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Unit 1 ID+LC > STDs > Flashcards

STDs Flashcards

1
Q

Most common notifiable disease in US?

Second most?

A
  1. Chlamydia

2. Gonorrhea

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2
Q

Gram - diplicocci

A

Neisseria

*each indiv cocci are kidney shaped

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3
Q

Which one accounts for false positives, specificity or sensitivity?

A

Specificity

  • tested 100 healthy people who did NOT have disease:
    what % of those have a NEGATIVE test
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4
Q

Which one accounts for false negatives, specificity or sensitivity?

A

sensitivity

if you tested 100 people who knew had the disease:
How many would have a POSITIVE test?

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5
Q

Ways to culture N. gonorrhoeae

A
  1. Chocolate agar: nonselective
  2. Thayer-Martin:
    more specific - contains ab
  3. Transgrow bottle: provides CO2
    - N.g req. >3% CO2 for growth
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6
Q

Which is strictly aerobic, N. gonorrhoeae or chalmydia?

A

N. gonor.

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7
Q

Gold std to dz N. gonorrhoeae

A
  1. Gram stain + culture on Thayer-martin or chocolate agar
  2. Oxidase Test (positive)
  3. Look for oxidative utilization of glucose (not maltose or sucrose)
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8
Q

What can be used as an alternative to culture with vaginal specimens or urine from girls?

A

NAAT

- better sensitivity

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9
Q

Why are preadolescent girls at higher risk for aquiring N. gonorrhoeae?

A

In cervix, developing cells are mostly columnar (at SCJ) cells: more adherent to Gonococcal cells

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10
Q

Gonococcus directly infect ________ structures. Which can lead to these 6 things.

A

Mucosal and glandular structures

  1. Opthlamia neonatorum
  2. Urethritis
  3. Pharyngitis
  4. Cervicitis
  5. Vulvovaginitis (children)
  6. Proctitis
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11
Q

Gonococcus can locally extend and cause urethritis and cervicitis, which can also result in bacteremia and cause distal infxns. List what happens with local extensions

A

Urethritis:

  • prostatis
  • vasiculitis
  • epididymitis

Cervicitis:

  • endometritis
  • salpingitis
  • oophoritis
  • pelvic peritonitis
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12
Q

Most common gonococcal complicaiton in men

A

acute epididymitis

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13
Q

With neonatal conjunctivitis, what ab can you use?

A

Drops:
TCN
Erythromycin

  • burnsssss (so try to prevent)
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14
Q

Gonococcal bacteremia can cause distal infxns, name some

A
  1. dermatitits
  2. arthritis
  3. endocarditis
  4. meningitis
  5. perihepatitis
  6. tenosynovitis
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15
Q

Designations of Major outer membrane proteins

A
  1. Opa
    - imp for intimate attachment
    - undergo antigenic variation
    - undergo phase variation
  2. Por
  3. Rmp
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16
Q

N. gonorrheae use:

  1. antgenic variation
  2. Phase variation
A
  1. antgenic variation
    - change the aa seq of surface proteins
    - same fxn, but no longer rec by immune sys
    - can be due to recombination (btwn two organisms with diff copies of pilin gene - 1 silent, 1 fxnal)
  2. Phase variation
    - on-off control for expression of genes encoding surface proteins
  • Both gives rise to antigenically and structurally diff pili
17
Q

tx option for gonorrhea?

A

3rd gen cephalosporins

  • ceftriaxone IM (in the butt) or cefixime PO both are given with azithromycin (chlam)
  • last line def for treating

*FQ are no longer recommended due to resisitance

18
Q

Chlamydia cell wall peptidoglycan is special how?

A

does not contain N-acetylmuramic acid

  • PCN no good
19
Q

Chlamydia are diagnosed via:

A 
NAAT
or visualized by:
1. bright field microscopy
- giemsa stain
2. electron microscopy
3. immnoflourescence microscopy
20
Q

Pathogenicity of chlamydia

A
  1. attachment factors (adhesins)
  2. inhibit phagolysosome fusion
  3. latent infxn
21
Q

Trachomatic serovariants cause:
A-C
D-K
L1-L3

A

A-C: Inclusion conjunctivitis

D-K: STDs and infant conjunctivitis and pneumonia

L1-L3: lymphogranuloma venereum
- swollen inguinal ln

22
Q

Women vs men asymptomatic chlamydial infxns

A

75% women

50% men

  • asymptomatic
23
Q

Most common cause of neonatal conjunctivitis in US

A

Chlamydia
- present 7-12 days after delivery

*unlike gonorrhea - more rapid presentation

24
Q

Spirochetes reproduce how?

- Can they be cultured in vitro?

A

reproduce by transverse fission

  • T. pallidum cannot be cultured in vitro
25
Q

Which stages of syphilis is most transmissible?

A

stage 1+2

Primary: localized

Secondary: systemic

26
Q

How many % of pts with untreated syphilis develop tertiary syphilis?

A

30%

  • 25% of that die of disease
27
Q

Incubation period of syphilis

A

~3 weeks

then primary syphilis lasts 2-6 weeks –> asymptomatic period

28
Q

What organism has painful chancroid ulcers?

A

Haemophilus ducreyi: GNB

  • not syphilis (painless)
29
Q

When are serologic tests highest during syphilis infxns?

A

serologic tests are highest in titer during secondary stage of syphilis

30
Q

Evidence of latent syphilis?

A

Only evidence is a POSITIVE SEROLOGIC TEST

- host suppresses infxn, and no lesions present

31
Q

Which is more protective in immunity to reinfection and protection against tertiary syphiis?
- HUmoral or Cell mediated?

A

Cell mediated (T cell) response

*humoral ab response is not protective but useful for dz

32
Q

Alternatives to treating syphilis if they are allergic to PCN?

A

Doxycycline

Tetracycline

33
Q

rxn some pts get to syphilis tx?

A

Jarisch-Herxheimer rxn

  • develops 2-24 hrs after PCN tx in pts infected with spirochetes
  • occurs in 50% of pts with primary, and 90% of secondary
  • NOT AN ALLERGY TO PCN: explain to pt

Unit 1 ID+LC (32 decks)

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