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Micro Exam #2 > (Mostly) Sexually Transmitted Diseases > Flashcards

(Mostly) Sexually Transmitted Diseases Flashcards

1
Q

Treponema pallidum is commonly referred to as…

A

Syphilis

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2
Q

Describe the structure of Treponema pallidum

A

Long, thin spirochete

- Unseen in light microscope, seen by silver stain

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3
Q

What type of microscope can view Treponema pallidum?

A

Dark Field Microscope

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4
Q

What surrounds every Treponema pallidum cell?

A

Glycosaminoglycan sheath

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5
Q

How is Treponema pallidum made motile?

A

Endoflagella within the periplasm (3 per end)

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6
Q

What is unique about Treponema pallidum’s envelope?

A

No LPS

Cardiolipin in membrane

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7
Q

Does Treponema pallidum have many outer membrane proteins? Significance of this knowledge?

A

Few OM proteins

Makes it hard for immune system to find it and make Abs

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8
Q

Method used to culture Treponema pallidum?

A

None. So far unculturable in lab

Grown in rabbit testes instead

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9
Q

Oxygen metabolism of Treponema pallidum?

A

Microaerophilic

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10
Q

What is a chancre?

A

Defined, Unpainful papule at site of infection

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11
Q

Describe the symptoms common to Primary Treponema pallidum infection.

A

Ulcerated, Chancre, Regional LN swelling

Heals spontaneously, but organisms remain in blood

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12
Q

Describe the clinical presentation of secondary Treponema pallidum infection.

A

Red macular/macropapular rash anywhere

Condylomas in mount areas

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13
Q

What is unique about the red macular/macropapular rash of Treponema pallidum?

A

One of few to appear on soles and palms

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14
Q

What is a condyloma?

A

Raised, White, wart-like papule (seen in Treponema pallidum)

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15
Q

Difference between the early and late latent period?

A

Early – Within a year of secondary

Late – 1-20+ years

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16
Q

What is tertiary Treponema pallidum response?

A

Lesions of tissues through body caused by immune response

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17
Q

Why can’t you culture a tertiary Treponema pallidum response?

A

Treponema pallidum hasn’t been able to be cultured so far

Even if it could, its only immune response at this point, not the actual bacteria

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18
Q

Important causes of vertically transmitted disease

A 
Toxoplasma
Other -- HIV, Coxsackie, Chicken Pox, etc.
Rubella
Cytamegalovieus
HErpes
Syphilis
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19
Q

Clinical presentation of tertiary Treponema pallidum response?

A 
Gummas
Bones: porous, bendable, fragile
Heart: aorta swells, ruptures
liver
CNS
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20
Q

Two manifectstions of Treponema pallidum in the CNS

A

Brain – General paresis

Spine – tabes dorsalis

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21
Q

Significance of Treponema pallidum in pregnant women?

A

20% abortion or stillbirth

80% have congenital defects

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22
Q

Primary defects associated with Treponema pallidum transmission in utero? (Name the group name)

A

Hutchison’s triad

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23
Q

What does Hutchison’s Triad entail?

A

Blindness
VIII Nerve Deafness
Hutchison’s Teeth

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24
Q

What are Hutchison’s Teeth?

A

Double pointed incisors

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25
Q

What organisms can carry Treponema pallidum?

A

Only humans

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26
Q

How is Treponema pallidum transmitted?

A

Exclusively STD

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27
Q

How long are infected individuals contagious with Treponema pallidum?

A

3-5 years

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28
Q

What population is seeing the most rapid increases in Treponema pallidum diagnosis?

A

Over 50

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29
Q

Two groups that should always be tested for Treponema pallidum

A

High-Risk Populations

After any stillbirth

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30
Q

Describe the infectivity and molecular mechanism of Treponema pallidum infection.

A

Highly infectious

Hyaluronidase facilitates spread/invasion of tissues + Rapid Motility

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31
Q

How is Treponema pallidum controlled (in a public health-y kind of way)?

A

Finding, Testing Sexual Contacts

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32
Q

How is Treponema pallidum diagnosed?

