment for a while

50
Q

Describe the malignant transformation of HPV.

A

Loses E2 which causes increased expression of E6 (degrades p53) and E7 (inactivated Rb) = loss of cell cycle controll

51
Q

Permissive vs non-permissive cells

A

Permissive cells = epithelial cells = HPV latency

Non-permissive cells = keratinocytes = HPV replication

52
Q

Tx of HPV warts?

A

Removal, imiquimod, sinecathechin, podofilox

53
Q

Organism of condyloma plana?

A

HPV 6&11

(Flat warts)

54
Q

Organism of condyloma acuminatum?

A

HPV 6&11

55
Q

Dx of HPV?

A

Look for kiolocytes with pap smear

(Vacuoles + big nuclei)

56
Q

Complications of HSV?

A

Meningitis or encephalitis

(10% of primary HSV infx cause meningitis)

57
Q

When is HSV usually passed from mother to baby?

A

90% during delivery

58
Q

Complications of syphilis?

A

Stillbirth, spontaneous infection of fetus causing congenital syphilis (frontal bossing, sharp teeth, saddle nose)

59
Q

Complications of GC?

A

Rash, arthritis, fever

Ophthalmia neonatorum

PID

60
Q

Complications of Chlamydia?

A

PID

Infant pneumonia

Ophthalmia neonatorum

61
Q

Complications of HPV?

A

Cervical, anal, throat cancers d/t HPV 16, 18, 31, or 33

62
Q

Waxing/waning of bacterial load

A

Think GC d/t antigenic variation

63
Q

Effect of drug resistance or sensitivity on bacterial load

A

If resistant, ENTIRE load will not decrease

If sensitive, ENTIRE load will decrease

(Compare to antigenic variation-induced waxing and waning of bacterial load)