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Micro > STD's > Flashcards

STD's Flashcards

1
Q

Nisseria Gonorrhea- resovoir

A

humans

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2
Q

N. Gon- trasmission

A

sexual

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3
Q

N. Gon- morphology

A

Gram negative diplococci

kidney bean shaped

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4
Q

N. Gon- metabolism

A

Facultative anaerobe that grows best in high CO2 environment.
Glucose only fermenter

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5
Q

N. Gon- virulence factors

A

Pilli- adherence to epithelial cells. undergo extensive antigenic variation. Antiphagocytic
IgA proteases
Outermembrane proteins- protein I and protein II- Opacity protein
chealators

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6
Q

N. Gon- toxins

A

endotoxin- LPS

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7
Q

N. Gon- clinical presentation in men

A

Asymptomatic

Urethritis

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8
Q

N. Gon- clinical presentation in female

A

cervical gonorrhea –> PID

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9
Q

complications of PID

A 
sterility
ectopic pregnancy
abscess
periotonitis
perihepatitis
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10
Q

N. Gon clinical complications n in both sexes

A

gonococcal bacteremmia

Septic arthritis- MCC of septic arthritis in sexually active individuals

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11
Q

N. Gon- clinical presentation in neonates

A

Acquired while passing through the birth cananl

Conjuctivits in the 1st 5 days- Opthalmia neonatorum

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12
Q

N. Gon tx- adult- 1st line

A

3rd gen Cephalosporin- Ceftriaxone

may add doxycycline to cover chlamydia and syphillis

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13
Q

N. Gon tx- adult- 2nd line

A

Fluroquinolones and Spectinomycin

neither is effective against syphillis

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14
Q

N. Gon tx- opthalmia neonatorum- prophylaxis

A

Erythromycin eye drops should be given as prophylaxis at birth to protect from N. Gon and chamydia.

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15
Q

N. Gon tx- opthalmia Neonatorum

A

systemic tx with ceftriaxone

concurrent Erythromycin to cover chlamydia

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16
Q

N. Gon- dx

A

Gram stain of pus
Culture
PCR

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17
Q

N. Gon- what do you see on gram stain

A

urethral pus shows diplococci within WBC

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18
Q

N. Gon- culture media

A

Choclate agar
Thayer Martin VCN
cytochrome oxidase-= pink colonies

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19
Q

N. Gon- immunity

A

can be reinfected numerous times

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20
Q

Gardinella Vaginallis- transmission

A

STD

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21
Q

G. Vaginallis- virulence

A

no capsule

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22
Q

G. vaginallis- toxins

A

none

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23
Q

G. vaginallis- disease

A

bacterial vaginitis

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24
Q

Ssx bacterial vaginitis

A

foul smelling (fishy) vaginal discharge
vaginal pruritis
dysuria

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25
Q

G. Vaginalis- tx

A

Metronidazole

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26
Q

G. Vaginallis- dx

A

clue cells

no lacto bacilli

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27
Q

What are clue cells

A

vaginal epithelial cells with tiny pleomorphic gram negative bacilli in the cytoplasm

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28
Q

G. Vaginallis- growth requirements

A

DOES NOT required factor X or factor V for growth

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29
Q

Chlamydia trachomatis- reservoir

A

humans

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30
Q

Chlamydia- morphology

A

Gram negative BUT lacks peptidoglycan and muramic acid

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31
Q

Chlamydia transmission

A

contact

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32
Q

Chlamydia- primarily effects what organs

A

Eyes
Genitals
Lungs

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33
Q

Chlamydia- global distribution

A

trachoma is mostly found in the under developed word, and transmission is via poor hygiene.