A

Look for spirochetes in chancres

Serologic Tests for Treponema pallidum

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33
Q

What do indirect tests look for? Direct tests?

A

Antibodies

the Organism

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34
Q

Descrive the Treponema pallidum indirect test.

A

Add Cardiolipin to patient’s serum
If + Reagin will cause it to clump
Many false positives

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35
Q

What is Reagin

A

IgM+IgA

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36
Q

What occurs in a direct Fluorescent Treponema Antibody test?

A

Sandwich assay for Treponema pallidum epitopes

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37
Q

How is early Treponema pallidum typically treated?

How is latent Treponema pallidum typically treated?

A

1 dose Penicillin G

3 doses Peni. for latent

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38
Q

Why does tertiary Treponema pallidum require much greater levels of penicillin?

A

You have to get through the Blood Brain Barrier

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39
Q

Describe the structure Neisseria gonorrhea.

A

G-
Coffee Bean Shape
Diplococcus

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40
Q

How is Neisseria gonorrhea cultured?

A

Best with selective media (vanco, colistin)

Also gros on MTM or chocolate blood

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41
Q

What oxygen metabolism does Neisseria gonorrhea use?

A

Aerobic, but likes 5% CO2

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42
Q

Describe the genetic setup on Neisseria gonorrhea

A

2 identical diploid chromosomes

NEVER heterozygous

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43
Q

Neisseria gonorrhea invades _______

A

Mucus membranes of UGT, Rectum, Eye, Throat

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44
Q

In either gender, Neisseria gonorrhea tends to present with… (4)

A

Urethritis
Proctitis
Pharyngitis
Arthritis

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45
Q

Unique Neisseria gonorrhea manifestations in women (5)

A

Vaginitis
Salphingitis
Pelvis Inflammatory Disease
Peritonitis

Major cause of infertility in women

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46
Q

How does Neisseria gonorrhea manifest in neonates?

A

Conjunctivitis

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47
Q

How is Neisseria gonorrhea spread?

A

Human STD

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48
Q

Neisseria gonorrhea is commonly associated with ______ co-infection. So What?

A

Chlamydia

Treat for both (presumed coinfection)

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49
Q

Why is Neisseria gonorrhea so widely spread?

A

Asymptomatic Carriers

50
Q

How is Neisseria gonorrhea diagnosed?

A

Males – Gram stain of urethral drip

Females – Culture of cervical/vaginal swab

51
Q

Unique components of Neisseria gonorrhea attachment?

A
  • Pilus cassette switching avoids immune response

- Opa protein has a great deal of antigenic variation caused by slippage of DNA repeats

52
Q

In females, Opas change during…

A

Menstrual Cycle

53
Q

Three proteins involved in Neisseria gonorrhea evasion

A

Por
Rmp
IgA Protease

54
Q

What is Por protein in Neisseria gonorrhea?

A

Outer membrane porin

Prevents phagolysosome fusion in host

55
Q

What is Rmp in Neisseria gonorrhea?

A

Host Abs bind to it, prevents Ab binding to Por and LOS

56
Q

Significance of IgA protease in Neisseria gonorrhea?

A

Stops IgA’s bacteriocidal, complement activating activity

57
Q

What two components of Neisseria gonorrhea mediate toxicity?

A

LOS

PG released from autolysins at low temp/alk. pH

58
Q

What does Fbp protein in Neisseria gonorrhea do?

A

Scavenges Fe from human lactoferrin and transferrin

59
Q

Neisseria gonorrhea secretes blebs with ____ inside

A

PG

60
Q

Why is Neisseria gonorrhea hard to drug?

A

Resistance is acquired very easily

61
Q

What do you do for patients with Pan-resistant Neisseria gonorrhea.

A

Say a prayer or something - they’re keeping their Neisseria gonorrhea

62
Q

How do you typically treat Neisseria gonorrhea?

A

Cephtriaxone or cefixime

plus doxycycline/erythromycin for chlamydia

63
Q

How is newborn Neisseria gonorrhea treated?

A

Tetracycline drops

64
Q

You’ve cured your Neisseria gonorrhea patient! Good job! What do you need to make sure not to forget?

