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MDSC 3312 MB > ST2 -Gonorrhea and Syphillis > Flashcards

ST2 -Gonorrhea and Syphillis Flashcards

1
Q

How are STD spread?

A

Skin to Skin contact with infected areas , including thighs , scrotum , vulva , penis , anus.
Touching below the waist (infected areas).
Oral sex – Infected genitals to mouth or infected mouth to genitals.
Kissing infected mouth area.
Anal sex.

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2
Q

What diseases are associated with eye infections?

A

gonorrhea, chlamydia, herpes

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3
Q

What diseases affect the oral region?

A

herpes, syphilis, gonorrhoea

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4
Q

Genital regions

A

herpes, syphilis, gonorrhoea

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5
Q

What is the major reservoir for gonorrhea carriage?

A

asymptomatic

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6
Q

There is high incidence of gonorrhea in?

A

High Incidence in some groups defined by geography , age , sexual risk behavior - sex worker

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7
Q

How is gonorrhoea transmitted?

A 
Male to female via semen 
Female to male urethra
Rectal intercourse ( Anal sex )
Pharyngeal infection ( Oral sex )
Perinatal transmission ( Mother to Infant )
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8
Q

Gonorrhoea is a pyogenic infection of the?

A

urethra and uterine cervix

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9
Q

With gonorrhea, there is an increase risk of?

A

Gonorrhea associated with increased transmission of And susceptibility to HIV infection

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10
Q

What are the virulence factors of gonorrhea?

A

pilli, fimbria, capsule,por, opa, rmp protein

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11
Q

What do the fimbriae involve?

A
  • Initial attachment to the cell surface with Fimbriae / Pili: ( Adherence ) to the Urethral mucosa
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12
Q

What prevents phagocytosis?

A

capsule

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13
Q

Por protein function

A

Por protein ( protein I ) : Protects the phagocytosed bacteria from intracellular killing .

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14
Q

Opa protein function

A

Opa protein ( Protein II ): Allows tight attachment to host cells & bacteria migrates into epithelial cells & multiplies

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15
Q

Rmp protein function

A

Rmp protein ( Reduction – modifiable protein ) = ( Protein III ) : Stimulates production of antibodies that block serum bactericidal activity against gonococci

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16
Q

What is the incubation period of gonorrhea?

A

2-8 days

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17
Q

Who are carriers of this infection?

A

women

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18
Q

What are the clinical findings of females?

A 
Cervicitis - Mucopurulent
Vulvovaginitis ( Prepubertal girls )
Endometritis - Uterus
Salphingitis and 
PID ( Pelvic inflammatory disease ) –May lead to sterility
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19
Q

Clinical findings of gonorrhea in women

A

Acute Urethritis –Purulent urethral discharge –( word ‘gonorrhea’ is derived from flow of seed resembling semen ).
Chronic urethritis – Stricture formation.
Multiple discharging sinuses ( Water can perineum ).

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20
Q

What is epididymitis? What is associated with it?

A

Symptoms : Unilateral. Testicular pain & swelling.

Infrequent but commonest local complication in males.

Usually associated with subclinical urethritis.

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21
Q

What are the non-specific signs of cervicitis in women with gonorrhoea infections?

A

Abnormal vaginal discharge , Inter menstrual bleeding , Dysuria , Lower abdominal pain.

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22
Q

What are the clinical findings with cervicitis?

A

Mucopurulent or purulent cervical discharge , easily induced Cervical bleeding.

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23
Q

When do the symptoms of cervicitis appears?

A

50% of women with clinical cervicitis have no symptoms.
Symptoms may occur within
8 - 10 days of infection

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24
Q

In 1-3% of persons affected by Gonorrhea, what occurs?

A

Disseminated Gonococcal Infection ( DGI ) in 1-3%
Fever, Septic rthritis ( Polyarthritis ).
Pustular-hemorrhagic skin rash

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25
Q

What are the consequences of gonorrhoea?

A

Pharyngitis –Orogenital sex

Conjunctivitis -Autoinoculation

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26
Q

What are the pathological manifestations in children/neonates?

A

i) Gonococcal - Ophthalmia

Neonatorum - if untreated – Blindness

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27
Q

How gonorrhoea is transmitted in newborns?

A

Neonates may become infected through passage of the birth canal.

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28
Q

How to prevent ophthalmia neonatorum?

A

: by Instillation of Tetracycline / Erythromycin / Silver nitrate in conjunctival sac of New Born

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29
Q

What are the complications of gonorrhoea in women?

A

Pelvic Inflammatory Disease (P I D) : – 10 - 20 % ( Women with Endocervical gonorrhea ) .

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30
Q

Acute infection complication in women

A

Salpingitis , Tubo-ovarian abscess ,

ndometritis , Bartholin abscess .

31
Q

Chronic infection complication in women

A

Ectopic pregnancy , Infertility .

32
Q

What are the symptoms/ how does chronic infection in women present?

A

May be Asymptomatic OR

May present with - Lower abdominal pain , Discharge , Irregular menstrual bleeding & Fever

33
Q

What is the transport media for gonorrhea?

A

stuart transport media

34
Q

What samples are taken?

A

pus, swabs, synovial fluid,swab

35
Q

Swabs are taken from

A

rectum, conjuctiva, throatSecretions / discharge from : Urethra – Urethral swab - Male , Cervix – Endocervical swab - Female

36
Q

For dgi . what samples are taken?

A

synovial fluid from joints

37
Q

What is the morphology,motile and location of gonorrhea?

