Section 14 - STIs Flashcards

1
Q

Why are STIs called infections and not diseases?

A

Disease means that a carrier won’t have symptoms, so infection is a more inclusive term

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2
Q

What is the cause of syphilis?

A

Treponema pallidum pallidum

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3
Q

How is Treponema pallidum pallidum transmitted?

A
  • Invasion of mucosal surfaces

- Can enter the body through a minute abrasion on the skin or mucous membrane

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4
Q

Does syphilis have more cases in males or females and why?

A

Males because many cases in females are asymptomatic

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5
Q

What is the incubation of T. pallidum?

A

1-90 days

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6
Q

What are the 3 phases of syphilis?

A

1) Primary
2) Secondary
3) Tertiary

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7
Q

What occurs in the primary phase of syphilis?

A
  • Skin lesions at site of inoculation
  • Usually painless and heal spontaneously
  • Highly infectious
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8
Q

What occurs in the secondary phase of syphilis?

A
  • Skin lesions on trunk, palms, soles of feet

- Lesion fluid highly infectious

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9
Q

When does the secondary phase of syphilis usually occur?

A

2-12 weeks after infection

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10
Q

What occurs in the latent phase of syphilis?

A
  • Asymptomatic

- Antibodies present

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11
Q

What are the 3 possible outcomes of the latent phase in untreated syphilis patients?

A

1) Relapse
2) No relapse
3) Tertiary phase

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12
Q

What occurs in the tertiary phase of syphilis?

A
  • Neurologic and cardiovascular symptoms

- May have gummas (nonspecific granulomatous lesions)

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13
Q

When does the tertiary phase usually occur?

A

If it occurs at all, it is a long time after initial infection

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14
Q

What can happen 3-12 weeks after syphilis infection?

A

Symptoms can disappear in no medical attention

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15
Q

What is congenital syphilis?

A
  • Newborns acquire it from mothers with untreated/improperly treated syphilis
  • Signs of secondary syphilis at birth
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16
Q

How can congenital syphilis be prevented?

A

If women are screened in early pregnancy and treated with penicillin

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17
Q

How is syphilis diagnosed?

A
  • Dark field or fluorescent microscopy

- Serodiagnosis

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18
Q

What does it mean if a primary serodiagnosis test for syphilis is negative?

A

Patient is not infecte

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19
Q

What does it mean if a primary serodiagnosis test for syphilis is positive?

A

A secondary test using treponemal antibodies must be carried out

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20
Q

What are 2 examples of nontreponemal antibody tests?

A
  • Venereal disease research laboratory test (VDRL)

- Rapid plasma reagin test (RPR)

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21
Q

Can nontreponemal antibody tests give false positives?

A

Yes, so all positive results should be confirmed by a test with treponemal antibodies

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22
Q

What are 2 examples of treponemal antibody tests?

A
  • Fluorescent treponemal antibody absorption (FTA-ABS)

- Agglutination tests

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23
Q

What are 2 examples of agglutination tests?

A
  • Microhemagglutination test (MHA-TP)

- Treponema pallidum particle agglutination test (TP-PA)

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24
Q

What is the treatment for syphilis?

A

Penicillin or doxycycline (protein synthesis inhibitors)

