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HRM > STDs > Flashcards

STDs Flashcards

1
Q

What bugs can cause urethritis?

A

Neisseria gonorrhea
Chlamydia trachomatis
Mycoplasma genitalium

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2
Q

Of the three causes of urethritis, which one is a gram- diplococci? What else is a distinguishing factor?

A

N. Gonorrhea

Also oxidase+

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3
Q

How N. gonorrhea be distinguished from N. meningitides?

A

N. gonorrhea only oxidizes glucose

N. meningitides oxidizes BOTH glucose and maltose

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4
Q

When is gonorrhea most common?

A

With menstruation or with an IUD

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5
Q

What is a telltale sign of gonorrhea?

A

Septic arthritis in sexually active people

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6
Q

Gonorrhea produces a discharge. What does it look like?

A

Gonorrhea → purulent discharge

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7
Q

What are some possible consequences of untreated gonorrhea?

A

PID
Ectopic pregnancy
Sterility
Fitz-Hugh-Curtis syndrome

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8
Q

What is Fitz-Hugh-Curtis syndrome?

A

PID with an inflamed liver capsule

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9
Q

What virulence factors does gonorrhea have?

A

Pili

IgA protease

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10
Q

What does having pili do for gonorrhea?

A

Allows for attachment to mucosal cells (urethra or vagina)

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11
Q

What is the result of gonorrhea killing ciliated cells?

A

Inflammatory response → urethritis (men) or cervicitis (women)

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12
Q

Besides seeing a gram- diplococci on a gram stain and evidence of the ability to metabolize glucose, what else can be done to diagnose a N. gonorrheal infection?

A

N. gonorrhea selectively grows on Thayer-Martin media

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13
Q

How is gonorrhea treated?

A

Ceftriaxone → for N. gonorrhea

Doxycycline → for the probably concurrent Chlamydia

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14
Q

Is Chlamydia gram- or gram+?

A

Neither

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15
Q

What kind of bacteria is Chlamydia?

A

Obligate intracellular parasite

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16
Q

Where does Chlamydia replicate in a host cell?

A

Chlamydia replicates in inclusion bodies

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17
Q

What serovars of Chlamydia are spread via sex?

A

L1-L3 cause Lymphogranuloma Venereum (LGV)

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18
Q

Does Chlamydia cause a discharge?

A

Yes…significant amount of a clear discharge

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19
Q

Other than a clear discharge, how else does Chlamydia present?

A

Painless ulcers that heal…but then there is regional lymphadenopathy that can lead to draining sinuses and proctitis or renal stricture

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20
Q

What are some complications of untreated Chlamydia?

A

Females → Fitz-Hugh-Curtis syndrome

Males → Reiter’s syndrome

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21
Q

What is Reiter’s syndrome? Is there a specific HLA type patient more likely to develop Reiter’s syndrome?

A

Reactive arthritis…also conjunctivitis

HLA-B27 is most likely to develop Reiter’s syndrome

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22
Q

How is Chlamydia diagnosed?

A

PCR
Iodine stain+
Giemsa stain+

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23
Q

How is Chlamydia treated?

A

Azithromycin
Tetracyclines
Erythromycin (oral/eye drops…for neonates)

24
Q

What is a non-cyst forming protozoan that can cause vaginitis?

A

Trichomonas vaginalis

25
Q

How does trichomonas vaginalis present?

A

Itching

Copious yellowish discharge

26
Q

What can potentially happen if a pregnant woman is infected by trichomonas?

A

Premature labor

27
Q

What is seen on a wet mount of vaginal/urethral discharge that would be diagnostic of trichomonas?

A

Tear-drop shaped trophozoites with 5 flagella and 1 nucleus

28
Q

What is the vaginal pH with a trichomonas infection?

A

Higher than 4.5 (4.5 is normal)

29
Q

How is trichomonas treated? Who all gets it?

A

Metronidazole

Patient AND partner

30
Q

What bacteria can cause Bacterial Vaginosis (BV)?

A

Gardnerella spp.

Mobiluncus spp.

31
Q

How is gardnerella BV diagnosed?

A

Gram stain → clue cell

KOH amine test → presence of amines

32
Q

How does vaginosis present?

A

Moderate amount of gray/white very SMELLY discharge

33
Q

What causes copious secretion of a cottage cheese like discharge?

A

Candida albicans

34
Q

When is candida albicans likely to occur?

A

After an antibiotic regimen or in immunocompromised patients

35
Q

How is candida diagnosed?

A

Pseudohyphae and budding yeast on tissue scrapings

36
Q

What is Treponema Pallidum?

A

Spirochete bacteria that causes syphilis

37
Q

How does T. pallidum initially present?

A

The first sign of syphilis is a painless chancre at the inoculation site that remains up to 6 weeks

38
Q

If left untreated, what can happen with a syphilis infection after the initial chancre heals?

A

Treponema pallidum disseminate and proliferate → 2° syphilis

39
Q

What are the symptoms of 2° syphilis?

A

Condyloma lata
Maculopapular rash on palms and soles
Meningitis, hepatitis, arthritis, etc.

40
Q

What is condyloma lata?

A

Wart-like painless lesions in moist areas

41
Q

How long do symptoms of 2° syphilis remain?

A

Up to 6 weeks…cycles can repeat many times

42
Q

If still untreated, what can happen if the treponema pallidum infection progresses to 3° syphilis?

A

Chronic inflammation of:
Bone and soft tissue (Gummas)
CV system (aortitis and AAA)
CNS (tabes dorsalis, general paralysis, Meningitis, Argyll Robertson)

43
Q

What is tabes dorsalis?

A

Demyelination of the dorsal column (proprioception, vibration, and discriminatory touch)

44
Q

What abnormalities can happen to an infant born to a mother with syphilis?

A 
Stillbirth
CN VIII deafness
Saber shins
Saddle nose
Hutchinson's incisors
45
Q

How is treponema pallidum diagnosed?

A

Dark-field microscopy (NOT gram stain)
Serological tests
Bunch of tests that can give false positives with SLE or mono
FTA-ABS (detects anti-treponemal antibodies)

46
Q

How is syphilis treated?

A

Penicillin G

47
Q

Is penicillin G oral or IV?

A

G is IV…GIVe penicillin G

48
Q

What is a potential complication of treating treponema pallidum?

A

Jarish-Herxheimer reaction d/t release of endotoxin-like factors (fevers, chills, and myalgias)

49
Q

Which HSV typically infects below the waistline?

A

HSV-2

HSV-1 potentially could after oral

50
Q

What kind of genome does HSV have? Is it enveloped

A

HSV is a linear dsDNA, enveloped virus

51
Q

How does herpes usually present?

A

Usually asymptomatic, but can cause vesicular lesions

52
Q

Where does herpes remain latent?

A

In the lumbosacral ganglia…travels through sensory nerves

53
Q

Can herpes cross placenta?

A

Yes…causes congenital defects, spontaneous abortion or neonatal encephalitis

54
Q

How is herpes diagnosed?

A

PCR
Multinucleate giant cells on Tzanck smear of skin lesions
Eosinophilic Cowdry intranuclear inclusion bodies on skin biopsy
Fluorescent antibody test is available

55
Q

How is herpes treated?

A

Acyclovir

56
Q

What forms the normal vaginal flora of reproductive age women?

A

Candida

Lactobacillus

57
Q

What forms the normal vaginal flora in young girls/old women?

A

Non-hemolytic strep
Staph
Corynbacterium
Lactobacillus

HRM (40 decks)

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