A

Nonmotile – Gram – ve Diplococci - Kidney shaped
(pairs of cocci) Or - Bean shaped adjacent sides concave. intracellular organisms -

                                       In  purulent  material  - Organisms mainly  Intracellular  ( within Polymorphs -  some  may be loaded  with   as  many  as  100 Cocci.)
38
Q

What is the role of the fimbriae?

A

on the surface.-Responsible -for- Adherence to -Urethral mucosa .(virulence factor)

39
Q

Capsule

A

Outer surface of cocci covered with loosely associated Micro - Capsule ( Slime ) Prevents Phagocytosis (virulence factor).

40
Q

Which sele ctive media is used and why?

A

Modified Thayer Martin – Enriched Medium with lysed blood and antibiotic- Selective for Neisseria gonorrhoeae especially when specimen is from vagina & rectum having other bacteria too – which are inhibited.

41
Q

What does colistin prevent?

A

: Inhibits Gram - ve flora ( N. gonorrhoeae & N. meningitidis resistant to colistin , most saprophytic species of Neisseria susceptible

42
Q

Vancomycin inhibits

A

: Inhibits Gram+ve.

43
Q

Nystatin inbhibits

A

Inhibits yeast flora.

44
Q

Trimetoprim inhibits

A

Inhibits swarming Proteus spp.

45
Q

What are the conditions and agar used?

A

5-10% CO2

46
Q

Colonies on blood agar

A

Small , Convex , Glistening , Soft , Mucoid Colonies.

47
Q

Oxidase, catalase test gonorrhea

A

oxidase and catalase +ve

48
Q

Oxidase test

A

Tetra-methyl- para phenylene -diamine hydrochloride.

Filter paper soaked with fresh oxidase reagent.

49
Q

Gonorrhea ferments

A

Gonococci ferments only Glucose with Acid production.

Does not ferment other sugars

50
Q

When is NAAT used and why? Which specimen ?

A

Essays for direct detection of Neisseria gonorrhoeae in Genito -urinary specimen.
The specificity & sensitivity of the Test is very High.
Advantage : Better detection & rapid result ( 2 - 4 hours ).

51
Q

When are serological tests useful?

A

Useful in chronic cases & in metastatic lesions ( arthritis ) DGI .
Includes : R.I.A.( Radio Immuno Assay ) & ELISA .

52
Q

Resistance in gonorrhea in seen against

A
  • Chromosomally mediated & Plasmid mediated to penicillin ( β Lactamase producing ).
53
Q

What is the treatment for gonorrhea?

A

Recommends the Treatment For - Uncomplicated Genital & Rectal Infection of N.gonorrhoeae :

Ceftriaxon 125 mg single IM OR
Cefrofloxacin 500 mg OR
Ofloxacin 400 mg single oral dose + Doxycycline 100 mg twice daily orally for 7 days.
Alternative to Doxycycline include Erythromycin 1 gm or Azithromycin 1 gm single oral dose for 7 days.

54
Q

What are prevention techniques?

A

Early detection of cases & Tracing of contact .

Health education & Other general measures .

Barrier method with Condom can greatly reduce the Transmission of Infection .

Avoid Multiple Sexual Partners .

Promotion of safe sex & individual counselling .

55
Q

Treponema subspecies

A

T. Pallidum considered to include three subspecies pallidum causing venereal syphilis, endemicum causing endemic syph. & pertenue causing yaws –

56
Q

Treponema shape

A

Relatively short , slender with fine spirals &

pointed or rounded ends.

57
Q

Treponema pallidum

A

syphilis

58
Q

Treponema Pertenue

A

yaws

59
Q

Treponema pinta

A

pinta

60
Q

How is syphilis transmitted?

A

By Direct Sexual contact And Trans- placentally ( Congenital Syphilis ).
Hospital personnel , Laboratory staff & Blood transfusion recipient may contract disease Accidentally.
Sharing of needles by I.V. Drug users.
Syphilis is one of ancient sexually transmitted disease .

61
Q

Syphilitic Lesions are a portal for?

A

HIV transmission

62
Q

Which stages of syphilis are contagious?

A

primary, secondary - contagious

63
Q

Late Syphills contagious?

A

No

64
Q

What is the pathogenesis of syphilis?

A

Treponema pallidum penetrates mucous surface or abraded skin & travel to draining Lymph node in about 30 min , where they Multiply during incubation period .
The Treponema invades the lymphatics & disseminates in the blood stream ; adheres to endothelial cells.

65
Q

What is the incubation period?

A

3wks to 10-90 dyas

66
Q

What is a primary lesion?

A

Primary lesion end - arteritis → Endothelial scarring → Intense Inflammatory reaction & tissue necrosis

67
Q

What occurs with replacement fibrosis?

A

→ Replacement fibrosis → Iry Chancre Ulcers heals but spirochetes disseminate .

68
Q

What are the virulence factors for syphilis?

A

outer membrane protin, hylauronidase, fibrone

69
Q

Outer membrane protein

A

– Promote adherence of Treponema pallidum to surface of host cell - facilitating the infection

70
Q

What is the role of hyaluronidase and fibronectin?

A

Enzyme hyaluronidase – Facilitates perivascular infiltration .
Fibronectin– Prevents phagocytosis of T.Pallidum by macrophages.

71
Q

Primary - symptoms, signs, infectiousness

A

Chancre (a small, usually painless skin sore ) , regional lymphadenopathy
Contagious

72
Q

Secondary syphillis

A

Rashes , sores on mucous membranes , hair loss , fever , condolamata lata.
Contagious
Occurs weeks to months after the primary stage

73
Q

Is latent and late/tertiary syphilis contagious? Which is symptomatic?

A

MDSC 3312 MB (7 decks)

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