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Pathology > STI > Flashcards

STI Flashcards

1
Q

What organism causes chlamydia

A

Chlamydia trachomatis

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2
Q

How long after exposure to chlamydia does one experience symptoms

A

1-2 weeks

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3
Q

List some complications of chlamydia infection

A

Pelvic Inflammatory Disease
chronic pelvic pain
infertility
ectopic pregnancy
arthritis
sterility in men (rare)

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4
Q

List 5 methods used to diagnose Chlamydia

A
  • Antigen testing (direct immunofluorescence, ELISA)
  • Cytology- Giemsa Staining
  • Nucleic Acid BAsed test
  • Culture
  • Antibody detection
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5
Q

What method of diagnosis is the most sensitive for genital Chlamydia Trachomatis

A

Nucleic Acid Amplification Test (NAATs)

(Culture is the most specific, less sensitive than NAATs)

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6
Q

What specimen is collected for Chlamydia diagnosis

A

Cervical swab
Swab from penis

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7
Q

What is the treatment for chlamydia ?

A
  • one single dose of Azithromycin
  • a week of bd doxycycline
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8
Q

What serover of Chlamydia causes Genital Tract Infections ?

A

Serovers D-K

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9
Q

What serover of Chlamydia causes Eye Infection?

A

Serover A B C

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10
Q

What serover of Chlamydia causes Lymphogranuloma venerum

A

L1,L2,L3

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11
Q

When the McCoy culture with iodine is used to grow Chlamydia, what result will you see for a positive test

A

The McCoy or HeLa are used to grow Chlamydia , and a positive result will show brown Iodine stained-cytoplasmic inclusions in infected host cells

Stain brown with iodine due to glycogen granules

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12
Q

What are two methods of identifying chlamydia infection with McCoy cell culture?

A

Using Iodine stains
Fluorescent Antibody Test

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13
Q

What is the most sensitive and widely used test to identify chlamydia infection?

A

This is the Antibody Detection-complement fixation test and a titre of 1:64 and greater is diagnostic

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14
Q

What is the aetiological agent for Gonorrhea?

A

Neisseria Gonorrhea (gram negative bean shaped diplococci)

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15
Q

What symptoms do infected patients experience?

A

Males: burning on urinating, yellow/white discharge from penis

Females: fewer females experience symptoms, but they may experience urinary frequency, burning, hesitancy

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16
Q

List 5 complications of Gonorrhea

A

Pelvic Inflammatory Disease
Septicaemia
Arthritis
Endocarditis
Meningitis

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17
Q

What Specimen is collected to diagnose Gonorrhea

A

Endocervical swab
high Vaginal Swab
Urethral swab
Anal swab
Throat Swab

for disseminated gonococcal infections:
- blood culture
- synovial fluid

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18
Q

What are the specimen collected for gonorrhea testing placed before being sent to the laboratory?

A
  • swab : placed in a transport medium like Stewart’s Medium
  • blood: blood culture bottles
  • joint fluid : in a universal container
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19
Q

List 4 lab investigations done to diagnose Gonorrhea

A
  • Gram staining
  • Culture with appropriate media
  • Isolation Test
  • Susceptibilty
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20
Q

What is the gram stain for N. gonorrhea

A

gram negative bean shaped diplococci, usually seen with pus cells

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21
Q

What media are inoculated to grow N. Gonorrhea ?

A

Chocolate Agar
Thayer - Martin Agar

22
Q

What is Thayer- Martin Agar treated with to kill bacteria that form part of the normal GU flora, but still grow Neisseria. Gonorrhea?

A

CVBN
colistin
Vancomycin
Bactrim
Nystatin

23
Q

What is done with the plates after they have been inoculated with Gonorrhea?

A

The inoculated plates are :
- incubated at 37oC
- in 5-10% CO2 (N.Gon is capnophillic)
- for 48hrs

24
Q

Describe the N. Gonorrhea colonies

A

small grey colonies

25
Q

True of false N. Gonorrhea are oxidase positive colonies

A

True - they turn black when the oxidase reagent is added to the culture medium

26
Q

Which biochemical tests are used to differentiate between N. Meningitidis and N. Gonorrhea?

A

Glucose, Maltose, Sucrose test

N. G- glucose positive, maltose negative, sucrose negative
N. M- glucose positive, maltose positive, sucrose negative

27
Q

How do we test if the N.Gonorrhea produces beta lactamases (which makes them resistant to penicillin)?

