STI Flashcards
1
Q
The below are what type of STD?
Syphillis
Herpes
Chancroid
A
Ulcerative
2
Q
The below are what type of STD?
Gonorrhea
Trichomoniasis
Chlamydia
A
non-ulcerative
3
Q
This is a genus of:
- person-person transmission
- normal mucosal flora
- has species w/ non-STIs like Yaws, Pinta, Bejel
A
Treponema
4
Q
Syphilis is caused by…
A
Treponema pallidum
5
Q
This is a:
G- intracellular spirochete w/ slow rotational motility
A
Syphilis
6
Q
What type of culture will treponema pallidum grow?]
What is used as an animal model?
A
primary cell cx
rabbit = animal model
7
Q
Lesions in syphilis/treponema pallidum are due to…
A
inflammatory response
8
Q
Which virulence factor on treponema is anti-phagocytic?
A
fibronectin coat
9
Q
What treponema virulence factor may facilitate perivascular infiltration?
A
hyaluronidase
10
Q
How is syphilis acquired?
A
direct sexual contact with active primary/secondary lesion
11
Q
What stage of syphilis?
- indurated swelling leads to chancre
- untreated heal in 3-8 weeks with fibrosis
A
primary syphilis
12
Q
how does treponema pallidum enter in primary syphilis?
A
subepithelial entry via skin breaks or paracellular
13
Q
Where does treponema pallidum disseminate to after local multiplication?
A
lymph nodes, blood
14
Q
you see a lesion with scanty serous, grayish/hemorrhagic crust… what is this indicative of?
A
syphilis chancre
15
Q
After primary syphilis, how long is dormancy?
A
2-10 weeks
16
Q
What stage of syphilis is described by…
maculopapular rash
condylomata lata (1/3 or patients)
A
secondary syphilis
17
Q
Late syphilis latency occurs if there is absence of S/S for how long?
A
> 1 year
18
Q
Seropositivity without syphilis occurs in what fraction of patients?
A
1/3
19
Q
Spontaneous syphilis cure occurs in what fraction of patients?
A
1/3
20
Q
Tertiary syphilis develops in what fraction of patients?
A
1/3
21
Q
What type of syphilis?
focal neuro changes, cortical degeneration (neurosyphilis)
CV changes/ascending aortic aneurysm (CV syphilis)
Granulomata in skin, bones, joints (late/benign syphilis)
A
Tertiary
22
Q
the following are signs and sxs of…
maculopapular cutaneous lesions
nasal obstruction w/ mucoid discharge
osteitis of nasal bones
A
congenital syphilis
23
Q
What is hutchinson’s triad of congenital syphilis?
A
notched incisors, interstitial keratitis, CNVIII deafness
24
Q
Every genital lesion should be considered ______ until proven otherwise
A
syphilitic
25
What type of microscopy is used to visualize syphillis?
darkfield
26
What tests are used to dx syphillis?
non-treponemal tests: screening
treponemal tests: confirmatory
27
What pathogen causes gonorrhea?
neisseria gonorrhoeae
28
What pathogen?
G- kidney-shaped diplococcus
neisseria gonorrhoeae
29
Plasmid/chromosome components make neisseria gonorrhoeae resistant to...
PCN, tetracyclines, spectinomycin, FLQ
30
Describe the growth requirements for gonorrhea?
fastidious
31
the following are virulence factors of...
```
•
Antigenic variation of pili
•
Nonpiliated phase variants
•
Porin protein and other proteins aid in
attachment
•
IgA protease
•
Plasmid and chromosome
```
Neisseria gonorrhoeae
32
What are four reasons for increased gonorrhea infx?
changed sexual practice
ineffective asx ID
resistant strains
public knowledge
33
What is the major reservoir for gonorrhea?
asx patients
34
Is nonsexual transmission of gonorrhea common?
extremely rare
35
How does n. gonorrhoeae attach to epithelium?
pili and surface proteins
36
What is altered by n. gonorrhoeae in response to the host environment?
antigenic variation of pili/surface proteins
37
What causes injury to host cells in gonorrhea infx?
Lipooligosaccharide and peptidoglycan
38
Where does gonorrhea manifest in males and with what characteristic sign?
anterior
urethra with thick
mucopurulent discharge
39
describe the colonization of gonorrhea in women...
endocervix
accompanied by urethral
colonization
40
N. gonorrhoeae can enter the body via...
(mucosal surfaces)
Eyes, mouth, urethra,
vagina, rectum
41
What are two complications from gonorrhea?
local effects
acute salpingitis/PID
42
What complication of gonorrhea?
pain, abnormal menses
ectopic pregnancy, infertility due to tube scarring
acute salpingitis/PID
43
Fever rash/arthritis dermatitis syndrome, endocarditis, meningitis describe which complication of conorrhea?
disseminated gonococcal infx
44
MC sign in disseminated gonococcal infx?
purulent arthritis
45
Gold standard for dx of gonorrhea...
PCR/nucleic acid amplification
46
What percent of gonococcal infx yield G- results?
60%
47
trachoma, conjunctivitis, lymphogranuloma venereum and non-gonococcal urethritis are caused by...
chlamydia trachomatis
48
The below are morphologic features of:
Obligate intracellular G- bacteria
requires host-derived ATP
Chlamydia trachomatis
49
What is the infx form of c. trachomatis, and what is the intracellular form?
infx: elementary body
intracellular: reticulate body
50
c. trachomatis commonly affects which patient population?
teenagers
51
The following s/s are characteristic of....
