Sexually Transmitted Infections Flashcards

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1
Q

What are the three bacterial species which produce STDs?

A

1) neisseria
2) chlamydia
3) treponema

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2
Q

What are the morphological characteristics of Neisseria gonorrhoeae?

A

1) gram-negative
2) diplococci
3) oxidase positive

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3
Q

Why are there no reliable animal models of gonorrhea?

A

because it only infects humans

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4
Q

Which STDs have the highest incidence in the US?

A

1) chlamydia

2) gonorrhea

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5
Q

What are the initial symptoms of a GC infection?

A

1) urethral or cervical discharge
2) dysuria
3) urethritis

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6
Q

What does flank pain indicate on physical exam?

A

kidney infection or urinary tract involvement

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7
Q

What is the differential diagnosis for gonorrhea?

A

Chlamydia, and then HIV and syphilis

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8
Q

Why do you consider HIV and syphilis with GC infection?

A

Because STDs travel together!

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9
Q

What two proteins cause gonorrhea to attach to the uretrhal or vaginal epithelium?

A

1) pilus protein

2) OPA protein

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10
Q

How does gonorrhea infect a host?

A

endocytosis and transport into epithelial cells. exocytosis and collection by immune system. Host cell damage and then release to mucosal surface for reinfection.

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11
Q

What is one of the signs of a gonorrhea infection?

A

PMN-rich exudate

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12
Q

Where can a GC infection go especially in females?

A

Dissemination through the blood causing disseminated disease`

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13
Q

What activates TNF in a GC infection?

A

LPS

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14
Q

What is disseminated gonococcal disease characterized by?

A

skin lesions, traveling arthritis

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15
Q

Where are 80-90% of GC cases found in women?

A

urogenital cervix

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16
Q

What is a major side effect of GC infection in women?

A

PID

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17
Q

What percentage of GC infections in women become PID?

A

10-20%

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18
Q

What are two distinguishing characteristics of GC infection in women vs. men?

A
  • 5x higher rate of being asymptomatic

- infection lasts longer - ~10 days

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19
Q

What is the number one preventable cause of infertility in women?

A

PID

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20
Q

How is GC diagnosed?

A

By taking a swab of the discharge

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21
Q

How does GC grow on blood agar? on chocolate agar?

A

GC doesn’t grow on blood agar, but will grow on chocolate agar

22
Q

Why are false positives of GC a common occurrence in females?

A

Gram-negative diplococci are a common part of the normal vaginal microflora

23
Q

What are NAATs?

A

Nucleic Acid Amplification Tests

24
Q

What is the standard treatment for GC? Why?

A

Ceftriaxone 250mg and doxycycline. Ceftriaxone 250mg for growing resistance and doxycycline for NGU

25
Q

What is doxycycline used in treatment of GC infection?

A

Because Chlamydia symptoms show up later than GC and as co-occurring infections are common it is better to treat both

26
Q

What is NGU?

A

Non-gonococcal urethritis

27
Q

Which countries/regions have the highest rate of GC infection?

A

Former Soviet bloc countries, and parts of the MWern US

28
Q

Why is reinfection with GC common?

A

There is no immunity to GC. Antigenic variation occurs during infection

29
Q

What is the major adhesion protein in GC?

A

Pilin

30
Q

Why is pilin antigenically variable?

A

There are many gene cassettes of the pilin gene which can be tandemly arranged and recombined

31
Q

What are some unique properties of chlamydia bacteria?

A
  • obligate unicellular bacteria
  • “energy parasite” using host’s machinery to make ATP as it cannot on its own
  • cannot be cultured as it needs to have living cells to grow
  • similar to gram-negative bacteria
32
Q

What two forms does chlamydia come in?

A

1) elementary body

2) reticulate body

33
Q

Which life form of chlamydia is infectious?

A

elementary body

34
Q

Which life form is larger?

A

reticulate body

35
Q

Which life form is intracellular?

A

reticulate body

36
Q

Where is chlamydia primarily pathogenic?

A

cervical and urethral epithelium

37
Q

What are the two antibiotics which Chlamydia is primarily susceptible to?

A
  • tetracyclines

- erythromycin

38
Q

What is the bacteria which causes syphilis?

A

treponema pallidum

39
Q

What type of shape is treponema?

A

spiral-shaped rod

40
Q

Can syphilis be cultured?

A

no!

41
Q

What is the characteristic lesion in primary syphilis?

A

chancre

42
Q

What is a chancre?

A

firm, painless, non-itchy skin ulceration

43
Q

What is the reservoir for syphilis?

A

Humans only

44
Q

What population has a higher incidence of STDs in general?

A

HIV+ individuals

45
Q

If syphilis is untreated, what happens?

A

You get a larger rash with palmar and solar lesions which indicates secondary syphilis

46
Q

How long can syphilis stay latent?

A

3-30 years

47
Q

Which population has an increase in the incidence in syphilis in the past 15 years?

A

males who have sex with other males

48
Q

How do you work-up syphilis?

A
  • dark-field or fluorescent microscopy
  • antibody tests
  • GC, chlamydia, and HIV screens if negative
49
Q

What is the primary treatment of choice for syphilis and why?

A

Pencillin because there is little if any abx resistance

50
Q

Is the treponema bacteria particularly hardy?

A

No, it cannot survive away from humans, nor in heat, other conditions.

51
Q

Why is syphilis sometimes called the “great imitator”?

A

Because its primary symptoms mimic those of other diseases