STD's Lecture 16,17

Question 1

Intro/Complications

Answer 1

• STDs increase the ease of contracting AIDS, also significantly decrease fertility.
• Urethritis and Cervicitis, and a sexual history are key to diagnosis.

Question 2

Nisseria Gonorrhea

Answer 2

• Gram negative Diplococci oxidase positive. Is isolated using thayer martin media that inhibits the growth of all organisms except niesseria.
• Has attachment virulence factors and conserved niesseria reduction modifidable protein that prevents Ab mediated killing.

Question 3

Gonorrhea Symptoms

Answer 3

-Men are almost always symtomatic with urethritis and yellow purelent discharge.
-Women can be assymptomatic and serve as pools of infection. Can also allow womens disease to progress further to upper tract and mixed (Anaerobe) infections.
-Can cause disseminated infections most commonly to the joints.
Fitz-Hugh-Curtis following PID there is inflammation of Liver Capsule (violin strings)

Question 4

Gonorrhea treatment

Answer 4

• Treat chlamydia at the time of Gonorrhea diagnosis because of co-infection.
• Cephalosporin for Gonorrhea and Azithromycin for Chlamydia.

Question 5

Chlamydia

Answer 5

• Chlamydia Trachomatis is obligate intracellular microbe. Infects with elementary body and is metabolically active as reticular body. Can see inclusion bodies on pathology
• Urethritis, Cervicitis, less discharge and clear to white.
• Women have less symptoms when compared to men.
• Reiters syndrome with arthritis, conjunctivis etc.

Question 6

Syphillis

Answer 6

• Treponemma pallidum is a spirochette that is imaged using dark field. Very slow generation time leading to stages of infection
• Incubation is infective without symptoms
• Primary syphillis - painless chancre
• Secondary Syphillis- Disseminated maculopapular rash including hands and soles of feet.
• Latent stage common
• Tertiery syphillis has neural involvment with asceptic meningitis, tabes dorsales(Posterior columns, proprioception), argyll robertson pupil (accomidate but not reactive to light). Can also have ascending Aortic Anyeurism. Gummas.
• Treatment with penicilin (latent early=1 shot, late = 3). Can cause a Jersch-Hechmeister reaction with a worsening of symptoms at the start of therapy.
• Rapid Reagent is screening test then specific Ab mediated test to verify

Question 7

Herpes

Answer 7

• Generally caused by HSV-2 which is DS DNA virus.
• Painful pus filled lesions and local lymphadenopathy
• Lives dormant in DRG.
• Can reactivate under certain conditions
• Infection during third trimester is dangerous to fetus.

Question 8

Haemophilus Ducreyi

Answer 8

Painful Chancre, school of fish

Question 9

Trichomonas Vaginalis

Answer 9

• Protozoan that can colonize if increased pH

- Malodorous discharge with KOH, burning and itching

Question 10

Gardenella Vaginalis

Answer 10

• Burning and itching, foul smelling. Clue cells with the appearance of cocci and an absence of the normal rod commensals (lactobaccili)
• Happens with a rise in pH

Question 11

Human Pampiloma Virus

Answer 11

-Causes Genital Warts and Cervical Caner DNA virus