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SP16- Gen Path Exam 3 > Sexually Transmitted Diseases > Flashcards

Sexually Transmitted Diseases Flashcards

1
Q

Worldwide, _______ new cases of STDs occur annually.

A

15 million (probably an underestimate due to unreported cases)

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2
Q

At what age is the peak incidence for STDs?

A 
#1)  20-24 years old (college)
#2)  15-19 years old (high school)
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3
Q

Of the _____ leading infectious diseases that must be reported to the CDC, _______ are STDs. What are the two common STDs that do not require reporting?

A

10
5
genital herpes and genital HPV

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4
Q

Syphilis (lues) is a chronic infection caused by the _______ Treponema pallidum.

A

spirochete
(remember, these little boogers are extremely motile and can swim through heavy connective tissue. Think of a snake…a Snake in a teepee (T.pallidum)… Spirochete… Syphilis)

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5
Q

True or False: Syphilis is 30 times more common in African Americans than whites.

A

True

notice that it says African Americans…not simply, “Africans”

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6
Q

How is syphilis transmitted?

A

direct contact with cutaneous or mucosal lesions during early stages (primary or secondary) at which point it is highly infectious

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7
Q

Do syphilis organisms (aka: the bacteria T.pallidum) disseminate to distant sites?

A

Yes, very rapidly through the bloodstream and lymphatics

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8
Q

There are _____stages of a syphilis infection. At which stage is it least contagious?

A

three

Tertiary = fewer lingering organisms = less infectious

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9
Q

What is the tell-tale sign of Primary Syphilis?

A

Chancre

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10
Q

What is a chancre?

A

a painless ulcer that develops at the site of inoculation (most often the external genitalia; but oral sites are also common)

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11
Q

A chancre will appear at the site of inoculation ______ days after the initial infection.

A

9 to 90 days

pretty large window, a sex-pot might have trouble figuring out who it’s from!

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12
Q

True or False: Syphilis can spontaneously resolve.

A

True, it can resolve within 4-6 weeks

HOWEVER, untreated patients will likely develop secondary stage disease (about 25% of patients to be exact)

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13
Q

It what way does the host mount an immune response against syphilis? What stage is this occurring?

A

production of antibodies (meanwhile, the organism continues to disseminate systemically)

occurs in the PRIMARY stage

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14
Q

True or False: Palmar rashes may occur during the Primary stage of syphilis.

A

False, palmar rashes denote secondary stage

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15
Q

How long does it take for Syphilis to reach the Secondary stage?

A

two months AFTER resolution of the primary chancre

tricky….just when they thought it was gone for good

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16
Q

In the secondary stage of syphilis, a _______ rash may affect the skin of the hands and feet.

A

maculopapular

MAC is no LOnger PoPULAR now that he has syphilis

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17
Q

Condyloma lata and ______ patches may affect the mucosa. Which is genital and which is oral?

A

mucous patches: oral

condyloma lata: genital

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18
Q

Secondary Syphilis resolves spontaneously over several weeks and patient will enter the ______ phase.

A

Latent

if still left untreated, the 1/3 of patients develop teriary syphilis 5 to 20 years later

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19
Q

What are the three forms of Tertiary Syphilis? Which occurs most often?

A
  1. Aortitis- “Cardiovascular” MOST COMMON
  2. Neurosyphilis- brain, meninges, spinal cord
  3. Gummas- focal granulomatous lesions
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20
Q

Gummas are focal granulomatous lesions that occur in _____, ______, and _____ of the upper airway or mouth. This occurs in which stage of syphilis?

A

bone, skin, mucous membranes

Tertiary Syphilis

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21
Q

What is meant by “congenital syphilis?”

A

maternal transmission of the disease across the placenta

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22
Q

What are the three possible patterns/outcomes of maternal syphilis transmission?

A
  1. Stillbirth (early fetal death)
  2. Infantile Syphilis
  3. Late Congenital Syphilis
23
Q

What is the manifestation of “infantile syphilis?”

A

live-born infants that present (immediately or within the first few months) with clinical signs of SECONDARY syphilis

24
Q

What is “Late Congenital Syphilis?”

A

(transmission is largely dependent on how long the mother has been infected with the disease. Two years is the cut-off)
Late Congenital: mother was untreated >2 years
=HUTCHINSON’s TRIAD

25
Q

What is Hutchinson’s Triad?

A
  1. Hutchinson’s Teeth (notched incisors and mulberry molars)
  2. Interstitial Keratitis (corneal edema, tearing, eye pain)
  3. CN VIII Damage (deafness)
26
Q

In order to diagnose syphilis there must be an ID of bacteria within primary or secondary lesions. What are the two types of tests done? Why two?