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34
Q

Chlamydia- Life cycle

A

Elementary body- dense spherule that infects cells –> trans forms to initial body –> when it is ready to leave the cell transforms back to EB to infect other cells

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35
Q

Chlamydia- characteristics of the IB

A

larger and more osmotically fragile
reproduces via binary fission
requires ATP from host

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36
Q

Chlamydia- metabolism

A

obligate intracellular parasites b/c it steels ATP from from host via- ATP/ADP translocator

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37
Q

Chlamydia-virulence factors

A

resistant to lysozymes

prevents phagosome- lysosome fusion

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38
Q

Chlamydia- clinical presentation- types A,B, and C

A

Trachoma- leading causing of blindness worldwide.
causes scarring of the inside of the eyelid –> redirection of eyelashes onto the corneal surface –> secondary infections cause blindness

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39
Q

Chlamydia- clinical presentation- types D-K- infants

A 
inclusion conjuctivitis (opthalmia neonatorum)
infant pneumonia
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40
Q

Chlamydia- clinical presentation- types D-K women

A

urethritis
cervicitis
PID

41
Q

Chlamydia- clinical presentation- types D-K men

A

NGU
epididymitis
Prostatitis

42
Q

Complications of Chlamydia infxn

A

women- sterility, ectopic pregnancy, chronic pain- after PID
Reiters syndrome
FItz- Hugh- Curtis syndrome
Lymphogranuloma

43
Q

Reiters syndrome

A

Arthritis
Conjuctivitis
Urethritis

44
Q

Fitz- Hugh- Curtiz syndrome

A

perihepatitis

45
Q

Chlamydia- serotypes L1,2, and 3 have what complication

A

lymphogranuloma verenum

46
Q

Chlamydia-tx- genital and eye infections

A

Doxycycline for adults
Erythromycin for kids and preggers
Azithromycin
Systemic tx is required for eye infection especially in infants

47
Q

Chlamydia- growth

A

Cannot be growth on traditional media

48
Q

Chlamydia -dx- inclusion conjunctivitis

A

Conjunctival scrapings will show intracytoplasmic inclusions in the epithelial cells
Stain with Iodine and Giemsa

49
Q

Chlamydia-dx- urethritis

A

urethral swab
Gram stain will not show gram negative intracellular diplococci
PCR
Immunofluorescence
Serologic for anti chlamydia antibodies and immune fluorescence

50
Q

Lymphogranulomatous venereum dx

A

Urologic test

Frei test

51
Q

Spirochete reproduction

A

Transverse fusion

52
Q

Spirochete motility

A

Six axial filaments

Filaments are between cytoplasmic and outer membrane

53
Q

Spirochete - culture

A

Cannot be cultured on an artificial media except for leptosporia

54
Q

Treponema pallium- reservoir

A

Humans

55
Q

T. Pallidum- transmission

A

Sexual

56
Q

T. Pallium- air preferences

A

Microaerophillic

57
Q

T. Pallidum- morphology

A

Thick rigid spirals

58
Q

T. Pallidum- temp sensitivity

A

Sensitive to high temperatures

59
Q

T. Pallidum- virulence

A

Motile

60
Q

T. Pallidum-dz

A

Syphillis

61
Q

T. Pallidum- how many clinical stages are there ?

A

4

62
Q

T. Pallidum- primary stage

A

Painless chancre at site of infiltration

63
Q

Syphillis- secondary stage

A

Disseminated- CNS, eyes, bones, kidneys, and joints all may be involved
Rash on soles and palms
Condylomata latum

64
Q

Condyloma latum

A

Painless wart like lesions in warm moist areas- scrotum and vulva

65
Q

T. Pallidum- latent stage

A

25% may relapse to secondary stage, this stage has a wide amount of vairability for how long it can last

66
Q

T. Pallidum tertiary syphillis

A

Gummas of skin and bone
Cardiovascular syphillis
Neurosyphillis-

67
Q

Gumma

A

Granulomatous lesions that eventually fibrose and necrose.
Non infectious
Skin- painless with sharp borders and solitary
Bone- deep knawing pain
Resolve with tx

68
Q

Cardiovascular syphillis

A

Chronic inflammatory destruction of the vaso vasorum –> medial necrosis of the aorta–> aneurysm of the ascending aorta or aortic arch
Aortic valve insufficiency or Coronary artery occlusion- if dissection travels back that far
Cannot be fixed with anti microbial therapy

69
Q

Types of neurosyphillis

A 
Asymptomatic neurosyphillis 
Subacute meningitis
Meningoaascular syphillis
Tabes dorsalis
General paresis
Argyll Robertson pupil
70
Q

Asymptomatic neurosyhphillis

A

clinically normal but CSF is positive for syphilis

71
Q

Subacute meningitis

A

fever, stiff neck, HA

CSF- high lymphocyte, high protein, low glucose and positive syphilis

72
Q

Meningovascular syphilis

A

bac attacked BV of brain and meninges leading to CV occlusion and infraction (brain, spinal, cord meninges).

