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Reproductive-Week 3/4 > Repro Microbiology > Flashcards

Repro Microbiology Flashcards

1
Q

Most STIs are asymptomatic (True or False)

A

True; hence why they are called STI’s and not STDs

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2
Q

Most common STIs

A

Chlamydia
Gonorrhea
Syphilis
Trichomonas

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3
Q

What are some special populations that would benefit from STI screening

A

Sexually active men/women
Pregnant women
HIV-infected patients

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4
Q

STI pathology can be divided into what three rough categories (based on location of infection)

A

Genital Ulcer Disease
Urethritis/Cervicitis
Vaginitis

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5
Q

Top causes of Genital Ulcer Disease (3 total)

A

HSV
Syphillis
Chancroid (H. decreyi)

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6
Q

Open lesions of the genital skin/mucosa; usually caused by HSV, Syphilis or H. decreyi

A

Genital Ulcer Disease

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7
Q

Double stranded DNA virus; MOST COMMON cause of Genital Ulcer Disease; most commonly asymptomatic with latent phase in DRG; can be passed to fetus during delivery; treat with Acyclovir, Famciclovir or Valacyclovir

A

HSV (usually HSV-2)

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8
Q

What are the three classical presentations of HSV infection

A

Skin-Eye-Mucosal (SEM)
CNS disease
Disseminated disease

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9
Q

Describe the Skin-Eye-Mucosal presentation of HSV

A

Conjunctivitis

Skin lesions/vesicles

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10
Q

In what ways can HSV-2 be transmitted

A

Between sexual partners (Horizontal)

Between mother and infant during DELIVERY (Vertical)

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11
Q

What are three organs systems that DISSEMINATED HSV likes to target

A

Liver (hepatitis, coagulopathies)
Lungs (respiratory distress)
Brain

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12
Q

HSV-1 usually causes sores around where

A

Mouth and lips (“cold sores”)

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13
Q

HSV-2 usually causes sores around where

A

Genitals

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14
Q

Histologic finding for HSV infection

A

Tzanck smear with Multinucleated Giant Cells

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15
Q

Treatment for HSV

A

Acyclovir
Famciclovir
Valacyclovir

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16
Q

MOST common viruses transmitted from mother to baby (either in utero or perinatal)

A

HSV
CMV
VZV

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17
Q

Spirochete bacteria; cause of Syphilis; 90% of cases are in the developing world; usually begins with PAINLESS chancre, and can later result in Rash, Condyloma Lata and skin/heart/brain manifestations; can be spread from pregnant women to fetus (TORCH infection); treat with Penicillin

A

Treponema pallidum

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18
Q

Earliest sign of Syphilis

A

PAINLESS Chancre

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19
Q

Rash from Syphilis is on what areas

A

Palms

Soles

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20
Q

Secondary stage of Syphilis

A

Rash on PALMS and SOLES
Systemic symptoms
Condyloma lata (mucous papules)

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21
Q

Tertiary stage of Syphilis

A

Necrotizing granulomas (“gummas”) of skin, bone and mucous membranes
“Tree-bark” Aortitis (aneurysm)
CNS abnormalities

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22
Q

Syphilis infection of the CNS; can cause paresis and Tabes Dorsalis (Dorsal roots and columns); characterized by ataxia, Argyll Robertson pupils and poor proprioception

A

Neurosyphilis

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23
Q

Signs/Symptoms of Congenital Syphilis

A 
Snuffles (runny nose)
Pneumonia
Meningitis
Hutchinson's incisors (triangular)
Deafness
Saber shins
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24
Q

Diagnostic techniques for Syphilis

A

Dark-field microscopy
Rapid Plasma Reagin (RPR)
VDRL
FTA-ABS (confirmatory)

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25
Q

Treatment for Syphilis

A

Penicillin

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26
Q

Syphilis is more common (90%) in the (developed/developing) world

A

Developing

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27
Q

Gram-negative rods; RARE in the United States; cause Genital Ulcer Disease; PAINFUL genital ulcers with MARKED regional lymphadenopathy; Treat with Azithromycin

A

Haemophilus ducreyi (Chancroid)

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28
Q

Difference between the ulcers of Syphilis and H. ducreyi

A

Syphilis: painless

H. ducreyi: painful

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29
Q

Treatment for Haemophilus ducreyi (Chancroid)