A

Treat everyone they doinked

65
Q

How is Neisseria meningitidis spread?

A

Respiratory Droplets

NOT an STD. Here because Med School is dumb

66
Q

Describe the structure of Neisseria meningitidis.

A

G-
Coffee bean shapes
Diplococcus
Polysachharide capsule

67
Q

How many types of Neisseria meningitidis are there?

Name the top 5.

A

About 12

A, B, C, Y, W-135

68
Q

Blood related presentation of Neisseria meningitidis?

A

Meningococcemia
Purpura and Petechial Hemorrhages
- Caused by toxic effects of LOS, soluble PG

69
Q

Non-blood clinical presentation of Neisseria meningitidis?

A

15% involvement of meninges
Acute Headache, Vomiting, Stiff Neck
Sometime neurological symptoms, coma, and death

70
Q

In CNS cases of Neisseria meningitidis, what two findings might you expect?

A

PMNL in CSF

Purulent exudate of PMNL and Nm surrounding brain

71
Q

What is meningococcal septicemia?

A

DIC and Circulatory Collapse

72
Q

_____ modification with ______ disrupts microcolony. This is what allows Neisseria meningitidis to spread from the respiratory tract.

A

Pilin

Phosphatidylglycerol

73
Q

Name a couple placed most prone to have an Neisseria meningitidis outbreak

A

College dorm, Military barracks

74
Q

Most epidemics of Neisseria meningitidis are due to…

A

Specific Capsular Antigen Types

75
Q

Pathogenesis of Neisseria meningitidis is most similar to…

A

Gonococcus

76
Q

Unique pathogenesis of Neisseria meningitidis?

A

Antiphagocytic Polysaccharide Capsule
Special Pili for BBB endothelial cells
Bonus Adhesins in OM

77
Q

How does the antiphagocytic polysaccharide capsule work?

A

Antigen B is sialyted

More disguised than others

78
Q

Why do we care that Neisseria meningitidis has BBB attaching pili?

A

The proteins recruit proteins away from junction complexes, depleting cell jxns, making barrier porous

79
Q

Can Neisseria meningitidis be vaccinated for? How?

A

Currently there are vaccines for all types

Menvo + BEXSERO or Trumenba

80
Q

How is Neisseria meningitidis treated?

A

3rd gen. Cephalosporin

81
Q

Why are Rifampin and 3rd gen ceph. used prophylactically?

A

They can cross the BBB whenever they want

82
Q

Why might you prescribe Vancomycin for Neisseria meningitidis, even though it can’t penetrate BBB?

A

If the BBB is damaged/porous it can cross.

If a different, G+, bacteria causes meningitis, its helpful

83
Q

How does Moraxella catarrhalis tend to present?

A

Opportunistic sinusitis, bronchitis, pneumonia

Otitis media in children

84
Q

Moraxella catarrhalis tends to exacerbate what other disease in adults?

A

COPD

85
Q

Top three causes of otitis media?

A

S. Pneu
H. flu
Moraxella catarrhalis

86
Q

How do you treat Moraxella catarrhalis?

A

3rd generation Ceph. OR Cipro

OR not at all

87
Q

Physical characteristics of Chlamydia trachomatis

A

Like G- Envelope
Small genome
Cell wall without MurNAc

88
Q

How must Chlamydia trachomatis grow?

A

Obligate intracellular parasite

89
Q

How is Chlamydia trachomatis often grown in the lab?

A

embryonated chicken eggs
McCoy cells in monolayer tissue cultures
Mouse Brains

90
Q

Two forms of Chlamydia trachomatis?

A

Elementary Bodies

Reticulate Bodies

91
Q

Describe Elementary Bodies in Chlamydia trachomatis.

A

Infective Form
0.3uM diameter
Tough S-S membrane

92
Q

Describe Reticulate bodies in Chlamydia trachomatis.

A

Replicative Form
1.0uM diameter
Fragile SH HS

93
Q

Does Chlamydia trachomatis tend to manifest as chronic or acute?

A

Chronic

94
Q

Five ways that Chlamydia trachomatis infection may present in the clinic

A 
Trachoma
Inclusion Conjunctivitis
Neonatal Pneumonia
Chlamydia
Latent Infection
95
Q

How does a person get a Trachoma (Chlamydia trachomatis)?

