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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
How does trichomonas vaginalis present?
Itching | Copious yellowish discharge
26
What can potentially happen if a pregnant woman is infected by trichomonas?
Premature labor
27
What is seen on a wet mount of vaginal/urethral discharge that would be diagnostic of trichomonas?
Tear-drop shaped trophozoites with 5 flagella and 1 nucleus
28
What is the vaginal pH with a trichomonas infection?
Higher than 4.5 (4.5 is normal)
29
How is trichomonas treated? Who all gets it?
Metronidazole Patient AND partner
30
What bacteria can cause Bacterial Vaginosis (BV)?
Gardnerella spp. | Mobiluncus spp.
31
How is gardnerella BV diagnosed?
Gram stain → clue cell | KOH amine test → presence of amines
32
How does vaginosis present?
Moderate amount of gray/white very SMELLY discharge
33
What causes copious secretion of a cottage cheese like discharge?
Candida albicans
34
When is candida albicans likely to occur?
After an antibiotic regimen or in immunocompromised patients
35
How is candida diagnosed?
Pseudohyphae and budding yeast on tissue scrapings
36
What is Treponema Pallidum?
Spirochete bacteria that causes syphilis
37
How does T. pallidum initially present?
The first sign of syphilis is a painless chancre at the inoculation site that remains up to 6 weeks
38
If left untreated, what can happen with a syphilis infection after the initial chancre heals?
Treponema pallidum disseminate and proliferate → 2° syphilis
39
What are the symptoms of 2° syphilis?
Condyloma lata Maculopapular rash on palms and soles Meningitis, hepatitis, arthritis, etc.
40
What is condyloma lata?
Wart-like painless lesions in moist areas
41
How long do symptoms of 2° syphilis remain?
Up to 6 weeks...cycles can repeat many times
42
If still untreated, what can happen if the treponema pallidum infection progresses to 3° syphilis?
Chronic inflammation of: Bone and soft tissue (Gummas) CV system (aortitis and AAA) CNS (tabes dorsalis, general paralysis, Meningitis, Argyll Robertson)
43
What is tabes dorsalis?
Demyelination of the dorsal column (proprioception, vibration, and discriminatory touch)
44
What abnormalities can happen to an infant born to a mother with syphilis?
``` Stillbirth CN VIII deafness Saber shins Saddle nose Hutchinson's incisors ```
45
How is treponema pallidum diagnosed?
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
How is syphilis treated?
Penicillin G
47
Is penicillin G oral or IV?
G is IV...GIVe penicillin G
48
What is a potential complication of treating treponema pallidum?
Jarish-Herxheimer reaction d/t release of endotoxin-like factors (fevers, chills, and myalgias)
49
Which HSV typically infects below the waistline?
HSV-2 | HSV-1 potentially could after oral
50
What kind of genome does HSV have? Is it enveloped
HSV is a linear dsDNA, enveloped virus
51
How does herpes usually present?
Usually asymptomatic, but can cause vesicular lesions
52
Where does herpes remain latent?
In the lumbosacral ganglia...travels through sensory nerves
53
Can herpes cross placenta?
Yes...causes congenital defects, spontaneous abortion or neonatal encephalitis
54
How is herpes diagnosed?
PCR Multinucleate giant cells on Tzanck smear of skin lesions Eosinophilic Cowdry intranuclear inclusion bodies on skin biopsy Fluorescent antibody test is available
55
How is herpes treated?
Acyclovir
56
What forms the normal vaginal flora of reproductive age women?
Candida | Lactobacillus
57
What forms the normal vaginal flora in young girls/old women?
Non-hemolytic strep Staph Corynbacterium Lactobacillus

HRM (40 decks)

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