```
urethritis (often asymptomatic) and
epididymitis in males
•
Watery discharge
•
cervicitis, salpingitis , and PID in
women
•
lymphogranuloma venereum
```
chlamydia trachomatis
52
Some strains of c. trachomatis have a gene that encodes for what type of toxin?
similar to toxin B of c. diff
53
what causes mucosal separation in chlamydial infx?
protein scaffold collapse
54
What is gold standard for dx of c. trachomatis?
cell cx
55
what non-cx test is available for dx of c. trachomatis?
nucleic acid amplification test
56
Which pathogen has the following characteristics?
Main reservoir is genital tract of sexually active persons
Colonization is present in >80% of persons who have
had 3 or more sex partners
ureaplasma urealyticum
57
This pathogen:
Responsible for ~50% of
nongonococcal ,
nonchlamydial urethritis in men
Cause of
chorioamnionitis and postpartum fever in
women
ureaplasma urealyticum
58
What two mycoplasmas cause NGU?
mycoplasma genitalium
ureaplasma urealyticum
59
Which mycoplasma causes pyelonephritis and PID?
mycoplasma hominis
60
Three categories of vaginitis?
trichomoniasis
bacterial vaginosis
yeast
61
which trichomonas is commensal in mouth?
t. tenax
62
Which trichomonas is commensal in intestine?
t. hominis
63
Which trichomonas is cause of STD?
t. vaginalis
64
This pathogen has the following features:
- extracellular anaerobe
- flagellated protozoan
- exists as trophozoite
t. vaginalis
65
Which pathogen has the following epidemiological characteristics?
Etiologic agent has a cosmopolitan
distribution
Is transmitted by sexual intercourse
Is a very common STD
t. vaginalis
66
t. vaginalis parasite establishes after sexual intercourse where?
mucosa
67
Male or female trichomonas?
Is usually asymptomatic
•
Scanty, clear to mucopurulent
discharge
male
68
Male or female trichomonas?
```
Is usually symptomatic
•
Profuse vaginal discharge: frothy and
malodorous
•
```
female
69
_______ Creates an environment for bacterial vaginosis
trichomoniasis
70
What DNA probe is available for dx of trichomoniasis?
affirm VP III
71
What is the most sensitive diagnostic for trichomoniasis?
Cx
72
What is the most common diagnostic for trichomoniasis?
wet mount
73
What condition has the following characteristics?
NOT AN STI
•
Caused by an overgrowth of opportunistic pathogen in vagina due
to change in pH
bacterial vaginosis
74
The below hx is suggestive of...
```
History of previous STDs
•
History of sexual activity
•
Current use of intrauterine devices
•
History of previous pregnancy or abortion
•
```
bacterial vaginosis
75
the below labs are suggestive of...
pH: 5.0-6.0
+ Clue Cells
< 1 lactobacilli
Vaginosis
76
Vaginosis presents similarly to...
trichomoniasis
77
The below are common causes of...
```
Absence of competing normal flora
•
Introduction to abnormal site
•
Pathologic change in microenvironment
•
Inborn or acquired immune defect
•
Use of broad spectrum antibiotics
```
candidiasis
78
80-90% of vulvocandidiasis are caused by...
c. albicans
79
Can vulvocandidiasis be an STI
yes
80
The below presentation is suggestive of:
Thick, white,
frothy
discharge in women
Itching, irritation
Burning sensation during
intercourse or urination
Vaginal pain and soreness
vulvocandidiasis
81
The discharge of candidiasis is different from vaginosis in what way?
no
| odor
82
Which haemophilus species can cause chancroid?
H. ducreyi
83
Non-motile, G- coccobacillus that causes chancroid?
H. Ducreyi
84
The below are indicative of...
Typical lesion is a tender papule on the genitalia that
develops into a tender ulcer w/ sharp margins
•
Presence of a soft chancre
•
Regional adenopathy and bubo development
chancroid
85
chancroid is more common in what regoins?
tropical
86
What population of chancroid patients may be asymptomatic or have nondescript
lesion
Females
87
Chancroid or chancre sore?
soft ragged edge
pus
chancroid
88
the below presentation is indicative of...
```
Vesicle or papule (usually
solitary) that quickly progresses
to pustulation and ulceration
•
Progressive enlargement w/
autoinoculation and development
of multiple ulcers
•
Ulcer is painful and tender,
bleeds readily, and lacks
induration
```
chancroid
89
Direct examination for H. ducreyi can be
| misleading due to presence of
polymicrobial flora in ulcer
90
Diagnosis requires identification of Haemophilus ducreyi from the...
genital ulcer or swollen lymph node
91
Is PCR available for chancroid?
yes
92
to grow h. ducreyi what must be present on media?
growth supplements
93
The below can cause...
```
Escherichia coli
Enterobacter
Enterococcus faecalis
Bacteroides
Peptostreptococcus
```
PID
94
What condition?
results when microorganisms ascend to the endometrium,
fallopian tubes, and contiguous pelvic structures producing
PID
95
The three below factors commonly cause...
```
•
the subject is a sexually active adolescent
•
there are multiple sexual partners
•
there is frequent douching
```
PID
96
The below presentation is suggestive of...
```
•
Lower abdominal pain
•
Abnormal vaginal discharge
•
Painful intercourse
•
Increased pain during menstruation
•
Irregular menstruation
•
Fever and chills
•
Scarring
```
PID
97
What clinical signs/labs can help ID PID?
fever, leukocytosis, or
| elevated ESR