A

Azithromycin

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30
Q

Types of Chlamydia that cause Genital ulcers/buboes; treat with Doxycycline

A

L1-3

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31
Q

Clinical features of Chlamydia trachomatis L1-3 genital infection

A

Painless papule
Buboes
“Groove” sign

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32
Q

Top causes of Urethritis/Cervicitis (2 total)

A

Chlamydia

Gonorrhea

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33
Q

Top causes of Vaginitis (3 total)

A

Candida
Bacterial Vaginosis (BV)
Trichomonas

34
Q

Infection of the Vagina; characterized by discharge, itching and/or odor; commonly caused by Candida, Bacterial Vaginosis and Trichomonas; can also be caused by Lichen Planus and medications (OCPs)

A

Vaginitis

35
Q

Examples of non-infectious Vaginitis

A

Lichen Planus

Medications (OCPs)

36
Q

Describe the NORMAL Vaginal flora

A

Lactobacillus

37
Q

What can predispose a woman to Candida Vaginitis

A

Antibiotic treatment wiping out the normal Lactobacillus flora
Menstrual cycles/Menopause

38
Q

Yeast with germ tubes/pseudohyphae; can form biofilms; MOST COMMON cause of Vaginitis; “cottage cheese” discharge that is white and clumpy; Treat with Fluconazole or Miconazole

A

Candida

39
Q

Which mucosal surfaces are often affected by Candida

A

Mouth (thrush)
Esophagus/upper GI
Vagina
Moist skin folds (diaper rash)

40
Q

Virulence factor for Candida

A

Biofilms (avoid antibiotics and immune system)

41
Q

Treatment for Candida Vaginitis

A

Fluconazole (orally)

Miconazole (vaginal suppository)

42
Q

Etiologic agent for Bacterial Vaginosis (BV); presents with FISHY smelling, gray discharge; see “Clue cells” wet mount with pH >4.5; treat with Metronidazole

A

Gardnerella vaginalis

43
Q

Signs of Gardnerella vaginalis (Bacterial Vaginosis)

A

FISHY smell
Gray discharge
“Clue cells” (obscured borders)
pH >4.5

44
Q

Treatment for Gardnerella vaginalis (Bacterial Vaginosis)

A

Metronidazole

45
Q

Protozoan cause of Vaginitis; foul-smelling, GREEN discharge; can see “Strawberry Cervix”; wet mount will show motile trophozoites; treat with Metronidazole and ALSO TREAT PARTNERS

A

Trichomonas

46
Q

Signs of Trichomonas vaginitis

A 
Foul-smelling
Green discharge
Itching/burning
"Strawberry" cervix
Motile trophozoites on wet mount
47
Q

Treatment for Trichomonas

A

Metronidazole (remember to treat partner as well)

48
Q

Chlamydia and Gonorrhea are both gram (positive/negative) and (intra/extra) cellular

A

Negative; Intracellular (although Chlamydia is OBLIGATE intracellular)

49
Q

Infection of the urethra or cervix; can be associated with discharge and dysuria, but most commonly ASYMPTOMATIC

A

Urethritis/Cervicitis

50
Q

Urethritis/Cervicitis are usually asymptomatic (True or False)

A

True

51
Q

Gram negative/poorly stained bacteria; OBLIGATE intracellular; grows in cytoplasmic vacuole; requires host ATP cause of Urethritis and Cervicitis; can also cause trachoma (blindness), atypical pneumonia and psittacosis; has INERT elementary bodies that spread and invade other cells to form reticulate bodies

A

Chlamydia

52
Q

Pathologies that can be caused by Chlamydia

A

Urethritis/Cervicitis
Trachoma (blindness)
Atypical Pneumonia
Psittacosis (from parrots)

53
Q

For Chlamydia, elementary bodies are (extracellular/intracellular) and are (active/inert)

A

extracellular; inert

*originally intracellular, but will be release to infect other cells

54
Q

For Chlamydia, reticulate bodies are (extracellular/intracellular) and are (active/inert)

A

intracellular; active

55
Q

Genital tract infections are usually caused by what types of Chlamydia

A

D-K

56
Q

Treatment for Chlamydia Genital tract infections

A

Doxycycline

Azithromycin

57
Q

Reactive Arthritis that can be caused by Chlamydia infection; triad of Uveitis, Urethritis and Arthritis (can’t see, can’t pee, can’t climb a tree); treat with NSAIDS

