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Repro / GU > SM_203b: Microbiology of STIs > Flashcards

SM_203b: Microbiology of STIs Flashcards

1
Q

Urethritis is caused by ____, ____, or ____

A

Urethritis is caused by Neisseria gonorrhoeae, Chlamydia trachomatis, or HSV

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2
Q

Neisseria gonorrhoeae is a ____

A

Neisseria gonorrhoeae is a Gram negative diplococci

  • Infectis oly humans
  • Causes gonorrhea (clap)
  • Gonococci
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3
Q

Neisseria gonorrhoeae determinants of pathogenicity are ____ and ____

A

Neisseria gonorrhoeae determinants of pathogenicity are pili and opa (opacity associated proteins)

  • Pili: antigenic variation, initial adherence to epithelial cells, blocking phagocytosis by neutrophils
  • Opa proteins: multiple variants of the protein may be expressed, anchor the bacterium onto the host cell surface
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4
Q

Pili of Neisseria gonorrhoeae display ____ which allows evasion of the immune system

A

Pili of Neisseria gonorrhoeae display antigenic variation which allows evasion of the immune system

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5
Q

Neisseria gonorrhoeae clinical disease is ____, ____, ____, ____, and ____

A

Neisseria gonorrhoeae clinical disease is urethritis / mucopurulent cervicitis, disseminated gonoccal disease, pelvic inflammatory disease, epididymitis / prostatitis, and gonococcal ophthalmia

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6
Q

Describe urethritis / mucopurulent cervicitis caused by Neisseria gonorrhoeae

A

Urethritis / mucopurulent cervicitis caused by Neisseria gonorrhoeae

  • Urethritis: associated with dysuria, urethral discharge, frequent or urgent urination
  • In women: urethral colonization or infection always accompanies cervicitis
  • Must differentiate urethritis from common UTI
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7
Q

Disseminated gonococcal disease presents with ____, ____, ____, ____, and ____

A

Disseminated gonococcal disease presents with fever, polyarthralgias, oligoarticular septic arthritis, tenosynovitis, and rash

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8
Q

Pelvic inflammatory disease is ____ that frequently causes ____ and ____

A

Pelvic inflammatory disease is ascending infection of the uterus, fallopian tubes, and peritoneal cavity that frequently causes infertility and ectopic pregnancy

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9
Q

Pelvic inflammatory disease presents with ____, ____, and ____

A

Pelvic inflammatory disease presents with

  1. Mucopurulent vaginal discharge
  2. Midline abdominal pain and abnormal vaginal bleeding
  3. Bilateral lower abdominal and pelvic pain with nausea and vomiting
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10
Q

Pelvic inflammatory disease exam shows ____, ____, and ____

A

Pelvic inflammatory disease exam shows mucopurulent cervicitis, cervical motion tenderness, and uterine and adnexal tenderness

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11
Q

Treatment of pelvic inflammatory disease involves antibiotics against both ____ and ____

A

Treatment of pelvic inflammatory disease involves antibiotics against both Neisseria gonorrhoeae and Chlamydia (cefoxitin + doxycycline)

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12
Q

Describe diagnostic tests for Neisseria gonorrhoeae

A

Neisseria gonorrhoeae diagnostic tests

  • In males, urethral exudates with Gram negative diplococci in neutrophils
  • Bacteria from exudate samples grow on Mueller-Hinton or Thayer-Martin media
  • Nucleic acid amplification tests on first-void urine samples
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13
Q

Neisseria gonorrhoeae is treated with ____

A

Neisseria gonorrhoeae is treated with intramuscular ceftriaxone + oral azithromycin

  • 30% of isolates are now penicillin resistant
  • Azithromycin serves as anti-chlamydial treatment
  • HIV test
  • Treat sex partners simultaneously
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14
Q

Describe prevention of Neisseria gonorrhoeae

A

Neisseria gonorrhoeae prevention

  • Condom use
  • Screening of pregnant women at high risk for gonorrhea
  • Antimicrobial eye drops for newborns
  • Notify public health department
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15
Q

Chlamydia trachomatis is ____

A

Chlamydia trachomatis is an obligate intracellular pathogen related to Gram negatives

  • Serovars A-C are associated with endemic trachoma, D-K with classic chlamydial STD, and L1-3 with lymphogranuloma venereum
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16
Q

Chlamydia trachomatis determinants of pathogenicity are ___ and ___

A

Chlamydia trachomatis determinants of pathogenicity are life cycle consisting of EBs / RBs and type III secretion system

  • Elementary bodies (EB): inert, spherical, extracellular form
  • Reticulate body (RB): intracellular form, multiples and forms intracellular inclusions
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17
Q

Chlamydia trachomatis clinical disease is ____, ____, ____, and ____

A

Chlamydia trachomatis clinical disease is urethritis / cervicitis, inclusion conjunctivitis, lymphogranuloma venereum, and trachoma

