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Repro Micro > Micro: STD Overview > Flashcards

Micro: STD Overview Flashcards

1
Q

What is most common STD?

A

Chlamydia

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2
Q

What is HPV incidence common to?

A

Chlamydia… super prevalent

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3
Q

What % of people in 10-25 age group have HSV?

A

10-15%

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4
Q

What are 4 causes of genital ulcers?

A

HSV 1 and 2
Primary syphilis
chlamydia trachomatas L1-L3 (LGV)
Haemophilis ducreyi: chancroid

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5
Q

What are 3 causes of drips?

A 
chlamydia trachomatas D-K
Neisseria ghonorhea
Ureaplasma urelyticum
Trichomonas
Candidiasis: drug induced
BV: gardnerella vaginalis and other anaerobes
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6
Q

What are 3 causes of warts?

A

HPV
Secondary syphilis
Molluscum contagiousum (Pox virus)

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7
Q

HSV 1 typically located? 2 located?

A

1: above belt
2: below belt

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8
Q

HSV diagnosis?

A

blood PCR is #1
Fab assay
Tzanck smear

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9
Q

HSV tx?

A

Acyclovir

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10
Q

Multinucleated giant cells seen in?

A

Tzanck smear:
HSV
CMV
RSV

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11
Q

*S: WHY DOESNT ACYCLOVIR WORK ON HUMAN DNA POLYMERASE?

A

Needs viral thymidine kinase

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12
Q

*S: WHAT IS UNIQUE ABOUT ACYCLOVIR BIOAVAILABILITY?

A

Acy. bioavailability goes down with HIGHER doses

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13
Q

*S: What are the AEs of acyclovir?

A
  1. Crystaline nephrophathy (HYDRATE!)

2. CNS toxicity

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14
Q

What do you take for ACV resistant strains? (HIV pts.)

A

Foscarnet: does not need thymidine kinase

pyrophosphate analog, jams up without using thymidine kinase

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15
Q

Can you tell the difference between primary and secondary herpes?

A

No… lesions look the same

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16
Q

What are the hallmarks of primary, secondary, and tertiary syphilis?

A

1: painless Chancre
2 maculopapular rash
3: granulomas (gummas), demensia, aortic aneurism (tree bark)

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17
Q

What are the diagnostic tests for syphilis?

A 
Non-treponemal: 
    RPR
    VDRL
Treponema: 
     FTA-ABS
Dark field microscopy
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18
Q

What is the drug for syphilis?

A

Penicillin

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19
Q

*S: What is the difference between the benzadine preparation of penicillin and others?

A

Slower release from a intramuscular injection

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20
Q

What is important difference between syphilis and herpes lesions?

A

Herpes=Hurts

Syphilis=no pain

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21
Q

What is interesting about syphilis secondary rash?

A

HANDS AND FEET!

Tracts in

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22
Q

What is LGV?

A

Lymphogenital venarium:

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23
Q

What if a chancre is painful?

A

Haemophilis ducryum…?

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24
Q

How many chancres present with primary syphilis?

A

One chancre! If multiple, and painful, think herpes

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25
Q

If you have a primary infection, what is the likely history?

A

Flu-like symptoms?

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26
Q

What is a feared complication of HSV 1 and 2?

A

Meningitis

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27
Q

What is the hallmark of meningitis?

A

Neck soreness

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28
Q

How do you diagnose meningitis?

A

CSF:

viral: aseptic->HSV=Acyclovir/no tx… it will go away
bacterial: terrible!

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29
Q

What is the risk for fetus in primary HSV vs. secondary HSV?

A

Primary: less antibody protection, fetus is more likely to get HSV
Secondary: more antibody protection

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30
Q

What type of response do you need to HSV?

A

Cellular, then humoral (antibodies) if it gets out of hand

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31
Q

Is acyclovir efficacious at clearing HSV?

A

No, since herpes is latent in neurons

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32
Q

What is the last place for a secondary syphilis rash to show up?

