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Microbiology > STIs and UITs > Flashcards

STIs and UITs Flashcards

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Biology 101 flashcards
1
Q

Which STIs are reportable?

A
  • chlamydia
  • gonorrhoea
  • syphilis
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2
Q

Untreated HPV is associated with what condition later on in life?

A

cervical cancer

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3
Q

What can untreated congenital syphilis lead to?

A

birth defects

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4
Q

Chronic pain is a result of what untreated STIs?

A

gonorrhoea and chlamydia

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5
Q

What is the most prevalent bacterial STI in Canada?

A

Chlamydia

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6
Q

What are the long-term sequelae of Chlamydia?

A

Females: pelvic inflammatory disease (PID), infertility (due to PID), ectopic pregnancy, chronic pelvic pain (due to PID), Reiter’s syndrome (sterile arthritis at joints)

Males: Epididymo-orchitis (inflammation of testicle), Reiter’s syndrome

Newborn: trachoma, pneumonia

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7
Q

What are the treatment options for Chlamydia?

A

Azithromycin single dose OR Doxycycline for 7 days, people should abstain from having sex for 7 days post-treatment

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8
Q

Are most females symptomatic or asymptomatic when they are infected with Chlamydia?

A

asymptomatic

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9
Q

What is Pelvic Inflammatory disease?

A

It is infection and inflammation of the upper genital tract caused by either Chlamydia trachomatis or Neisseria gonorrhoeae

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10
Q

What are symptoms of PID?

A
  • fever, abdominal pain, abnormal discharge

- adnexal (painful palpation of ovaries) and cervical motion tenderness (painful palpation of the cervix)

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11
Q

How is the diagnosis of PID made?

A

based on symptoms, microbiology and diagnostic imaging

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12
Q

What is the outpatient treatment regimen for treating PID?

A

Ceftriaxone 250 mg IM + Doxycycline 100 mg x 2day for 14 days + Metronidazole 500 mg x 2 day for 14 days

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13
Q

What is key in the treatment of PID?

A

Catching it early and then treating it promptly to preserve fertility

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14
Q

What are long-term sequelae of PID?

A

ectopic pregnancy, sterility, chronic pelvic pain

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15
Q

What type of bacterial infection is Gonorrhea?

A

Neisseria gonorrhoeae is gram negative facultative intracellular bacteria

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16
Q

What is the second most commonly reported bacterial STI in Canada?

A

Gonorrhea

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17
Q

What STI afflicts more males than females?

A

Gonorrhea

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18
Q

What is the common long-term sequelae in both males and females?

A

disseminated infection

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19
Q

What is the long-term sequelae in neonates?

A

ophthalmia neonatorum, sepsis

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20
Q

Why is there an even higher risk of developing PID from gonorrhea?

A

Because N. gonorrhoeae have fimbriae that attach to sperm cells, once ejaculated they can travel up and cause PID in females

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21
Q

How are N. gonorrhoeae able to reach joints, meninges and the heart??

A

Phagocytized bacteria can survive and multiply in neutrophils, traveling t distal sites in the body

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22
Q

T/F: most women who contract gonorrhea are asymptomatic

A

True

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23
Q

Female vaginal bleeding and Male urethral discharge are symptoms of _

A

gonorrhea

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24
Q

What is the treatment for Gonorrhea?

A

Ceftriaxone 250 mg IM (to treat the gon) + Azithromycin 1g PO (to treat the clam)

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25
Q

What is the incubation period of Gonorrhea?

A

2-7 days

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26
Q

Who should be screened for Chlamydia and Gonorrhea regardless if symptomatic?

A

All sexually active females under 25 years of age and all pregnant women (significant reduction in perinatal mortality)

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27
Q

For Chlamydia and Gonorrhea culture testing, what areas need to be swabbed for sampling?

A
  • endocervical or vaginal & urethral

- pharyngeal and rectal (if applicable)

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28
Q

What is a pro and con of using Nucleic Acid Amplification Tests (NAATs)?

A

PRO: can use urine: easier sample to collect from men

CON: impedes tracking of AMR and not approved for use in pharyngeal and rectal diagnosis

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29
Q

How have Gonorrhea rates changed between 2009 and 2017?

A

increased by 109%

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30
Q

What bacteria causes Syphilis?

A

Treponema pallidum

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31
Q

How have rates of syphilis changed since 2009?

A

They have increased by 259%

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32
Q

What gender (between ages of 25-39) account for 93% of cases?

A

males

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33
Q

How is congenital syphilis contracted?

A

Infectious syphilis can be transmitted from mother to fetus during pregnancy or delivery

34
Q

What is the risk of transmission from mother to fetus of primary and secondary syphilis?

A

> 70%

35
Q

What is the risk of transmission from mother to fetus of early latent syphilis?

