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Micro I > STIs > Flashcards

STIs Flashcards

1
Q

What is required of all STDs?

A

Reportable by law

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2
Q

What are the 3 ulcerative STDs?

A

Syphilis, Chancroid, Genital herpes

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3
Q

What are the 3 non-ulcerative STDs?

A

Gonorrhea, Trichomoniasis, Chlamydia

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4
Q

What genus includes species that are normal flora on mucosal surfaces, cause various non-STD diseases such as yaws, pinta, and bejel, and is transmitted from person to person via direct contact?

A

Treponema

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5
Q

What is the causative agent of Syphilis?

A

Treponema pallidum

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6
Q

Which organism is G-, spirochete with a slow rotational motility, is an obligate internal parasite, and uses rabbits as an animal model?

A

Treponema pallidum

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7
Q

What are the virulence factors of Treponema pallidum? (3)

A
  1. Adherence- membrane proteins
  2. Hyaluronidase- perivascular infiltration
  3. Fibronectin coat- antiphagocytic
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8
Q

What are the lesions of Treponema pallidum a result of?

A

The inflammatory response

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9
Q

What STD is exclusively a human pathogen and is transmitted via sexual contact with a person who has an active primary or secondary lesion?

A

Syphilis

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10
Q

How can Syphilis be acquired via nongenital contact? (3)

A

Lesion near mouth, needle sharing, transplacental transmission

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11
Q

How does primary Syphilis enter the skin?

A

Break in skin or passage between epithelial cells

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12
Q

Once Syphilis enters the skin, what happens locally?

A

Local multiplication and dissemination via blood

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13
Q

What occurs clinically with primary Syphilis?

A

Primary lesion (indurated swelling) develops and surface necrosis results in chancre formation

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14
Q

How long will it take for an untreated primary Syphilis lesion take to heal?

A

Heals in 3-8 weeks, with fibrosis

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15
Q

What is the principle lesion of primary Syphilis called?

A

Chancre

may occur in areas other than genitalia, cervical may be painless, often more atypical than typical

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16
Q

How does a chancre begin?

A

Papule/ superficial erosion

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17
Q

What lesion develops a scanty serous exudate with a thin, grayish, slightly hemorrhagic crust, has a usually smooth base with a raised firm border and is indurated?

A

Primary Syphilis chancre

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18
Q

How long is the dormancy period of secondary Syphilis?

A

2-10 weeks

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19
Q

What 3 things develop in secondary Syphilis?

A
  1. Maculopapular rash (highly infectious)
  2. Condylomata lata (warty lesions)
  3. Immune complexes (in arteriolar walls)
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20
Q

Does latent Syphilis display signs and symptoms?

A

No

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21
Q

When is considered the early and late phases of latency of Syphilis?

A

Early latency within 1 year of infection, late latency greater than 1 year after infection

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22
Q

What are the 3 outcomes of latent Syphilis?

A

Spontaneously cure, seropositivity without disease, tertiary syphilis

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23
Q

How long after infection does tertiary (4) Syphilis manifest?

A

5-30 years after infection

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24
Q

What are the 3 primary characteristics of tertiary Syphilis?

A
  1. Neurosyphilis
  2. CV syphilis
  3. Granulomata (gummas)
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25
Q

What is defined as meningovascular changes with focal neurological changes and cortical degeneration?

A

Neurosyphilis

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26
Q

What is defined as CV changes with aneurysm of ascending aorta?

A

CV syphilis

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27
Q

Where are granulomata (gummas) found?

A

Any tissue but especially skin, bones, joints

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28
Q

What type of syphilis involves signs and symptoms developing at around 3 weeks of age, has maculopapular cutaneous lesions, nasal obstruction with infectious mucoid discharge, and osteitis of nasal bones?

A

Congenital syphilis

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29
Q

What is Hutchinson’s triad and what is it associated with?

A

Associated with congenital syphilis

Triad = notched incisors, interstitial keratitis, 8th nerve deafness

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30
Q

What should every genital lesion be considered unless proven otherwise?

A

Syphilitic

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31
Q

What technique is used to detect treponemes from primary or secondary syphilis lesions?

A

Darkfield microscopy

can also use direct immunofluorescence

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32
Q

In diagnosing syphilis, what tests include cardiolipin flocculation tests (VDRL, RPR) that are nonspecific and used as screening tests?

A

Nontreponemal tests

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33
Q

In diagnosing syphilis, what tests include specific antibody tests (FTA-ABS, MHA-TP) and are confirmatory for positive screening tests?

A

Treponemal tests

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34
Q

What is the causative agent of Gonorrhea?

A

Neisseria gonorrhoeae

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35
Q

What organism is gonococcus, G- diplococcus with kidney bean-shaped cells and has fastidious growth requirements?