A

Palms and soles – could present like something else!

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33
Q

What rash has a similar appearance to secondary syphilis, but no palms and soles?

A

Neisseria meningitidis

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34
Q

TEST: RYAN: How do you visualize spirochetes without using antibodies?

A

DARK FIELD MICROSCOPY

Too thin to gram stain

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35
Q

Can you culture syphilis?

A

No, extremely hard to culture.

Run RPR/VRPL non treponemal test

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36
Q

Would syphilis symptoms go away?

A

Yes, then return and be secondary or tertiary

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37
Q

TEST: RYAN: Oxidase + gram negative diplococcus (kissing kidney beans) ([ut hydrogen peroxide and it makes bubbles)

A

Neisseria gonorrhoeae

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38
Q

Can humans have permanent immunity to nneisseria gonorheoae?

A

No, antigenic variation of pillis (attachment structure)

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39
Q

Growth medium for neisseria gonorheoae?

A 
Thayer martin (type of chocolate agar with antibiotics that select ng)
Gram stain
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40
Q

Tx of neisseria gonorrhoeae?

A

Ceftriaxone (plus azithromicin or doxycycline)

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41
Q

What does neisseria gonorrhoeae cause?

A

urethritis
cervicitis
pelvic inflamatory disease

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42
Q

*S: WHAT DRUG OPTION FOR TX OF N. GONORRHOEAE IS CONTRAINDICATED IN PREGNANCY?

A

DOXYCYLINE

OTHERS ARE CEFTRIAXINE AND AZITHROMYCIN

43
Q

Why do we do dual therapy with antibiotics?

A

Treat confections, 50% of people have chlamydia

44
Q

What is the street name of gonorrhoeae?

45
Q

What is the guaranteed symptom of gonorhoeae?

A

Doc, it hurts to pee

46
Q

What is the two types of chlamydia?

A

Elementary body: infecting agent: exits

Reticulate body: replication inside cell

47
Q

What is unique about chlamydia’s structure?

A

No cell wall (has muramic acid?)

Penicillin doesn’t work!

48
Q

What are the subtypes of chlamydia?

A

A-C: eyes
D-K: groin
L1-L3: LGV

49
Q

What does chlamydia cause?

A

urethritis
cervicitis
PID

50
Q

How do we diagnose chlamydia?

A

Urine dipstick

51
Q

What is tx for chlamydia?

A

Axithromycin or doxycycline AND Ceftriaxone

52
Q

What mentioned is not a bacteria or virus?

A

Trichimonas vaginalis

53
Q

What is trichomonad vaginalis?

A

A parasite protozoan

54
Q

What does trichomonad cause?

A

Vaginitis

Dysuria

55
Q

How do we diagnose trichomona?

A

Wet mount looking for twitching motility of flaggellates

56
Q

Drug for trichomonad?

A

metronidazole (SWEAT; Tinidazole also)

57
Q

*S: Drugs for tichimonas are CI in what?

A

Pregnancy

Breast feeding

58
Q

*S: What is an unusual effect of trichimonas tx?

A

Metronidazole/tinidazole CI with alcohol

secondary malignancies in animals

59
Q

*S: What is the name of the effect of metronidazole/tinidazole with alcohol?

A

Disulfiram effect

60
Q

*S: what is a drug used for alcoholics?

A

Disulfram: makes people nauseous

61
Q

What is very typical of trichimonas exudate?

62
Q

What is seen in trichimonas wet mount?

63
Q

What is typical of yeast infection history?

A

Antibiotic tx causes overgrowth
Immunosuppression
Diabetes mellitus

64
Q

What is tx. for yeast?

A

Azoles or nystatin

65
Q

What is diagnosis for yeast?

66
Q

*S: What is Ci of azoles?

67
Q

*S: What do azoles cause?

A

Condom/Diaphragm degradation:

Birth defects

68
Q

What does yeast infection look like grossly?