A
  1. Screening Tests
  2. Specific Tests

*often the screening test is NEGATIVE in early disease stages but will produce a false-positive, so then a specific test is done to confirm

27
Q

_____ and ____ are the screening tests.

A

RPR (rapid plasma reagin)

VDRL (venereal diesease research lab)

28
Q

The specific test for syphilis uses _____ ______ Antibody.

A 
Fluorescent Treponemal 
(FTA): remains postive indefinitely, even after antibiotic treatment
29
Q

True or False: Syphilis is treated with penicillin.

A

True

30
Q

True or False: There has been a decrease in the prevalence of gonorrhea in the last 2 years.

A

False, a large increase (350,000–> 800,000)

31
Q

Which organism is responsible for gonorrhea?

A

NEISSERIA gonorrhoeae

32
Q

What type of reaction typically results from gonorrhea? Does it always appear this way?

A

intense inflammatory reaction with purulent exudate

NO! 80% of females and 40% of males are completely asymptomatic

33
Q

Treatment of gonorrhea has become complicated by what phenomena?

A

emergence of penicillin-resistant strains

34
Q

Untreated gonorrhea can lead to _____.

A

sterility

35
Q

How would an ascending gonorrhea infection affect males? females? infants?

A

Males: acute prostatitis, epididymitis, orchitis
Females: inflammation of uterus/fallopian tubes/ovaries with secondary scarring (pelvic inflammatory disease)
Infants: blindness from contamination during birth

36
Q

__________ is the most common class of STDs reportable to the CDC. Most of these infections are caused by ________.

A

Non-gonococcal Urethritis and Cervicitis

Chlamydia trachomatis

37
Q

Why are Ceftriaxone and doxycycline often used to treat chlamydia?

A

these drugs are effective against chlamydia and gonorrhea (sometimes its difficult to distinguish which disease is present due to similar presentation)

38
Q

_______ arthritis is a possible complication of chlamydia.

A

Reactive

39
Q

Reactive Arthritis (Reiter Syndrome) is an ________ condition that develops in response to genitourinary or gastrointestinal infections.

A

immune-mediated

40
Q

True or False: Genital herpes simplex is an extremely uncommon STD.

A

False! it affects 50 million people in the U.S.

41
Q

HSV _____ causes most forms of genital herpes and is tranmitted via _____.

A

HSV-2 (sometimes, but less commonly by hsv-1)

direct contact

42
Q

Initial HSV infections can be asymptomatic or cause painful lesions/lymphadenopathy/malaise which heals within _______weeks.

A

3 to 6

43
Q

Recurrent HSV lesions are small painful vesicles that quickly ulcerate and heal within _____.

A

7 to 10 days

HSV actively sheds during periods of visible lesions

44
Q

______ herpes occurs in children born to mothers with genital herpes. There is a ____ mortality rate with this form of herpes.

A

Neonatal

HIGH (60%)

45
Q

Upon exfoliative cytology or biopsy of Genital Herpes Simplex there will be a ______ effect. What does this look like?

A

viral cytopathic

= ballooning degeneration of epithelial cells with large multinucleate TZANCK cells

46
Q

What do Tzanck Cells look like? These are seen with which STD?

A

“Peas in a Pod”

Genital Herpes

47
Q

_______ is an extremely common STD and is responsible for a number of proliferative lesions on the genital mucosa (benign and malignant).

A

Human Papillomavirus (HPV) Infection

48
Q

What is the most common form of HPV lesions?

A

Condyloma acuminatum (venereal warts)

49
Q

Venereal warts are caused by HPV ____ and HPV ____.

A

6

11

50
Q

Describe venereal warts.

A

Benign
Papillary nodules
Frequently clustered
locations: anogenital region & oral mucosa
Synchronous lesions are common (aka:oral and genital)

51
Q

True or False: Venereal Warts are always benign.

A

False

Usually True but not always: malignant transformation is rare but it can occur

52
Q

Condyloma acuminatum (venereal warts) appear histolgically as a papillary proliferation of _____ epithelium exhibiting a _______ change.

A

squamous

koilocytic

53
Q

What the heck is a “koilocytic” change?

A

cells have a darker-than-normal staining nucleus and a perinuclear halo

54
Q

True or False: Venereal warts are treated with penicillin.

A

False: they are treated with surgical excision, laser treatment, cryotherapy, or imiquimod (Rx. cream)

SP16- Gen Path Exam 3 (12 decks)

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