STIs and HIV

Question 1

What type of bacteria is Chlamdydia trachomatis? [1]

Is it gram postive or gram negative? [1]

Answer 1

Obligate aerobic intracellular pathogen

Chlamydia trachomatis is a gram-negative bacteria

Question 2

What are the two types of Chlamdydia trachomatis (that need to know) [2]

What do they cause? [2]

Answer 2

Serovars D-K: infects genital tract epithelial cells
Males: Urethritis, epipdidymitis, prostatitis
Females: Cervicitis, PID, Fitz-Hugh Curtis (liver capsule adhesions)
Neonate - conjunctivitis and pneumonia

Serovars L1-3
Causes: Lymphogranuloma venereum

Question 3

Explain lifecycle of Chlamdydia trachomatis
- what are the two different forms? [2]
- Which type is infectious? [1]
- which type of replicative? [1]

Answer 3

Exists in two different forms:
- the elementary body, which is the infectious form
- the reticulate body, which is the replicative form

Infect as an elementary body, then turns in to reticulate body, after a while becomes elementary body and bursts and infects

Question 4

Which type of chlamydia causes lymphogranuloma? [1]

Answer 4

Serovars L1-3

Question 5

What are complications of Chlamdydia trachomatis? [2]

What are treatments for Chlamdydia trachomatis? [2]

Answer 5

Complications
* Reactive arthritis
* INFERTILITY – can cause ectopic pregnancy due to scarring of uterus

Treatment
* Azithromycin
* Doxycycline

Question 6

What are male [5], female [4] and neonate [1] from having Neisseria gonorrhoea

Answer 6

Males:
* Urethritis
* proctitis
* sore throat
* epididymitis
* prostatitis

Females:
* Cervicitis,
* PID
* ,Peri-hepatitis
* septic abortion - gets into amniotic sac and infects baby

Neonates
* Conjunctivitis

Question 7

What are systemic complications of Neisseria gonorrhoea? [4]

Answer 7

• Septic arthritis
• blindness
• infertility
• septicaemia

Question 8

How do you treat Neisseria gonorrhoea? [1]

Answer 8

Ceftriaxone

Question 9

Difference in discharge between chlamydia and gonorrhoea? [1]

Answer 9

It is important to note that the discharge present in gonorrhoea is different to that in chlamydia. It tends to be much more profuse and very often purulent, thick and a yellowy/green colour. It causes mento have very severe dysuria, and they’re usually in incredible pain.

Question 10

Genital warts are caused by which virus? [1]

Answer 10

Human Papilloma Virus

Question 11

Which variants of HPV are linked to cancer? [4]
Which variants of HPV are targeted by Gardasil vaccine? [2]

Answer 11

Cancerous: HPV 16, 18, 31,33

Vaccine: HPV 16 and 18

Question 12

What are the two types of Herpes Simplex Virus? [2]

What are the modes of transmission for each? [2]

Answer 12

HSV-1 oral
HSV-2 genital

Question 13

What are the treatment options for herpes? [3]

Answer 13

Management:
Topical podophyllotoxin
imiquimod
Cryotherapy

Question 14

What type of cells does herpes virus intergrate into?

epithelial cells
nerve cells
muscle cells
endothelial cells

Answer 14

What type of cells does herpes virus intergrate into?

epithelial cells
nerve cells
muscle cells
endothelial cells

Question 15

Management for herpes? [3]

Answer 15

Acyclovir, Famciclovir, Valaciclovir

Question 16

Explain life cycle of Syphilis (Treponema pallidum) [4]

Answer 16

Primary:
* single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the penis; vagina; anus; rectum; and
lips or in the mouth
* 3 to 6 weeks and heals regardless of whether you receive treatment.

Secondary:
* Rash, fever, lymphadenopath, Condyloma latum (wart like lesions on genitals)
* This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet

Latent:
* No signs or symptoms

Tertiary:
* However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system.
* Tertiary syphilis is very serious and would occur 10–30 years after your infection began
* Can result in death

Question 17

What type of syphilis is this?

Primary
Secondary
Latent
Tertiary

Answer 17

What type of syphilis is this?

Primary
Secondary
Latent
Tertiary

Question 18

Explain mechanism of how HIV causes disease?

Answer 18

• HIV infects CD4+ T cells (T helper cells), macrophages and dendritic cells
• Acute (primary) HIV infection leads to massive loss CD4+ cells
• Chronic HIV infection is associated with ongoing loss of CD4+ cells, decline in immune function and progressive immunosuppression
• HIV-associated disease incorporates: direct effect of HIV includes wasting, diarrhoea, neurological problems

Question 19

Which stages of HIV lifecycle to HAART target / what are the drug types? [5]

Answer 19

Protease Inhibitors (PIs)
Integrase Inhibitors (IIs)
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Entry Inhibitors (EIs; fusion inhibitors, CCR5 antagonist)

Question 20

What are short term [4] and long term [5] problems of HAART treatment?

Answer 20

Problems with HAART

• Short-term side effects: nausea, vomiting, headache, sleep disturbance (caused by efavirenz)
• Long term: lipodystrophy (NRTIs and PIs), renal dysfunction (tenofovir), peripheral neuropathy (d4T, AZT, DDI), lactic acidosis (may be fatal, d4T, DDI)

Question 21

Label A & B

Answer 21

A: Serovars D-K
B: Serovars L1-L3

Question 22

Name 3 opportunisitic infections and 3 malignancies caused by HIV infection

Answer 22

• Opportunistic infections cause viral, fungal, bacterial, mycobacterial and parasitic infections
• Malignancies: Kaposi’s sarcoma, lymphoma, carcinoma of cervix