A

Reiter Syndrome

58
Q

Triad for Reiter Syndrome (Chlamydia)

A

Uveitis
Urethritis
Arthritis

(Can’t see, can’t pee, can’t climb a tree)

59
Q

Treatment for Reiter’s Syndrome

A

NSAIDs

60
Q

Gram-negative diplococcus; second most common bacterial STI; can cause urethritis, cervicitis, PID, conjunctivitis and arthritis/rash; treat with Ceftriaxone and Azithromycin

A

Neisseria gonorrhoeae

61
Q

Two important pathogens in the Neisseria family

A

N. meningitidis

N. gonorrhoeae

62
Q

Neisseria (meningitidis/gonorrhoeae) is prone to disseminated, blood-borne infection

A

N. meningitidis

63
Q

special agar used to grow Neisseria species

A

Chocolate agar (heated blood agar)

64
Q

How to tell the difference between Neisseria meningitidis and gonorrhoeae

A

Fermentation patterns
N. meningitidis: glucose and maltose
N. gonorrhoeae: glucose only

65
Q

Virulence factors for N. meningitidis

A

IgA protease

Capsule

66
Q

Virulence factors for N. gonorrhoeae

A

IgA protease

Pili (attach to mucosa)

67
Q

Which patients are prone to Neisseria infection

A 
Sickle cell (asplenic)
C6-9 deficiency
68
Q

Pathologies caused by Neisseria gonorrhoeae

A 
Urethritis/Cervicitis
PID
Conjunctivitis (infants)
Arthritis
Rash
69
Q

_________________ is a co-pathogen in ~20% of Neisseria gonorrhoeae cases, so be sure to treat for BOTH

A

Chlamydia

70
Q

Treatment for Neisseria gonorrhoeae

A

Ceftriaxone AND Azithromycin

71
Q

Pathology of Chlamydia and Gonorrhea; infection and inflammation of the female pelvic organs; tenderness of the uterus, adnexal or cervix; can lead to infertility and Fitz-Hugh-Curtis Syndrome (liver capsule inflammation/adhesions)

A

Pelvic Inflammatory Disease

72
Q

Minimal Criteria for PID

A

Uterine tenderness OR
Adnexal tenderness OR
Cervical motion tenderness

73
Q

Neonatal conjunctivitis; due to N. gonorrhoeae or Chlamydia; can be prevented with erythromycin ointment at delivery (Gonorrhoeae ONLY)

A

Ophthalmia Neonatorum

74
Q

Prophylaxis for Ophthalmia Neonatorum (neonatal conjunctivitis)

A

Erythromycin ointment at birth (Gonorrhoeae ONLY)

75
Q

(RPR/TPPA) is a test good for assessing the PREVIOUS exposure to Syphilis

A

TPPA (will stay elevated for life after initial exposure)

76
Q

(RPR/TPPA) is a test good for assessing the RECURRENCE of Syphilis infection

A

RPR (will decline with treatment but come back with reinfection)

77
Q

(Screening/Diagnostic) tests have a high SENSITIVITY to minimize false negatives

A

screening tests (catch potentially affected individuals in a wide population)

78
Q

(Screening/Diagnostic) tests have a high SPECIFICITY to minimize false positives

A

Diagnostic tests (to confirm the presence/absence in a symptomatic patient with a positive screening test)

79
Q

Why is the Benzathine form of Penicillin best to treat Syphilis

A

Includes a diamine stabilizer for prolonged half-life (T. pallidum grows slowly, so long exposure needed)

80
Q

How have Strep. agalactiae infections in infants been reduced in the last few decades

A

Screening for GBS in pregnant women at 35-37 weeks

Given antibiotic prophylaxis if positive or with history

81
Q

Why are B-lactams and Aminoglycosides synergistic?

A

B-lactams can disrupt the cell wall of Gram positive bacteria, making it easier for Aminoglycosides to enter and affect ribosomes

82
Q

What are the TORCHES infections

A 
TOxoplasma
Rubella
CMV
HErpes
Syphilis

Reproductive-Week 3/4 (13 decks)

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