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Microbiology Final > STIs > Flashcards

STIs Flashcards

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1
Q

Syphilis species

A

Treponema pallidum

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2
Q

Gonorrhea species

A

Neisseria gonorrhoeae

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3
Q

Nongonococcal urethritis species

A

Chlamydia trachomatis
Ureaplasma urealyticum
Mycoplasma genitalium

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4
Q

Chancroid species

A

Haemophilus ducreyi

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5
Q

Granuloma inguinale species

A

Calymmatobacterium granulomatis

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6
Q

Ulcerative STDs

A

Syphilis
Chancroid
Genital herpes

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7
Q

Non-ulcerative STDs

A

Gonorrohea
Trichomoniasis
Chlamydia

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8
Q

“The great impostor”

A

Syphilis

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9
Q

T. pallidum morphology

A

Gram negative
Spirochete w/ slow rotational motility
Obligate internal parasite

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10
Q

T. pallidum virulence

A

Outer membrane proteins
Hyaluronidase
Fibronectin coat (antiphagocytic)

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11
Q

Cause of lesions in syphilis

A

Inflammatory response

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12
Q

Transmission of syphilis

A
  • Direct sexual contact w/ person who has active primary or secondary lesion***
  • Needle sharing
  • Transplacental
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13
Q

Stages of syphilis

A

Primary
Secondary
*Latent
Tertiary

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14
Q

Primary syphilis

A
  • Local multiplication and infiltration of nearby LN
  • Primary lesion: CHANCRE

Untreated lesion heals in 3-8 weeks

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15
Q

Chancre formation

A

Principal lesion of PRIMARY syphilis:

  • Starts as papule
  • Superficial erosion
  • Scanty serous exudate may occur, w/ formation of a thin, grayish, hemorrhagic crust
  • Base is usually smooth, and the border is raised, firm, and indurated
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16
Q

Secondary syphilis

A

Dormancy for 2-10 weeks:

  • MACULOPAPULAR RASH: superficial lesions of HIGH infectivity
  • CONDYLOMATA LATA: mucosal warty lesion
  • Immune complexes form in anteriolar walls
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17
Q

Latent syphilis

A
  • Absence of clinical signs and symptoms
  • Early latency (w/in 1 year of infection): relapse possible
  • Late latency (>1 yr after infection): immunity to relapse
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18
Q

Tertiary syphilis

A

Manifests 5-20 yr after infection:

  • Neurosyphilis (neuro changes and cortical degeneration)
  • Cardiovascular syphilis (aneurysm of ascending aorta)
  • Granulomata (gummas) in any tissue (esp. skin, bone, joints) = late/benign syphilis
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19
Q

Congenital Syphilis

A
  • Maculopapular cutaneous lesions
  • Nasal obstruction w/ mucoid discharge (infectious)
  • Osteitis of nasal bones
  • Neurosyphilis
  • HUTCHINSON’S TRIAD

*Earlier onset of symptoms after birth = worse prognosis

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20
Q

Hutchinson’s Triad

A

Notched incisors
Interstitial keratitis
8th nerve deafness

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21
Q

Syphilis diagnosis

A
  • Darkfield microscopy or direct immunofluorescence
  • Nontreponemal tests (screening)
  • Treponemal tests (confirmation)
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22
Q

Nontreponemal tests

A

VDRL, RPR

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23
Q

Treponemal tests

A

FTA-ABS, MHA-TP

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24
Q

N. gonorrhoeae morphology

A

Gram negative
Diplococcus
Kidney bean shaped
Fastidious growth requirements

25
Q

N. gonorrhoeae virulence

A
  • Antigenic variation of pili
  • Nonpiliated phase variants
  • Porin protein and other proteins for attachment
  • IgA protease
  • Plasmid and chromosome mediated resistance to abx
26
Q

Highest rate of gonorrhea infection

A

Adolescents

27
Q

Reservoir for gonorrhea

A

Asymptomatic patient

28
Q

Clinical presentation of gonorrhea

A

Wide spectrum:

  • Varying locations
  • Females: Presence in endocervix w/ urethral colonization
  • Males: Presents in anterior urethra w/ mucopurulent discharge
29
Q

Complications of Gonorrhea

A
  • Local effects
  • PID (most common)
  • Disseminated gonococcal infection (DGI)
30
Q

Disseminated gonococcal infection (DGI)

A

Bacteremia leads to widespread infection:

  • Fever rash (arthritis-dermatitis syndrome)
  • Endocarditis
  • Meningitis
  • Purulent arthritis*** (most common)
31
Q