73
Q

Tabes dorsalis

A

Posterior column- vibratory and propioceptive sense –> ataxia
Dorsal root and ganglia- loss of reflexes, pain, and temperature sensations

74
Q

General Paresis

A

progressive degeneration of nerve cells in the brain –> mental deterioration, psychiatric symptoms

75
Q

Argyll Roberson pupil

A

prostitute pupil- constricts but doesn’t accomodate
present in tabes dorsalis and general paresis
midbrain lesion- pupil constricts during accomodation but doesn’t react to light

76
Q

T. Pallidum- rule of 6’s

A 
Sexual transmission
6 axial fillaments
6week incubation
6 weeks for chancre to heal
6 weeks from chance heal to secondary syphilis
6 weeks for secondary syphilis to resolve
66% of secondary pts have resolution
6 yr min until dev tertiatry syphilis
77
Q

Types of congenital syphilis

A

early congenital syphilis

late congenital syphilis

78
Q

Congenital Syphilis

A

T. Pallidum can cross plancenta
high mortality rate
develop early or late congenital syphilis

79
Q

early congenital syphilis

A 
occurs within 2 yrs
wide rash, condyloma latum
snuffles- mucus membrane and runny nose
LN, liver, spleen, enlargement
bone infection
80
Q

Late congenital syphilis

A

neurosyphilis + 8th CN deafness
saddle nose, saber shins, hutchitsons teeth, mulberry molars
eye disease

81
Q

When does T. Pallidum damage the fetus

A

not until the 4th month of gestation- so damage can be prevented by treating before then

82
Q

T. Palldum- tx

A

Pen G
Erythromysin
Doxycyline

83
Q

Jarish Herxheimer rxn

A

T. Pallidum releases a pyrogen when it is dying so right after tx is started pts feel worse.

84
Q

T. Pallidum- Dx- cutaneous lesions

A

cutaneous lesions- Dark field microscopy, immunofluorescensce, ELISA, silver stain

85
Q

T. Pallidum- Non specific treponemal test

A

VDRL and RPR- look for non specific markers of syphillis infection- anti cardiolipin and lecithin Ab. but 1% of people w/o syphilis have these
all pregnant women should be screen with this bfr 4 months of gestation

86
Q

T. Palldium- Specific treponemal test

A

FTA-ABS- Anti Treponemal Ab

87
Q

Can PCR be used to diagnose T. Pallidum

A

Yes

88
Q

Candida Albincans- where is this normally found

A

Normal flora of skin, mouth and GI tract

NOT NORMALLY FOUND IN BLOOD

89
Q

Candida- morphology

A

Pseudohyphae and yeast

90
Q

Candida- clinical presentation in a normal host

A

Oral thrush (if u see this do HIV test)
vulvovaginal candidiasis
cutaneous infxns- diaper rash, in skins of obese people

91
Q

Candida- clinical presentation in an immunocompromised host

A

Thrush- invades esophogous
disseminated candidiasis
chronic mucocutaneous candidiasis
vagintis, and cutaneous infxns

92
Q

Symptoms of esophogeal candidiasis

A

retrosternal chest pain
dysphagia
fever

93
Q

Candida tx- considerations

A

depends on location of infxn and severity

94
Q

Candida- thrush - tx

A

oral fluconazole
nystatin swish and spit
clotrimazole candies

95
Q

Candida- Cutaneous infxn- tx

A

topical imidazole

oral fluconazole

96
Q

Candida- Esophogeal tx

A

(most common in HIV)- fluconoazole, capsofugin

97
Q

Candida- systemic candidiasis- tx

A

IV amphoteracin B
fluconazole
Capsofugin

98
Q

Candida- chronic mucocutaneous candidiasis- tx

A

ketonazole

fluconazole

99
Q

candida dz

A

KOH and silver stain
blood culture
blood assay for D glucan

Micro (10 decks)

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