STIs Flashcards

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1
Q

What are the three ulcerative STDs?

A

Syphilis
Chancroid
Genital herpes

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2
Q

What are the three non-ulcerative STDs?

A
  • Gonorrhea
  • Trichomoniasis
  • Chlamydia
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3
Q

Once syphilis is latent late, what are the three options for the disease?

A
  • spontaneous cure in ∼1/3 of cases
  • seropositivity w/o disease in ~1/3 of cases
  • tertiary syphilis in ~1/3 of cases
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4
Q

What is used for the presumptive dx of syphilis? Confirmatory?

A

P: Cardioleptin floccuation (VDRL, RPR)
C: specific antibody test (FTA-ABS, MHS-TP)

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5
Q

G- diplococcus with kidney bean shaped cells; fastidious growth requirements

A

Neisseria Gonorrhoeae

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6
Q

G- spirochete with slow rotational motility; obligate parasite

A

Treponema Pallidum

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7
Q

Two primary VF of Neisseria Gonorrhoeae

A

IgA Protease for colonization
Plasmid for resistance
also antigenic variation of pili and porin proteins

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8
Q

Why has there been a rise in gonorrhea cases?

A

Changed sexual mores and practices
Ineffective methods for detection of asymptomatic cases
Presence of beta-lactamase positive strains
Lack of public appreciation of its importance

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9
Q

Complications of gonorrhea

A

Acute salpingitis or pelvic inflammatory disease (PID)- most common
Disseminated Gonococcal Infection (DGI)

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10
Q

What does DGI of gonorrhea consist of?

A

Bacteremia leads to fever rash and mucopurulent arthritis (most common)
can also lead to endocarditis and meningitis

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11
Q

What tests are used to look for N. gonorrhea?

A

Agglutination, DNA probe, biochemical tests are used for confirmation
Nucleic acid amplification (PCR) is now the gold
standard

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12
Q

What are some complications of chlamydia?

A

sterility and ectopic pregnancy
>50% of infants born to infected mothers show conjunctivitis
5-10% present with pneumonia

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13
Q

What is the best way to diagnose chlamydia? What is the gold standard?

A

Nucleic acid probes (95%)–Normal flora can cause a positive test
Gold standard is isolation for a week in culture (HeLa cells)

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14
Q

What mycoplasmas are involved in NGU?

A

Mycoplasma genitalium

Ureaplasma urealyticum

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15
Q

What is the main reservoir for ureaplasma urealyticum?

A

genital tract of sexually active persons
(Colonization is present in >80% of persons who have had 3 or more sex partners)
~50% of nongonococcal, nonchlamydial urethritis in men

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16
Q

What are the three main causes of vaginitis?

A

Trichomoniasis
Bacterial vaginosis
Yeast vaginitis

17
Q

Extracellular, anaerobic, flagellated protozoan

A

trichomonas vaginalis

18
Q

What are the forms of trichomonas vaginalis?

A

trophozoite only

19
Q

T. vaginalis In the female

A
  • Is usually symptomatic

* Profuse vaginal discharge: frothy and malodorous

20
Q

What is the most common way to diagnose T. vaginalis? The best?

A

Wet mount; culture (more sensitive)

21
Q

What usually occurs as normal flora but then becomes problematic due to an overgrowth of opportunistic pathogen in vagina due
to change in pH? What else puts them at risk?

A

Bacterial vaginosis-NON-STI
• History of previous STDs
• History of sexual activity
• Current use of intrauterine devices

22
Q

What is found in the vaginal secretions of pt with bacterial vaginosis as opposed to normal secretions?

A

Clue cells and pH of 5.0-6.0

23
Q

Any three of which 5 characteristics will classify bacterial vaginosis? (top 3 esp)

A
• Homogeneous quality of
secretions
• Presence of CLUE CELL
• Release of fishy amine odor
when 10% KOH is added
• A vaginal pH of >4.5
• Presence of curved gram
negative or gram variable
rods
24
Q

Which two causes of vaginitis are difficult to distinguish?

A

trichomonas and vaginosis

25
Q

What is the most commonly encountered opportunistic mycoses (fungal
infections) worldwide?

A

Candidiasis

26
Q

What are some (3) underlying causes of candidiasis?

A

1) Absence of competing normal flora (broad spectrum abx)
2) Introduction to abnormal site
3) “Pathologic” change in microenvironment

27
Q

Thick, white, frothy discharge in women (no

odor). Which has an odor?

A

Candidiasis; t. vaginalis

28
Q

Which form of c. albicans is most adhesive?

A

Germ tube is more adhesive than yeast cell

29
Q

What can be used to diagnose c. albicans?

A

Chromagar to determine species

Hyphae and pseudohyphae under microscopy, also look for the appearance of germ tubes

30
Q

soft border, painful chancre that bleeds readily

A

hemophilus ducreyi

31
Q

chancroid vs chancre sore

A

soft ragged edge with pus vs

hard raised edge

32
Q

What is PID? What are typical agents?

A

Anything not PGN or surgery related that causes endometritis, salpingitis, pelvic peritonitis, or tuboovarian abscess
• Neisseria gonorrhoeae or Chlamydia trachomatis