Gonorrhea diagnosis

A

Gram stain is problematic (hiding intracellularly)

Culture:

  • Agglutination, DNA probe, biochemical tests for confirmation
  • PCR is GOLD STANDARD
32
Q

Etiology of nongonococcal urethritis

A

C. trachomatis
Ureaplasma urealyticum
Mycoplasma genitalium

33
Q

C. trachomatis morphology

A

Gram negative
Metabolically deficient*** (require host DNA)
Obligate intracellular bacteria

34
Q

Elementary body

A

Infectious form of C. trachomatis

35
Q

Reticulate body

A

Intracellular form of C. trachomatis

36
Q

C. trachomatis complications

A

PID
Sterility
Ectopic pregnancies
Inclusion conjunctivitis and pneumonia (newborns)

37
Q

Causes of PID

A

N. gonorrhoeae

C. trachomatis

38
Q

Chlamydia clinical presentation

A

ASYMPTOMATIC urethritis and watery discharge (males)

Cervicitis, saplingitis, PID (females)

*Some serotypes cause lymphogranuloma venereum

39
Q

Cause of chronic inflammation with chlamydia

A

Toxin producing strains

40
Q

Chlamydia diagnosis

A

GOLD STANDARD - Isolation in cell culture:

  • Human immortalized cell lines
  • INCLUSION BODIES

Noncultural tests:

  • Antigen detection (less sensitive)
  • PCR (95% sensitivity!)
41
Q

Ureaplasma urealyticum reservoir

A

Genital tract of sexually active persons (>80% of people with 3 or more sex partners)

42
Q

Ureaplasma urealyticum key notes

A
  • Responsible for 50% of nongonococcal, nonchlamydial urethritis in men
  • Cause of chorioamnionitis and postpartum fever in women
43
Q

Trichomonas vaginalis morphology

A

LARGE flagellated protozoan
Exists only as a trophozoite
Extracellular anaerobe

44
Q

Trichomonas transmission

A

ONLY sexual contact

45
Q

Trichomonas presentation

A

Male: Asymptomatic to scanty, clear mucopurulent discharge

Female: Profuse vaginal discharge (frothy and malodorous)

46
Q

Diagnosis of trichomonas

A
  • Wet mount for examination
  • Culture (more sensitive)
  • Monoclonal antibodies
  • DNA probe test (Affirm VP III)
47
Q

Cause of bacterial vaginosis

A

Overgrowth of opportunistic pathogen in vagina due to change in pH
NOT AN STI***

48
Q

Vaginal secretions of bacterial vaginosis (labs)

A

Elevated pH: 5.0-6.0

CLUE CELLS present

49
Q

Criteria for bacterial vaginosis diagnosis

A

Pick any three:

  • Homogenous quality of secretions
  • CLUE CELLS
  • Fishy amine odor when 10% KOH added
  • pH >4.5
  • Presence of curved gram negative or gram variable rods
50
Q

Cause of yeast infections

A

Candida albicans (80-90%)
C. tropicalis
C. glabrata

Can be an STD***

51
Q

Yeast infection clinical presentation

A
  • Thick, white, frothy discharge WITHOUT ODOR
  • Itching, irritation
  • Burning sensation during intercourse or urination
  • Vaginal pain and soreness
52
Q

Candida diagnosis

A
  • Microscopy
  • Gram stained shows large “G+” cells
  • Chromagar
  • Germ tube culture
53
Q

Haemophilus ducreyi morphology

A

Gram negative
Coccobacillus
Non-motile

54
Q

Chancroid lesion

A

“Soft chancre”:

  • Develops quickly (3-5 days)
  • Papule quickly progresses to pustulation and ulceration
  • Progressive enlargement w/ autoinoculation
  • Ulcer is painful and tender, bleeds readily and lacks induration!***
55
Q

Diagnosis of chancroid

A
  • Identification of H. ducreyi from genital ulcer or swollen LN
  • Media needs growth supplements (chocolate agar)
  • PCR available (false positive with other haemophilus spp)
56
Q

Risk factors for PID

A
  • STD (esp. gonorrhea or chlamydia) present
  • Prior PID
  • Sexually active adolescent
  • Multiple sex partners
  • Frequent douching
57
Q

Clinical manifestations of PID

A 
Lower abdominal pain
Abnormal vaginal discharge
Painful intercourse
Dysmenorrhea
Irregular menstruation
Fever/chills
Scarring
58
Q

Diagnosis of PID

A

Clinical signs with evidence of inflammation - fever, leukocytosis, and/or elevated ESR

Microbiology Final (8 decks)

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