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
Pleomorphic, non-staining bacteria
Ureaplasma
26
Oxidase +
GC (Cytochrome oxidase produced by all G- bacteria except Enterobactericaea)
27
"It hurts to pee"
GC
28
3 diseases caused by GC?
Urethritis Cervicitis PID
29
Which two STD's commonly occur together? What is the implication of such co-infection?
GC and chlamydia Usually treat for both if diagnosis of one is made
30
Tx of GC?
Cephalosporin + azithromycin or doxy to cover chlamydia
31
"Cultured on chocolate agar" Dx?
Neisseria or haemophilus
32
"Cultured on Thayer-Martin medium" Dx?
Neisseria
33
What is chocolate agar?
Agar with lysed RBC's Grows Neisseria or haemophilus
34
What is Thayer Martin medium?
Chocolate agar that contains Abx that will kill off normal flora Grows Neisseria
35
Antigenic variation
GC (New pilus structure)
36
3 diseases caused by Chlamydia trachomatis D-K?
Non-gonococcal urethritis Cervicitis PID
37
Function of elementary body? Reticulate body?
**_E_**B = attachment/**_e_**ntry **_R_**B = **_r_**eplication (Chlamydia)
38
Why are beta-lactams an inappropriate treatment choice for Chlamydial infections?
Chlamydia lack a cell wall
39
Dx of Chlaymdia trachomatis D-K? Tx?
NAAT on urine Azitro or doxy + cephalosporin for GC
40
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?
She most likely has trich and was prescribed **_metronidazole_**, which produces a disulfiram-like reaction with alcohol consumption
41
Presentation of trich?
Painful vaginitis with yellow, frothy, very productive discharge +/- dysuria
42
Presentation of vulvovaginal Candidiasis?
Itchy, white discharge, esp in a patient on **_immunosuppressants_**, with **_diabetes_**, or during/after **_Abx_**
43
Dx of Candidiasis? Tx?
KOH prep Azoles or nystatin
44
Clue cells
Epithelial cells with adherent Gardnerella
45
What is the "whiff test"?
Add KOH to to vaginal discharge --\> releases amines --\> fishy smell --\> Dx of vaginitis
46
How does bacterial vaginitis present?
Fish-smell discharge, usually nonpainful
47
Most common STD in US
Conyloma acuminatum (HPV)
48
Structure of HSV vs HPV
Both are DNA viruses but HSV is enveloped and HPV is nonenveloped
49
Implication of HPV being nonenveloped?
Can persist in environment for a while
50
Describe the malignant transformation of HPV.
**_Loses E2_** which causes increased expression of E6 (degrades p53) and E7 (inactivated Rb) = **_loss of cell cycle control_**l
51
Permissive vs non-permissive cells
Permissive cells = epithelial cells = HPV latency Non-permissive cells = keratinocytes = HPV replication
52
Tx of HPV warts?
Removal, imiquimod, sinecathechin, podofilox
53
Organism of condyloma plana?
HPV 6&11 (Flat warts)
54
Organism of condyloma acuminatum?
HPV 6&11
55
Dx of HPV?
Look for kiolocytes with pap smear (Vacuoles + big nuclei)
56
Complications of HSV?
Meningitis or encephalitis (10% of primary HSV infx cause meningitis)
57
When is HSV usually passed from mother to baby?
90% during delivery
58
Complications of syphilis?
Stillbirth, spontaneous infection of fetus causing congenital syphilis (frontal bossing, sharp teeth, saddle nose)
59
Complications of GC?
Rash, arthritis, fever Ophthalmia neonatorum PID
60
Complications of Chlamydia?
PID Infant pneumonia Ophthalmia neonatorum
61
Complications of HPV?
Cervical, anal, throat cancers d/t HPV 16, 18, 31, or 33
62
Waxing/waning of bacterial load
Think GC d/t antigenic variation
63
Effect of drug resistance or sensitivity on bacterial load
If resistant, ENTIRE load will not decrease If sensitive, ENTIRE load will decrease (Compare to antigenic variation-induced waxing and waning of bacterial load)