A

Infection from birth from infected birth canal

Infection in early childhood by contact/mechanical vector

96
Q

How does Trachoma (Chlamydia trachomatis) present clinically?

A
  • Mucopurulent discharge, Pannus formation, cornea obstruction
  • Irritation from pannus+eyelashes+other bac –> blindness
97
Q

How do people get inclusion conjunctivitis from Chlamydia trachomatis? How does it present clinically?

A 
Mostly neonates (infected birth) and adults (self-inoculation)
Less severe trachoma, maybe respiratory complications
98
Q

Presentation of Neonatal pneumonia via Chlamydia trachomatis? When should you suspect?

A

Shortness of breath, no Fever

If symptoms occur with inclusion conjunctivities

99
Q

Chlamydia trachomatis patients tend to also be infected with ________

A

Gonorrhea

100
Q

Symptoms of Chlamydia (Chlamydia trachomatis) in males

A

Non-gonococcal urethritis
Epididymitis
Prostatis

101
Q

Symptoms of Chlamydia (Chlamydia trachomatis) in females

A

Urethritis
Cervicitis
Salphingitis
PID

102
Q

Long term significance of salphingitis in Chlamydia and Gonorrhea?

A

Common cause of infertility from fallopian rupture

103
Q

Symptoms of a latent infection with Chlamydia trachomatis.

A

Small abscess
Inguinal Buboes form sometime thereafter
If chronic, can cause fibrous lymphatic restrictions or bowel obs.

104
Q

How are the buboes seen in latent Chlamydia trachomatis differentiated from plague?

A

Chlamydia trachomatis buboes are never in cervical lymph nodes

105
Q

The STD form of Chlamydia trachomatis is most common in…

A

NA, SA, Eur

106
Q

Trachoma Chlamydia trachomatis is most common where?

A

Asia/Africa

Hot, Dry places with poor access to clean water

107
Q

_________ is a leading cause of infectious blindness in the world.

A

Trachoma Chlamydia trachomatis

108
Q

Why would you treat both localizations of Chlamydia trachomatis infection at the same time in a patient?

A

They can cross-infect

109
Q

Pathogenesis of Chlamydia trachomatis?

A
  • Elementary bodies bind host receptor, induce endocytosis
  • Chlamydia prevent phagolysosome fusion
  • Induce cytokines (IL-1) and cause inflammation
  • Remain for long periods without killing host
110
Q

Why are vaccines against Chlamydia trachomatis ineffective?

A

Intracellular location of pathogen

111
Q

_____ is the key to control. This is accomplished by ___.

A

Screening.

PCR

112
Q

How is Chlamydia trachomatis treated?

A

Azithromycin

Tetracycline and macrolides may also work

113
Q

Drastic measures to prevent Trichiasis Chlamydia trachomatis corneal keratinization include….

A

Surgery

Epilation (pulling out lashes)

114
Q

You’re awesome! You just cured your patients Chlamydia trachomatis! Now, just don’t forget to…

A

Identify and treat all of their sexual conacts

Expedited partner therapy if necessary

115
Q

How does Chlamydia pneumoniae tend to present clinically?

A

Mild URT disease

Possibly progressing to mycoplasma-like pneumonia

116
Q

Chlamydia pneumoniae may be associated with what other major diseases?

A

Atherosclerosis
Asthma
Stroke
Late-Onset Alzheimers

117
Q

How to treat Chlamydia pneumoniae?

A

Usually Untreated

Tetracycline might help

118
Q

Chlamydia psittaci is also known as..

A

Parrot Fever

119
Q

How does Chlamydia psittaci tend to present in the clinic?

A

Acute, Severe Pneumonia and Sepsis

Patchy, well-defined lung involvement

120
Q

How is Chlamydia psittaci transmitted?

A

Contact with psittacine birds (esp. bites or feces)

121
Q

How is Chlamydia psittaci controlled and treated?

A

Quarantine of Imported Birds

Tetracycline

Micro Exam #2 (15 decks)

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