A

Cefinase Test

28
Q

What aetiological agent causes Syphillis

A

Treponema Pallidum

29
Q

Syphillis occurs in three stages: List the clinical features of the primary stage

A
  • chancre at sites of infection (painless ulcers)
    occurs 3-6 weeks after initial infection, and heals within 3-6 weeks without a scar
30
Q

Syphillis occurs in three stages: List the clinical features of the secondary stage

A

1) Rash on the trunks (soles and palms) that can spread throughout the body-maculopapular rash
2) Alopecia

  • onset 6weeks to 6months after initial infection if left untreated
  • also : fever, malaise, hepatosplenomegaly, generalized lymphadenopathy, sore throat, arthralgia, anorexia etc
31
Q

List the three dermatological manifestations of Secondary Syphilis

A
  • maculopapular rash
  • condylomata on genitals
  • mucous patches on mouth ,tongue (round grey lesion)
32
Q

What are the three general categories of tertiary syphilis and describe the features in each

A

Gummatous syphilis: painless noninfectious lesions found in skin and bones that can lead to scarring

Cardiovascular Syphilis

Neurosyphilis: Tabes Dorsalis (dorsal column affect), ataxia, general paresis of insane (GPI)- delusions of grandeur, depression, demetia

33
Q

Describe what the term asymptomatic neurosyphilis means

A

There is a presence of treponems in the CSF with no clinical manifestations of infection

34
Q

Treponema Pallidum crosses the placenta blood barrier, to the fetus and may cause what complications

A
  • stillbirth
  • spontaneous abortion
  • neonatal death
35
Q

List 4 clinical manifestations of Late Congenital Syphillis

A
  • Hutchinsons’s triad : hutchinson’s teeth, 8th nerve deafness, interstitial keratitis
  • Sabre Shins :anterior tibia bowing
  • Perforation of the palate
  • Clutton’s Joint
36
Q

List the specimen collected for diagnosis of each stage of syphilis

A

Primary: chancres scrapings, fluid
Secondary : blood
Tertiary: CSF

37
Q

What is the name of the test used to diagnose Syphilis

A

Treponemal Test
- Fluorescent Treponemal Antibody Absorption Test FTA-Abs

38
Q

List two examples of non-treponemal tests used for Syphilis Screening

A

VDRL
Rapid Plasma Reagin (RPR)

39
Q

Diagnosis of Syphilis can be done using Direct examination methods or Serology tests.

What can be observed in dark field microscopy ?

A

Tiny helical-shaped organisms moving in a cork-screw like fashion

40
Q

How long after the appearance of the first primary lesion (chancre), will the VDRL test positive ?

A

1-2 weeks

note VDRL is useful in diagnosing congenital syphilis, and for monitoring treatment

41
Q

Describe how the VDRL test for syphilis works

A

The VDRL test measures the antibodies formed against the different substances released from cells infected with the t.pallidum organism. So the antibodies bind to the substances released from the cell» flocculation. The test can be Reactive, Weakly Reactive or Non Reactive
We use the lowest titre that is reactive

42
Q

In order for the blood specimen to be tested with the VDRL test, what has to be done?

A
  • collected and allowed to clot
  • serum separated from sample
  • placed in incubation at 56oC for 30mins
  • cooled to rt for testing
43
Q

What is the treatment for Syphilis ?

A

Penicillin G- parenteral

44
Q

What should be used to treat a penicillin allergic patient who has syphilis ?

A

Tetracyclin-HCl

45
Q

What is the treatment for syphilis >1yr duration

A

Benzathine-penicillin G

46
Q

What is the treatment for neurosyphilis ?

A

Aqueous Crystalline Penicillin G + Benzathine Penicillin G = IM weekly for 3 consecutive weeks

OR//

Aqueous procaine penicillin G = for 10days + 3 weeks of benzathine penicillin

47
Q

What is BActerial VAginosis?

A

It is a poly microbial syndrome characterized by replacement of normal H2O2 producing lactobacilli with Anaerobic bacteria,
Gardnerella vaginalis

48
Q

What is seen under the microscope with a vaginal discharge sample positive for Bacterial Vaginosis?

A
  • Gram Stain : epithelial cells covered with gram positive bacilli - CLUE CELLS
49
Q

What are the criteria used to diagnose bacterial vaginosis

A
  • Clue Cells
  • Positive Wiff test ( fishy odour after KOH added to discharge sample)
  • pH high
50
Q

What is the most sensitive test for trichomoniasis vaginalis

A

Diamond Media for Culture

51
Q
A

Pathology (7 decks)

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