A

N. gonorrhoeae

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36
Q

What are the virulence factors of N. gonorrhoeae? (5)

A
  1. Antigenic variation of pili
  2. Nonpiliated phase variants
  3. Porin proteins (attachment)
  4. IgA protease
  5. Plasmid and chromosome- mediated resistance
    (to PCN, tetracyclines, spectinomycin, fluoroquinolones)
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37
Q

What is the major reservoir for N. gonorrhoeae and how is it transmitted?

A

Reservoir = asx pt

Genital, oral-genital, rectal intercourse transmission

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38
Q

What disease has become more prevalent due to changed sexual practices, ineffective methods for detection/ asx cases, presence of beta-lactamase + strains, and lack of public appreciation of its importance?

A

Gonorrhea

39
Q

What is a critical step in the pathogenesis of N. gonorrhoeae?

A

Attachment to epithelia via pili and surface proteins

40
Q

How does N. gonorrhoeae adapt to the host environment?

A

Alter their surface properties

non-immunity due to antigenic variation of pili and retardation of phagocytic activity

41
Q

How do N. gonorrhoeae organisms cause injury to cells?

A

Released lipooligosaccharide and peptidoglycan

42
Q

What disease manifests itself in females as having a presence in the endocervix accompanied by urethral colonization?

A

N. gonorrhoeae

entry and exit via mucosal surface

43
Q

What disease manifests itself in males as having a presence in the anterior urethra with a thick mucopurulent discharge?

A

N. gonorrhoeae

entry and exit via mucosal surface

44
Q

What are the main complications of Gonorrhea? (3)

A
  1. Various local effects
  2. Acute salpingitis or pelvic inflammatory disease (PID)
  3. Disseminated gonococcal infection (DGI)
45
Q

What do the following clinical presentations represent?

  • Pain w/ abn menses, bleeding due to organisms spreading along fallopian tubes and into pelvic cavity
  • Long-term- chronic pelvic pain, infertility, ectopic pregnancy
A

Acute salpingitis or pelvic inflammatory disease (PID)

complication of N. gonorrhoeae

46
Q

What other organisms can cause complications similar to that of gonorrhea?

A

Chlamydia trachomatis and anaerobes

47
Q 
What does the following clinical presentation represent?
Purulent arthritis (arthritis-dermatitis syndrome), endocarditis, meningitis
A

Disseminated gonococcal infection (DGI)

complication of N. gonorrhoeae

48
Q

What is the gold standard for diagnosis of gonorrhea?

A

Culture (nucleic acid amplification PCR)

49
Q

What are the 3 etiologies of nongonococcal urethritis?

A

Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium

50
Q

What disease is caused by Chlamydophila psittaci?

A

Psittacosis

51
Q

What disease is caused by Chlamydophila pneumoniae?

A

Acute pneumonia

52
Q

What is the causative agent for trachoma, inclusion conjunctivitis, lymphogranuloma venereum, and NGU?

A

Chlamydia trachomatis

53
Q

What organism is an obligate intracellular bacteria, G-, metabolically deficient, and have both an infectious form and fragile intracellular form?

A

Chlamydia trachomatis

54
Q

What population has the highest prevalence of infection with Chlamydia trachomatis?

A

Teenagers

55
Q

What organism is described by the following things:

  • Ascension in females results in salpingitis and PID
  • Complications of scarring include sterility and ectopic pregnancy
  • Many infants born to infected mothers show evidence of infection +/- pneumonia
A

Chlamydia trachomatis

56
Q

What areas of the US are most affected by Chlamydia trachomatis?

A

Southeast US

57
Q

The clinical presentation of Chlamydia trachomatis resembles that of N. gonorrhoeae with the addition of what?

A

Watery discharge

58
Q

Chronic inflammation from C. trachomatis is due to what?

A

Toxin-producing strains

functions like Toxin B of Clostridium difficile

59
Q

What causes mucosal cell separation with C. trachomatis infection?

A

Protein scaffolding of infected cells collapse

60
Q

What is the gold standard for diagnosis of chlamydial infections?

A

Isolation in cell culture

61
Q

Isolation in cell culture is the gold standard for diagnosis of chlamydial infections. What is preferred in the non-culture based group?

A

Nucleic acid amplification (NAAT)

62
Q

What are the 2 mycoplasma causative agents of NGU?

A

Mycoplasma genitalium and Ureaplasma urealyticum

(responsible for ~50% of nongonococcal, nonchlamydial urethritis in men and chorioamnionitis and postpartum fever in women)

63
Q

What is the main reservoir for mycoplasma STDs?

A

Genital tract of sexually active persons

64
Q

What trichomoniasis organism is commensal in the mouth?

A

Trichomonas tenax

65
Q

What trichomoniasis organism is commensal in the intestine?

A

Trichomonas hominis

66
Q

What trichomoniasis organism is the cause of STDs?