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18
Q

Describe Chlamydia trachomatis urethritis and cervicitis

A

Chlamydia trachomatis urethritis and cervicitis

  • Less severe than gonorrhea
  • Both males and females may be asymptomatic
  • Complications include epididymitis, prostatitis, and pelvic inflammatory disease
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19
Q

____ caused by Chlamydia trachomatis is acquired by a newborn during passage through the birth canal

A

Inclusion conjunctivitis caused by Chlamydia trachomatis is acquired by a newborn during passage through the birth canal

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20
Q

____ is an STD caused by certain serovars of Chlamydia trachomatis

A

Lymphogranuloma venereum is an STD caused by certain serovars of Chlamydia trachomatis

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21
Q

Initial ulcererative genital lesion followed by fever and development of swollen tender inguinal lymph nodes is ____ caused by ____

A

Initial ulcererative genital lesion followed by fever and development of swollen tender inguinal lymph nodes is lymphogranuloma venereum caused by Chlamydia trachomatis

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22
Q

Trachoma is ____ caused by Chlamydia trachomatis

A

Trachoma is infection of the eye that is a common cause of preventable blindness caused by Chlamydia trachomatis

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23
Q

Describe diagnostic laboratory tests for Chlamydia trachomatis

A

Diagnostic laboratory tests for Chlamydia trachomatis

  • Grown in McCoy cells in the lab
  • DNA and RNA amplification tests (NAATs): more sensitive and as specific as culture, allow screening for Chlamydia trachomatis by testing urine samples or vaginal swabs
24
Q

Chlamydia trachomatis is treated with ____

A

Chlamydia trachomatis is treated with azithromycin or doxycycline

  • Prevention: condom use and appropriate public health measures, screening of pregnant women
25
Q

Describe HSV

A

HSV

  • Both types I and II can cause vesicular painful tender lesions
  • Recurrences are common
  • Can cause symptoms of urethritis if lesions occur within the urethral meatus
  • May be treated with acyclovir or other drugs in this familia
26
Q

This is ____

A

This is Neisseria gonorrhoeae

27
Q

Lesions of the genitalia can be caused by ____, ____, ____, ____, and ____

A

Lesions of the genitalia can be caused by

  • Treponema pallidum
  • Haemophilus ducreyi
  • Chlamydia trachomatis (LGV strains)
  • HSV
  • HPV
28
Q

Treponema pallidum is a ____ that causes ____

A

Treponema pallidum is a spirochete that causes syphilis

  • 6-14 spirals, only 0.15 um thick
  • Slow dividing time
29
Q

Describe determinants of pathogenicity of Treponema pallidum

A

Treponema pallidum determinants of pathogenicity

  • Periplasmic flagellum
  • Few proteins on the outer membrane: few targets for immune system
  • Organism gains access to subcutaneous tissue through microscopic abrasions
  • Organism slowly multiples: chancre
  • Humoral immune response: diagnosis
  • Resolution of chancre but organism still persists and disseminates: rash
  • Partially effective immune response: resolution of rash
  • Asymptomatic (latency) but organism persists
  • Years later: gummas, neurologic disease, aortic enlargement
30
Q

Syphilis is a chronic STD with stages of ____, ____, ____, and ____

A

Syphilis is a chronic STD with stages of primary, secondary, prolonged latency, and tertiary

31
Q

Describe primary syphilis

A

Primary syphilis

  • Nontender ulcerative genital lesion (chancre)
  • Occurs 2-10 weeks after infection
  • Spontaneously heals in about a month
32
Q

Describe secondary syphilis

A

Secondary syphilis

  • Generalized rash, especially on soles and palms
  • Generalized nontender enlarged lymph nodes
  • Lesions spontaneously resolve but may recur
33
Q

Describe tertiary syphilis

A

Tertiary syphilis (1/3 of untreated patients)

  • General paresis: personality and cognitive changes
  • Tabes dorsalis: changes in gait, bladder control, and sensation
  • Cardiovascular syphilis: enlargement of the ascending and transverse aorta
  • Gummas: granulomatous lesions that may occur in any organ
34
Q

Gummas, enlarged aorta, and Charcot joint are ____

A

Gummas, enlarged aorta, and Charcot joint are tertiary syphilis

35
Q

Describe congenital syphilis

A

Congenital syphilis

  • Fetus infected in utero
  • Causes stillbirth, prematurity, and other adverse effects: hydrops fetalis (accumulation of fluid / edema), cutaneous lesions, hepatosplenomegaly, bone abnormalities (sabre shins - sharp anterior bowing of the tibia), snuffles (rhinitis)
36
Q