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25
How can secondary and tertiary syphilis be prevented?
Early diagnosis and treatment
26
What is the gram status and morphology of neisseria gonorrhoeae?
Gram negative diplococci
27
What is the only host of Neisseria gonorrhoeae?
Humans
28
What is the chance of infection for women after one encounter with Neisseria gonorrhoeae?
50%
29
What is the chance of infection for men after one encounter with Neisseria gonorrhoeae?
20%
30
What can Neisseria gonorrhoeae cause in newborns?
Ophthalmia neonatorum (infection in the eyes)
31
Neisseria gonorrhoeae is a capnophile, what does that mean?
It requires CO2 for proper growth, so it grows best at 10% oxygen concentration
32
In what type of environment does Neisseria gonorrhoeae flourish?
Humid environments
33
What are the virulence factors of Neisseria gonorrhoeae?
- Pili - Por proteins - Opa proteins - Lipoligosaccharide - Rmp proteins - IgA protease - Capsule
34
What do pilus do?
Aid in attachment to human mucosal epithelium
35
What contributes to antigenic diversity in gonococci?
The constant and hypervariable regions of pilus
36
What do por proteins do?
Form pores through outer membranes
37
What causes serotypes of Neisseria gonorrhoeae?
Por proteins
38
What do opa proteins do?
Assist in binding to epithelial cells
39
What is lipoligosaccharide?
An endotoxin
40
What do Rmp proteins do?
Inhibit "cidal" activity of serum
41
What does IgA protease do?
Contains an enzyme that destroys IgA1
42
Why is a capsule important?
Resists phagocytosis
43
What are the symptoms of gonorrhea in females?
- Generally asymptomatic | - If there are symptoms, will develop in 2-7 days (vaginal discharge)
44
What are complications of untreated gonorrhea in females?
- PID - Chronic pelvic pain - Infertility
45
What are the symptoms of gonorrhea in males?
- Urethral discharge | - Dysuria
46
What are some other conditions that can occur with gonorrhea?
- Anorectal, pharyngeal, or ophthalmic infections | - Ophthalmia neonatorum in newborns
47
How is gonorrhea diagnosed?
- Direct gram stain for symptomatic males | - Culture for women because their normal flora contains gram negative coccobacilli
48
What type of specimen is used for a gram stain for gonorrhea?
Urethral discharge
49
What is the treatment for gonorrhea?
Antibiotics
50
Do you get lifelong immunity after being infected with gonorrhea?
No
51
What is the cause of chlamydia?
Chlamydia trachomatis
52
What are the different serotypes of chlamydia trachomatis and what diseases do they cause??
- L1, L2, and L3 cause STIs and ocular and respiratory infections - A, B, and C cause trachoma (eye infection)
53
Can chlamydia trachomatis be grown on artificial media?
No
54
What is the life cycle of chlamydia trachomatis?
- Enters epithelial cell - Forms reticulate/initial body - Replicated by binary fission - Inclusions - Elementary bodies - Release from cell - Infectious cycle
55
What is the purpose of elementary bodies?
Adapted for extracellular survival and for initiation of infection
56
What is the purpose of reticulate bodies?
Adapted for intracellular multiplication
57
How is chlamydia diagnosed?
- Presumptive diagnosis based on symptoms | - Definitive diagnosis with culture and identification of inclusion bodies or a combination of 2 non-culture methods
58
What is the most common cause of vaginal candidiasis?
C. albicans
59
What are symptoms of vaginal candidiasis?
Itching, erythema, discharge (nil to thick)
60
What is the cause of trichomoniasis?
Trichomonas vaginalis
61
What are the symptoms of trichomoniasis?
- Profuse, offensive, yellow-green discharge | - Can be asymptomatic
62
What is the treatment for trichomonoiasis?
Metronidazole
63
How is HSV-1 transmitted?
Through saliva
64
What conclusion can be made about every person with a cold sore?
They are positive for HSV-1
65
How is HSV-2 transmitted?
Venereal route
66
If someone is infected with HSV-1 will they be immune to HSV-2?
Nah
67
What are the symptoms of genital herpes?
- Primary lesions on penis/vulva 3-7 days after infection - Lesions break down to form painful ulcers - Swollen lymph nodes, fever, headache, malaise
68
What are some complications that can occur from genital herpes?
- Virus from lesion can enter sensory nerve endings and become a latent infection in DRG neurons - Reactivation can cause recurrent lesions
69
What can be happen if a mother infected with HSV passes it along to her newborn child?
- Neonatal disseminated herpes | - Encephalitis
70
How are genital herpes diagnosed?
- Virus DNA in vesicle fluid or ulcer swab | - Immunofluorescence
71
What is the treatment for genital herpes?
- Antivirals | - Recurrent infections are treated with 6-12 months of low dose antivirals
72
What is the key symptom of HPV?
Papillomas/warts on penis, vulva, and perineal regions
73
What can HPV infection lead to?
Cervical cancer
74
How is HPV infection diagnosed?
- Cytology sections (Pap smears for koilocytes) | - Nucleic acid detection using PCR
75
What type of vaccine is available against HPV?
Quadrivalent
76
What are the 3 groups of HIV-1?
- M (main) - N (new) - O (outlier)
77
What type of cell does HIV infect?
Cells with CD4 surface markers (Th cells)
78
How do HIV cells gain entry?
Viral gp120 envelope glycoprotein binds to CD4 receptor
79
What is the treatment for HIV?
HAART (highly active antiretroviral therapy)
80
What is the drawback to HAART treatment?
- Mitochondrial toxicity and altered fat distribution - HIV inhabits CSF and GI tract, which drugs cannot reach - Resistance
81
How is HIV diagnosed?
- Serological (HIV-1 and HIV-2 antibodies) - Molecular analysis to detect HIV-1 RNA or proviral DNA - Measuring load of HIV-1 RNA