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STD Flashcards

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Biology 101 flashcards
1
Q

Neisseria gonorrhoeae characters:

A
  • flow of seed
  • gram negative diplococcus
  • resembles coffee bean
  • fastidious: requires special media + CO2
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2
Q

Gonorrhea Virulence:

A
  • Pilli: attachment/antigenic variation (evade immunity from previous infection)
  • Por protein: intracellular survival by evading destruction
  • Opa Protein: mediates binding to epithelial cells
  • Lipooligosaccharides + Beta lactamase enzyme: resistance to penicillin
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3
Q

Gonorrhea Pathogenesis:

A
  • attaches to mucosal cells via pili and penetrates the cells
  • infection of the subepithelial space
  • Lipooligosaccharides stimulate inflammatory response (TNF/cytokines/WBC) = discharge
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4
Q

Gonorrhea Epidemiology:

A
  • humans only host
  • direct mucosal contact
  • no toilet sets transmission
  • adolescents more susceptible
  • 90% males symptomatic, 50% females
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5
Q

Gonorrhea Diagnosis:

A
  • gram stain of urethral discharge in men
  • culture on thayer martin media (culture all sites)
  • Non-culture based have become the gold standard (do not require CO2):

PCR, NAAT, assays with single swab, urine based

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6
Q

Gonorrhea signs/treatment:

A
  • urethritis (men)
  • cervicitis (women)
  • treat with single dose injection of ceftriaxone + oral azithromycin
  • always treated for chlamydial co-infection
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7
Q

Chlamydia trachomatis characters:

A
  • obligate intracellular bacterium
  • small gram negative bacillus
  • sterotypes
  • requires living tissue for culture
  • no lasting immunity
  • SILENT: can live up to 2 years in female genital tract (PID), 75% female 50% male infections asymptomatic = tubal infertility
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8
Q

Chlamydia sterotypes:

A
  • Endemic trachoma (eye disease): A, B, C
  • Genitourinary syndromes: D-K
  • Lymphogranuloma venereum (LGV): L1-L3
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9
Q

Two forms of Chlamydia

A

Elementary body: infectious form

Reticulate body: noninfectious intracellular form that promotes replication

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10
Q

Chlamydia pathogenesis:

A

receptors for EB found only on mucous membranes of

  • urethra
  • endocervix, endometrium, fallopian tubes
  • anorectum
  • respiratory tract
  • conjuctiva

EB enters cells, replicates, infects other cells

Inflammatory response: granulocytes, lymphocytes, plasma cells

inflammatory response with re-infection is strong and can lead to end organ damage (blindness, sterility)

also causes uretheritis (men) and cervicitis (women)

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11
Q

Chlamydia Epidemiology:

A
  • humans only host
  • direct mucosal contact
  • more widespread than gonorrhea
  • most common infectious disease in US
  • adolescents
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12
Q

Clamydia Diagnosis/treatment:

A
  • same as gonorrhea
  • single swab for both
  • azithromycin, single dose
  • doxycycline
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13
Q

Urethritis

A

men

  • Dysuria, discharge, burning
  • Diagnose with gram stain, if intracellular gram negative diplococcic seen it is gonorrhea
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14
Q

Epididymitis

A

men

  • Swelling, erythema or scrotal sac, unilateral, tender
  • May not have discharge
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15
Q

Mucopurulent cervicitis

A

Women

  • Asymptomatic
  • dyspareunia, bleeding, dysuria, lower abdominal pain
  • Positive swab test, NOT gram test (low sensitivity)
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16
Q

PID

A

-Presents as tubo-ovarian abscess, endometritis, or peritonitis

-1 in 4 develop chronic sequelae
•	Antimicrobial therapy has no effect on    subsequent rates 
•	Ectopic pregnancy 7 fold increase risk
•	Infertility 10-15% risk increase
•	Chronic pelvic pain
17
Q

Disseminated gonococcal infection (GC)

A
  • Dermatitis arthritis (skin lesions)
  • Septic monoarticular arthritis
  • Treatment: IV certriaxone initially then switch to oral
18
Q

Gonococcal infections at other sites:

A
  • pharyngeal
  • conjuctivitis
  • perirectal
  • skin lesions
19
Q

Chlamydia infection at other sites:

A
  • perirectal
  • conjuctivitis (less symptomatic than GC
  • Dysuria-Pyuria Syndrome: young women with pyuria (WBC in urine)
20
Q

Lymphogranuloma Venereum:

A
  • caused by L1-L3 or chlamydia
  • endemic in africa, asia, india, south america, caribbean
  • presents as inguinal lymphadenopathy (lymph node disease)
  • look for groove sign (swollen inguinal canal)
  • proctitis
  • presents with fever, tenesmus, bleeding, rectal pain
  • extends into colon
21
Q

Lymphogranuloma Venereum proctitis:

A
  • inflammation of rectum seen in MSM and het women

- pelvic nodes and lumbar nodes involved

22
Q

Reactive arthritis:

A
  • post infectious sequelae more common after CT than GC
  • Classic triad: arthritic, conjuctivitis, urethritis
  • also see skin lesions
23
Q

Treponema pallidum

A
  • syphilis
  • corkscrew shaped, helical
  • cannot be cultured
  • cant see under light microscope
24
Q

Endemic Treponemal diseases:

A
  • yaws: africa
  • pinta: central/south america
  • bejel: middle east
25
Q

Syphilis pathogenesis:

A
  • enters via skin/mucus membrane
  • travels to lymphatics and then blood
  • invades CNS in 30-40% of patients with primary or secondary disease
  • stages of primary, secondary, latent, and tertiary
26
Q

primary syphilis:

A
  • chancre at site of inoculation (mouth, genitals)
  • women usually dont even see it and are asymptomatic
  • painless ulcer with smooth base, border raised rolled or indurated
  • heals spontaneously usually without scar in 1-6 weeks
  • serologic tests for syphilis may not be positive at this time
27
Q

secondary syphilis

A
  • can go to many organ systems
  • 2-8 weeks after ulcer
  • sprochetes disseminated, meninges seeded

“great imitator”

  • skin manifestations: rash, alopecia, condylomata lata (plagues on genitals)
  • PALMAR/PLANTAR LESIONS
  • fever, malaise, anoerxia, wt loss, pharyngitis, myalgia
  • mucus patches
  • adenopathy (enlarged lymph)
  • CNS: headaches, meningitis
  • arthritis, hepatitis, osteitis all possible
28
Q

Latent syphilis:

A
  • no manifestations
  • positive serology
  • after four years patient is noninfectious and resistant to reinfection
29
Q

Tertiary syphilis:

A
  • gummatous syphilis (10-15 years): lesions in skeletal, spinal, and mucosal areas, eye and viscera (lung, stomach, liver, genitals, breast, brain heart)
  • Cardiovascular syphilis (20-30 years): aortic aneurysm
  • neurosyphilis: stroke in young people, psych wards, eye disease, tabes dorsal (gait)
30
Q

Diagnosis of syphilis:

A
  • cannot culture
  • darkfield microscopy
  • nontreponemal (screening)
  • specific treponemal (confirmatory)
31
Q

Syphilis treatment:

A
  • penicillin

- allergic individuals can use doxycycline

Microbiology (16 decks)

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