Describe diagnostic laboratory tests for syphilis

A

Syphilis diagnostic laboratory tests

  • Darkfield microscopy
  • Nontreponemal serologic assays
  • Treponemal serologic tests
  • Two-step test to diagnose syphilis includes both a nontreponemal and a treponemal serology assay
  • Organism cannot be cultured
37
Q

Syphilis is treated via ____

A

Syphilis is treated via penicillin G

  • Sex partners must be tested and/or treated
  • HIV testing: HIV incidence is 10% among men with early syphilis
  • Prevention: condom use and appropriate public health measures, screening of pregnant women
38
Q

_____ can occur after treatment of syphilis with penicillin G and present with _____, _____, and _____

A

Jarisch-Herxheimer reaction can occur after treatment of syphilis with penicillin G and present with fever, headache, and muscle aches

  • Noted within first 24 hours of treatment
  • Thought to be due to release of bacterial components into the bloodstream following death of the organisms
39
Q

Haemophilus ducreyi causes a ____ and ____

A

Haemophilus ducreyi causes a chandroid and tender inguinal adenopathy

  • Chancroid: genital lesion similar to that of primary syphilis, usualyl has a shaggier border and is very tender
40
Q

HPV causes ____ and ____

A

HPV causes genital warts and cervical / anal cancers (HPV 16 and 18)

  • Most infections are subclinical and self-limited
  • Removal, such as cryotherapy is palliative and recurrences are the rule
41
Q

HPV vaccine acts against the ____

A

HPV vaccine acts against the L1 capsid protein

  • Prevents many cases of cervical cancer
  • 9-valent vaccine (Gardasil 9)
  • recommended for females and males 11-12 years of age and other individuals who have not been previously vaccinated
42
Q

This is ____

A

This is Treponema pallidum (syphilis)

43
Q

Vaginitis is caused by ____, ____, ____, ____, ____, and ____

A

Vaginitis is caused by Chlamydia trachomatis, Neisseria gonorrhaeoe, HSV, Trichomonas vaginalis, bacterial vaginosis, and yeast

44
Q

Trichomonas vaginalis is ____

A

Trichomonas vaginalis is a pear-shaped protozoa

  • 15-20% of women with vaginal symptoms
45
Q

Trichomonas vaginalis determinants of pathogenicity are ____, ____, and ____

A

Trichomonas vaginalis determinants of pathogenicity are flagella, motility, and sexual transmission

46
Q

Trichomonas vaginalis clinical disease is ____ in women

A

Trichomonas vaginalis clinical disease is vaginitis in women

  • Malodorous yellow-green frothy vaginal discharge, vulvar itching, dysuria, frequent urination, pain with sexual intercourse (dyspareunia), strawberry cervix
  • Most infected men are asymptomatic
47
Q

Describe diagnostic lab tests for Trichomonas vaginalis

A

Trichomonas vaginalis diagnostic lab tests

  • Microscopic examination of vaginal or urethral secretions (wet prep): look for motile organism, low sensitivity
  • NAAT
  • Rapid antigen and DNA hybridization tests: point of care
48
Q

Trichomonas vaginalis is treated with ____

A

Trichomonas vaginalis is treated with oral metronidazole or oral tinidazole

  • Sexual partners should be tested and treated if appropriate
  • Prevention: condom use and appropriate public health measures
49
Q

Describe bacterial vaginosis

A

Bacterial vaginosis

  • 40-50% of patients with vaginal symptoms
  • Whether an STD is still controversial
  • Associated bacteria dispalce Lactobacillus spp. (normal flora of the vagina)
  • Few neutrophils (vaginosis)
50
Q

Bacterial vaginosis clinical disease is characterized by ____, ____, and ____

A

Bacterial vaginosis clinical disease is characterized by malodorous (fishy-smelling) white or gray vaginal discharge, irritation, and itching

  • Can lead to PID and premature labor
51
Q

Describe bacterial vaginosis diagnostic laboratory tests

A

Bacterial vaginosis diagnostic laboratory tests

  • Microscopic demonstration of clue cells: vaginal epithelial cells coated with coccobacillary organisms
  • Vaginal pH > 4.5
  • Liberation of distinct fishy odor immediately after mixing vaginal secretions with potassium hydroxide
52
Q

Bacterial vaginosis is treated with ____

A

Bacterial vaginosis is treated with metronidazole (oral or vaginal gel) or clindamycin cream

  • Routine treatment of sex partners is NOT recommended
53
Q

Yeast vaginitis is caused by ____ and is characterized by ____

A

Yeast vaginitis is caused by Candida albicans and is characterized by a cheesy discharge

  • 20-25% of patients with vaginal symptoms
  • Not an STD
54
Q

This is ____

A

This is bacterial vaginosis

55
Q

Describe STD syndromes and etiologies

A

STD syndromes and etiologies

Repro / GU (46 decks)

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