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STIs 2 Flashcards

1
Q

How is syphilis usually transmitted?

A

Direct sexual contact of the mucous membranes

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2
Q

What are the major symptoms of Syphilis? Which happens first, and which later?

A

Lesion at the point of entry initially

Generalized maculopapular rash later

Latency period

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3
Q

What are the two outcomes of the latency period of Syphilis?

A

Reappearance decades later

Immune clearance

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4
Q

What is the gram stain and morphology of treponema pallidum? Are they motile?

A

Thin, Gran negative spirochete

Motile

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5
Q

Is Treponema pallidum aerobic or anaerobic?

A

Microaerophilic –sensitive to oxygen toxicity

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6
Q

True or false: Treponema Pallidum is sensitive to heat, drying and disinfectants?

A

True

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7
Q

Does Treponema pallidum grow in culture? Does it stain? What is the consequence of this?

A

No–thus we know less about it than other bacteria

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8
Q

What is the causative agent of Syphilis?

A

Treponema Pallidum

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9
Q

What allows the spirochete structure of Treponema pallidum to be flexible?

A

Axial fibrils/edoflagella

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10
Q

Can you gram stain Treponema pallidum?

A

No–too thin

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11
Q

What is the best technique to visualize Treponema pallidum ?

A

Dark-field microscopy or fluorescent

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12
Q

How is Treponema pallidum transmitted?

A

Sexual contact or congential

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13
Q

What is the symptom of primary syphilis?

A

One PAINLESS, indurated skin lesions at the site of infection

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14
Q

What causes the lesion caused by Syphilis? How long does this last?

A

immune response

last for weeks to two months

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15
Q

What is the clinical sign of disseminated syphilis (2)? Are they infectious at this time?

A

Diffuse rash (including PALMS and SOLES) with flu-like syndrome

VERY infectious

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16
Q

What are the raised lesions that syphilis causes called? Where are these found on the body?

A

Condylomata lata–found in skin folds

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17
Q

How long does latent, asymptomatic syphilis last?

A

few years to decades

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18
Q

Is transmission possible during a latent infection with syphilis?

A

Yes, from relapse in secondary lesions or blood transfusions

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19
Q

What are the symptoms of tertiary syphilis?

A

Diffuse, chronic inflammation

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20
Q

What fraction of pts will go on to develop tertiary syphilis?

A

1/3

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21
Q

What are the lesions found on tertiary syphilis infections? Where are these found? What causes these?

A

Gummas–skin bone, other tissues. Caused by hyperimmune reaction

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22
Q

What are the two most devestating consequences of syphilis?

A

Neurosyphilis

Cardiosyphilis

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23
Q

What is the treatment of syphilis?

A

high-dose IV PCN

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24
Q

What are the symptoms of neurosyphilis?

A

Progressive decline in mentation, behavioral changes (dementia)

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25
Q

What are the symptoms of congenital syphilis? (4) How is this transmitted?

A

Mother to fetus transmission

  1. Saddle nose (chronic rhinitis).
  2. Maculopapular rash
  3. Teeth and bone malformations
  4. Blindness
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26
Q

What is Hutchinsons triad?

A

Teeth, blindness, deafness

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27
Q

What are the microbes that may pass from mother to fetus?

A 
Toxoplasma
Rubella
CMV
HIV
Herpes
Syphilis

(ToRCHeS)

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28
Q

How do you diagnose Syphilis?

A

Darkfield microscopy or direct fluorescence

Serology

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29
Q

Can you culture Treponema pallidum?

30
Q

What is the nontreponemal test for syphilis?

A

Measures cardiolipin antibodies (RPR, VDRL)

31
Q

What is the treponemal test for syphilis?

A

Detects antibodies specific to Treponema pallidum

32
Q

What happens to the sensitivity of treponemal and nontreponemal test as you move from primary to secondary etc?

A

higher % of pts with a positive test

33
Q

What is the treatment for syphilis?

34
Q

What is the preventative measure for syphilis?

35
Q

What are the symptoms of non-gonococcal urethritis (NGU)?

