STD's & other genital tract infections Flashcards
Differentiate between exogenous infections and endogenous
Exogenous: acquired through sexual activity STI
Endogenous: caused by normal genital flora
Role of normal flora?
- prevent adherence of pathogenic organisms
What can strep. agalactiae lead to in neonates?
Bacteremia
Sepsis
Meningitis
Pneumonia
In lower genital tract infections what bacteria can cause dysuria (3)
- N. gonorrhoea
- Chlamydia
- Herpes simplex virus
In lower genital tract infections what bacteria can cause urethritis
N. gonorrhoea
Non-gonococcal
- can be caused by chlamidya, trichomonas vaginalis, & mycoplasma genitalium
Vaginal candidiasis
Bacteria caused by?
Vaginal discharge properties?
Odour properties?
Microscopy properties?
Bacteria caused by?
- Candida albicans
Vaginal discharge properties?
- increased, white, cottage cheese
Odour properties?
- yeasty or no odour
Microscopy properties?
- KOH preparation showing budding yeasts and pseudohyphae
Is Vaginal candidiases considered an STI? why?
No, it is an endogenous bacteria
- caused by normal flora (not always infectious)
Trichomononiasis
Bacteria caused by?
Vaginal discharge properties?
Microscopy properties?
Bacteria caused by?
Trichomonas vaginalis
Vaginal discharge properties?
- yellow, green, frothy (small bubbles)
Microscopy properties?
- many polymorphonuclear leukocytes (PMNs)
Bacterial vaginosis
Bacteria caused by?
Vaginal discharge properties?
Microscopy properties?
Bacteria caused by?
Gardnerella vaginallis
- caused when you kill lactobacteria
Vaginal discharge properties?
- thin, white, grey, fishy odour
Microscopy properties?
- no (PMNs)
Which vaginitis conditions are NOT considered STDs (2/3)
Bacterial vaginosis
Vaginal candidiasis
Explain pelvic inflammatory disease
infection when cervical microorganisms travel upward to endometrium, fallopian tubes etc… (upper female tract)
Explain post-gynecologic surgery infections
Infections caused by patient’s own vaginal flora
- includes pelvic cellulitis or abscesses
What bacteria is syphilis caused by?
Treponema pallidum
What are the virulence factors for syphilis
TROMPs (t. Palladium Rare outer membrane proteins)
Specific surface antigens: antigenic variation of TprK outer membrane protein aids in immune evasion
Explain the 2 pathogenesis of syphilis:
Penetration
Dissemination
Penetration:
- enters body through skin/mucous membranes during sex
Dissemination
- T. palladium accesses circulatory system (before symptoms appear)
- can also invade CNS at any stage
What occurs during stage 1 (primary) of syphilis? When?
Chancre develops 2-10 weeks
- Hard, painless, small lesion
- HIGHLY infectious stage
- spontaneously heal in 1-6 weeks
What occurs during stage 2 (secondary) of syphilis if it overlaps or after primary stage? when?
Rash (2-8 weeks after primary stage)
- rash is painless + itch-less –> persists for up to months
- Condylomata lata: very infectious wart-like papules
Symptoms:
- sore throat, headache, mild fever, malaise, myalgia, widespread rash
When does condylomata lata occur
very infectious wart-like papules in stage 2
What occurs during latent syphilis? how long
- no more lesions
- SYMPTOMLESS period (patient is not contagious) (1-20 years)
- relapse may occur (still not contagious)
What kind of test is an indication for syphilis infection?
a positive serologic test
What occurs during tertiary syphilis (stage 3)?
Symptoms:
- granulomatous lesions, CV lesions
- neurosyphilis
- congenital syphilis
- Reappear either 1 year after primary infection of 10-30 years
What is the first line treatment of syphilis for all 4 stages?
Second line?
1st line: Long acting penicillin IM injection
2nd line: macrolides
What laboratory diagnosis is used for syphilis? (2)
Darkfield microscopy
Immunofluorescence
What are advantages of darkfield microscopy? disadvantages?
Adv
- definitive immediate diagnosis (useful for primary/secondary syphilis but can’t differentiate between the 2)
- rapid
Disadv
- not useful for latent or tertiary syphilis
- Sensitivity decreases as lesion heals
- False negatives: due to soap, antibiotic oint etc..
