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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
Describe HSV
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
This is \_\_\_\_
This is Neisseria gonorrhoeae
27
Lesions of the genitalia can be caused by \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_
Lesions of the genitalia can be caused by * Treponema pallidum * Haemophilus ducreyi * Chlamydia trachomatis (LGV strains) * HSV * HPV
28
Treponema pallidum is a ____ that causes \_\_\_\_
Treponema pallidum is a spirochete that causes syphilis * 6-14 spirals, only 0.15 um thick * Slow dividing time
29
Describe determinants of pathogenicity of Treponema pallidum
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
Syphilis is a chronic STD with stages of \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_
Syphilis is a chronic STD with stages of primary, secondary, prolonged latency, and tertiary
31
Describe primary syphilis
Primary syphilis * Nontender ulcerative genital lesion (chancre) * Occurs 2-10 weeks after infection * Spontaneously heals in about a month
32
Describe secondary syphilis
Secondary syphilis * Generalized rash, especially on soles and palms * Generalized nontender enlarged lymph nodes * Lesions spontaneously resolve but may recur
33
Describe tertiary syphilis
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
Gummas, enlarged aorta, and Charcot joint are \_\_\_\_
Gummas, enlarged aorta, and Charcot joint are tertiary syphilis
35
Describe congenital syphilis
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
Describe diagnostic laboratory tests for syphilis
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
Syphilis is treated via \_\_\_\_
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
\_\_\_\_\_ can occur after treatment of syphilis with penicillin G and present with \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
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
Haemophilus ducreyi causes a ____ and \_\_\_\_
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
HPV causes ____ and \_\_\_\_
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
HPV vaccine acts against the \_\_\_\_
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
This is \_\_\_\_
This is Treponema pallidum (syphilis)
43
Vaginitis is caused by \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_
Vaginitis is caused by Chlamydia trachomatis, Neisseria gonorrhaeoe, HSV, Trichomonas vaginalis, bacterial vaginosis, and yeast
44
Trichomonas vaginalis is \_\_\_\_
Trichomonas vaginalis is a pear-shaped protozoa * 15-20% of women with vaginal symptoms
45
Trichomonas vaginalis determinants of pathogenicity are \_\_\_\_, \_\_\_\_, and \_\_\_\_
Trichomonas vaginalis determinants of pathogenicity are flagella, motility, and sexual transmission
46
Trichomonas vaginalis clinical disease is ____ in women
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
Describe diagnostic lab tests for Trichomonas vaginalis
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
Trichomonas vaginalis is treated with \_\_\_\_
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
Describe bacterial vaginosis
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
Bacterial vaginosis clinical disease is characterized by \_\_\_\_, \_\_\_\_, and \_\_\_\_
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
Describe bacterial vaginosis diagnostic laboratory tests
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
Bacterial vaginosis is treated with \_\_\_\_
Bacterial vaginosis is treated with metronidazole (oral or vaginal gel) or clindamycin cream * Routine treatment of sex partners is NOT recommended
53
Yeast vaginitis is caused by ____ and is characterized by \_\_\_\_
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
This is \_\_\_\_
This is bacterial vaginosis
55
Describe STD syndromes and etiologies
STD syndromes and etiologies

Repro / GU (46 decks)

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