A

Hematuria/dysuria/frequency
Abdo pain
Discharge
Dyspareunia

36
Q

All pts with urethritis should be tested for what?

A

Gonorrhea and chlamydia

37
Q

What are the causes of non-gonococcal urethritis? (3)

A

Usually Chlamydia

Mycoplasm genitaloium
Ureaplasma uralyticum

38
Q

Do mycoplasma or ureaplasma have a cell wall? What is the significance of this (2)?

A

No–Resistant to PCNs cephalosporins etc and cannot stain

39
Q

What do mycoplasma and ureaplasma have in their cell walls?

40
Q

Are mycoplasma and ureaplasma intracellular or extracellular pathogens?

A

Extracellular

41
Q

What is the culture morphology of mycoplasma/ureaplasma?

A

Fried egg appearance

42
Q

True or false: M. Genitalium and M. Hominius are normal flora of the UG tract

43
Q

What does M. genitalium cause in men and women?

A

Men-NGU

Women- PID

44
Q

What is M. genitalium resistant to? What is the significance of this?

A

Resistant to doxycyline–thus if you treat them, it’s not chlamydia

45
Q

What are the symptoms or ureaplasma?

A

NGU in men

46
Q

What is the treatment for ureaplasma?

47
Q

What is chancroid?

A

STD caused by hemophilus ducreyi

48
Q

How common is chancroid?

A

very uncommon at the moment

49
Q

What is the gram stain and morph of haemophilus ducreyi?

A

gram negative pleomoprhic coccobaccilus

50
Q

Is Hemophilus ducreyi catalase positive?

51
Q

What are the X and V factors that are needed to grow Haemophilus? What is the agar that is needed?

A

X= Hemin
V- NAD

Chocolate agar

52
Q

What are the symptoms of Haemophilis ducreyi?

A

PAINFUL and soft lesion at the site of infection

Inguinal lymphadenopathy

53
Q

What is the treatment for haemophius cudreyi?

A

Macrolides

54
Q

How do you diagnose haemophilus ducreyi?

A

Chocolate agar with vanco

55
Q

How many lesions are seen with haemohiluius duceryi? How does this compare to chancroid?

A

Multiple for haemophilus (painful)

One for chancroid (painless)

56
Q

What is donovanosis or granulma inguinale cause by?

A

Klebsiella granulomatis

57
Q

What is the gram stain, morpho of Klebsiella?

A

Gram negative rod that is encapsulated

58
Q

What are the symptoms of donovanosis?

A

Painless wart-like lesions

59
Q

What are the sequlae of donovanosis ?

A

Significant genital damage

60
Q

What is the treatment for donovanosis?

A

Tetracycline/cipro

61
Q

How do you diagnose donovanosis ?

A

Apperance of Donovan bodies in pathological specimens

62
Q

What are the two main things in your differential when there is a genital/anal ulcers?

A

Herpes vs syphilis

63
Q

All pts with GUD should be evaluated for what three infections?

A

Syphilis
Herpes
H. ducreyi

64
Q

How long does it take for disseminated syphilis to appear after the appearance of the painless lesion?

65
Q

Which test will have a negative result after treatment: the treponemal test, or the non-treponemal test?

A

The non-treponemal test

66
Q

What are the only bacteria that have sterols in their cell membrane?

A

Ureaplasma

Mycoplasma

67
Q

What species of mycoplasma causes disease? Ureaplasma?

A

M. genialium

U. urealyticum

68
Q

What is the treatment for NGU?

A

Azithromycin

69
Q

A patient comes into your office with urethritis. You are unable to culture or successfully identify what the causative agent of his pain, but the clinical picture would suggest chlamydia or possibly gonorrhea. As such, you prescribe Doxycycline/a macrolide and send him on his way. A week later, after finishing his course of abx, he reports that he still is still symptomatic. What is the probable source of his infection, and what should the next step in treatment be?

A

Probably caused by NGU caused by mycoplasma (but not ureaplasma)

Next step should be treatment with azithromycin

70
Q

Is there urethritis with syphilis?

Microbio (50 decks)

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