A

Cottage cheese

69
Q

What is notable about bacterial vaginosis?

A

Low pain, looks like gross dischage

70
Q

What is microscopically present in BV?

A

CLUE CELLS: Epithelioid cell sloughing with bacteria on surface

71
Q

What is another clue for BV?

A

Stinky… with clue cells

72
Q

What is smelling test for BV?

A

Whiff test: KOH–>amines smell fishy

73
Q

What does absence of lymphadenopathy help rule out?

74
Q

What do cervical swabs tell us in pelvic pain?

A

Neisseria gonorrhea

75
Q

What is the base treatment for STD?

A

Azithromycin and ceftriaxone

76
Q

Why do neisseria gonorhea fluctuate?

A

Antigenic variation (NOT mutations, just different assortments of genes)

77
Q

What is the structure of HPV?

A

Nonenveloped CIRCULAR ds DNA

78
Q

What does non-envelped structure tell us?

A

Will not die off quickly

79
Q

What does HPV do in non-permissive/proliferating cells?

A

Cannot make “late” structural proteins to release, but still lives inside and replicate.
Causes overgrowth of cell.
Causes cancer in time: transformation.

80
Q

What is interesting about a wart?

A

It is a benign tumor, and still sheds virus.

This is why they are in clusters.

81
Q

What stage in skin does HPV begin to shed virus?

A

Keratinocyte stage as it moves out from germinal layers.

82
Q

What layer of skin is HPV latent in?

A

Basal germinal layer, does not shed virus.

83
Q

What does HPV do in permissive cells?

A

Keratinocytes: Sheds virus

84
Q

What is one of the leading causes of HPV death?

A

Cervical cancer

85
Q

What is important in the diagnosis of HPV?

A

Regular Pap smears

Vaccine

86
Q

*S: BOARDS: What is the bivalent HPV Vaccine? treats?

A

HPV ___ and ___

87
Q

*S: BOARDS: What is the quadrivalent HPV vaccine? Treats?/

A

HPV ___ and ___

___ and ___

88
Q

*S: What is treatment for HPV squamous cell cancer?

A

Imiquimod (unlikely q on boards)

89
Q

TEST: What is the HPV structure in non-malignant tumors?

A

Circular
full length
extra-chromosomal

90
Q

TEST: What is the HPV structure in malignant tumors?

A

Partial genome
Integrated to host dna
Lost E2 gene

91
Q

TEST: What does loss of HPV E2 lead to?

A

High level expression of E6 and E7,
E6: degrades p53
E7: inactivates Rb
Cell cycle control is lost (brakes removed)

92
Q

TEST: What is the difference between and malignant and non-malignant HPV wart?

A

E2 presence: lost=cancer via E6(p53)/E7(Rb)

93
Q

What is verucca plana caused by?

A

HPV ___ and ___

94
Q

What is condylata accumulate caused by?

A

HPV ___ and ___

95
Q

TEST: What does HPV microscopy look like?

A

Koilocytotic: Vaculated around the cytoplasm

Acetic acid on gross cervix: turns white

96
Q

After visualizing koilocytotic cells on HPV slide, what do you do?

A

Brush cervix with 5% acetic acid. Infected regions become white

97
Q

What is STI warts caused by?

A

HPV 16 18 33

98
Q

What is the antigen used in HPV vaccines?

A

L1 protein, a capsid protein

99
Q

What complications are we trying to prevent in STDs?

A

Congenital infecitons->encephalitis/still birth

CNS infections

100
Q

Syphilis congenital appearance?

A

Saddle nose
Serrated incisors
Saber shins

101
Q

Neisseria gonorrhea congential infections?

A

Eye infections

Blood: Rash, arthritis, fever, PID` in mom

102
Q

Chlamydia congential infections?

A

Eyes

Pneumonia

103
Q

*S: Erythromycin during pregnancy can cause what in the child?

A

Hypertrophic pyloric stenosis

Repro Micro (6 decks)

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