A

Trichomonas vaginalis

67
Q

What organism is a flagellated protozoan, exists only as a trophozoite and is an extracellular anaerobe?

A

Trichomonas vaginalis

68
Q

How is Trichomonas vaginalis transmitted?

A

Sexual intercourse

trophozoite acquired during sex, parasite establishes on mucosa and multiples, parasite transmitted

69
Q

Although a male infected with Trichomoniasis is usually asx, what clinical signs/ sxs would they present with if sx?

A

Scanty, clear to mucopurulent discharge

70
Q

If a female presents with profuse vaginal discharge that is frothy and malodorous, what should you be concerned for?

A

Trichomoniasis

creates environment for Trichomonas vaginalis

71
Q

How is Trichomoniasis diagnosed?

A

Wet mount exam commonly used but culture more sensitive

72
Q

Is bacterial vaginosis an STI?

A

No, caused by overgrowth of opportunistic pathogen in vagina due to change in pH

73
Q

History of previous STDs, history of sexual activity, and current use of intrauterine devices places someone at a higher risk for what?

A

Bacterial vaginosis

74
Q

What will the vaginal secretion pH be for someone with vaginosis?

A

5.0-6.0 (N < 4.5)

75
Q

What type of cells will be present in the vaginal secretions of someone with vaginosis?

A

Clue cells

76
Q

What are the criteria (in which you must have 3 of 5) for diagnosing an infection with bacterial vaginosis?

A
  • Homogenous secretions
  • Clue cells
  • Amine odor with KOH
  • pH > 4.5
  • Curved G- or G variable rods
77
Q

While the raised vaginal pH and increased concentrations of anaerobes + products are similarities between vaginosis and trichomoniasis, how can you differentiate between the quality of the discharge?

A

Both thin and homogeneous but vaginosis = grey and trichomoniasis = yellow-grey

78
Q

What are the most commonly encountered opportunistic mycoses (fungal infections) found on the normal flora of the skin and mucous membranes?

A

Candidiases (Candida spp.)

79
Q

The following are underlying causes of what infection?

  • Absence of competing normal flora
  • Intro to abn site
  • “Pathologic” change in microenvironment
  • Inborn/ acquired immune defect
  • Broad spectrum abx
A

Candidiasis

80
Q

Vulvovaginal candidiasis is more commonly known as what?

A

Yeast infection

81
Q

What is the #1 cause of infection with Vulvovaginal candidiasis (aka yeast infection)?

A

Candida albicans

remainder with C. tropicalis or C. glabrata

82
Q

The following clinical sxs are concerning for what?

  • Thick, white, frothy discharge in women
  • Itching, irritation
  • Burning sensation
  • Vaginal pain/ soreness
A

Candidiases ( STI but usually an endogenous infection)

83
Q

Which Haemophilus organism is non-motile, G- coccobacillus and is responsible for causing chancroid?

A

H. ducreyi

84
Q

How soon post-infection does a soft chancre of chancroid develop?

A

3-5 days (rather quickly)

85
Q

The following characteristics describe what?

  • Vesicle or papule that progresses to pustulation and ulceration
  • Enlargement and development of multiple ulcers
  • Ulcer is painful and tender, bleeds readily, and lacks induration?
A

Soft chancre of chancroid

86
Q

Does a chancroid or chancre sore have a soft ragged edge and pus?

A

Chancroid

87
Q

Does a chancroid or chancre sore have a hard raised edge?

A

Chancre sore

88
Q

How is a chancroid diagnosed?

A

ID of H. ducreyi from genital ulcer or swollen lymph node

89
Q

Why is direct examination of H. ducreyi sometimes difficult when trying to diagnose chancroid?

A

Misleading due to presence of polymicrobial flora in ulcer material

(also lymph material frequently sterile)
(media for primary isolation requires presence of growth supplements)

90
Q

What syndrome results when microorganisms ascend to the endometrium, fallopian tubes, and pelvic structures?

A

Pelvic inflammatory disease (PID)

91
Q

The following things place someone at higher risk for what condition?

  • STD
  • Prior episode
  • Sexually active adolescent
  • Multiple sexual partners
  • Frequent douching
A

Pelvic inflammatory disease (PID)

92
Q

The following sxs are indicative of what condition?
Lower abd pain, abn vaginal discharge, painful intercourse, increased pain during menstruation, irregular menstruation, fever and chills, scarring

A

Pelvic inflammatory disease (PID)

93
Q

How is pelvic inflammatory disease (PID) diagnosed?

A

Clinical criteria (but often inaccurate) so use evidence of inflammation (fever, leukocytosis, elevated ESR)

94
Q

What 2 things should be treated with respect to pelvic inflammatory disease (PID)?

A

Both infection and inflammation

Micro I (9 decks)

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