A

> 40%

36
Q

What are fetal complications that can arise if syphilis is contracted?

A

fetal death (40%), cerebral palsy, mental disability, organ malfunction

37
Q

Screening of pregnant females in the first trimester is required for the mothers when they have what STI?

A

syphilis

38
Q

What are signs of primary syphilis?

A

small, heard, painless ulcers (chancres) occuring at site of infection, regional lymphadenopathy (cervix, vulva, vaginal wall, penis, anus, mouth)

39
Q

What is the treatment of primary syphilis?

A

Symptoms manifest ~21 days post-exposure and resolve within 3-6 weeks without treatment

40
Q

How is primary and secondary syphilis diagnosed?

A

symptoms, serologic testing and samples from lesions (except oral and anal)

41
Q

How is primary syphilis treated?

A

Benzathine penicillin G (IM, single dose)

42
Q

What is the difference between primary and secondary syphilis?

A

In secondary we being to see systemic signs

43
Q

What are the symptoms associated with secondary syphilis?

A

rash (palms of the hands and soles of the feet). fever, malaise, lymphadenopathy, headache, mucous membrane lesions, patchy alopecia, meningitis

44
Q

How is secondary syphilis treated?

A

Benzathine penicillin G (IM, single dose)

45
Q

What is the early latent infection of syphilis?

A

Take the last time they had a symptom of secondary infection (ex.rash), from that day to about a year they are at risk for another episode
- asymptomatic phase (<1 year post-secondary phase)

46
Q

What is the late latent infection of syphilis?

A
  • asymptomatic (>1 year post-secondary stage)
  • patient may never develop any long-term complications
  • no longer have symptoms, no longer infectious
47
Q

What is the tertiary infection of syphilis?

A

this occurs 10-30 years after initial infection, increased occurence in HIV(+) patients, associated with inflammation and severe hyperimmune responses

  • (cardiovascular syphilis)
  • neurosyphilis
  • gumma (skin and soft tissue lesions)
48
Q

What is the treatment for the early latent phase?

A

Benzathine penicillin G (IM, single dose)

49
Q

What is the course of treatment for late latent and tertiary phase of syphilis?

A

longer therapy of the Benzathine

50
Q

How is the diagnosis of latent and tertiary syphilis made?

A

CSF, chest x-ray, physical and neurological exams, serology (may come out negative because not as sensitive in this stage)

51
Q

What strain are most cases of genital herpes associated with?

A

HSV2

52
Q

“Asymptomatic shedding and rate of recurrence greater with HSV_”

A

HSV2

53
Q

What is the incubation period of Herpes simplex virus?

A

~ 6 days, but can be weeks, months or years

54
Q

What is the estimated amount of 14-59 year olds that are infected with HSV?

A

14%

55
Q

What facilitates transmission of HSV?

A

Asymptomatic “silent”shedding of the virus facilitates transmission, direct skin to skin contact

56
Q

What are the primary manifestations of HSV?

A

clear, straw-coloured fluid-filled vesicles appear first and then develop into painful, burning ulcers as they rupture

57
Q

What are complications (20%) of the primary manifestations of HSV?

A

meningitis and encephalitis

58
Q

What is the course of treatment for primary HSV?

A

Acyclovir 200 mg PO x 5 per day for 5-10 days

59
Q

What triggers secondary manifestations of HSV?

A

stress

- fever, menstrual cycle, skin irritation, fatigue, coitus, immunosuppression

60
Q

What are the prodromal or “preceding” symptoms that occur where the new vesicles will form in secondary HSV?

A

pain, tingling, burning, itching and skin sensitivity

61
Q

What is the duration of secondary HSV?

A

mean duration of 9.3 -10.6 days

62
Q

What treatment can we give for HSV episodes?

A

Valacyclovir 500 mg PO bid for 3 days (start within 12 hours of symptom appearance)

63
Q

What can we offer for people who have 6 episodes/ year of HSV?

A

daily suppressive antiviral therapy, Valacyclovir 500 mg, PO daily, decreases the frequency/ severity of symptoms and reduces transmission by 48%

64
Q

(HSV) What is given as suppressive therapy for pregnant women; initiated at 36 weeks and continued until delivery?

A

Valacyclovir 500 mg, PO twice daily

65
Q

What is the most common STI in Canada?

A

Human Papillomavirus (HPV) 75% of sexually active adults with acquire a genital tract HPV infection during their lifetime, majority of these infections resolve within 18 months

66
Q

How many HPV genotypes exist and how many are associated with genitals?

A

200, 40

67
Q

How many of the HPV genotypes are associated with cancers?

A

15 high risk (oncogenic) genotypes including 16 &18

68
Q

What are the low-risk HPV genotypes?

A

non-oncogenic including 6 & 11, presents with genital warts; painful lesions that typically present 3-4 months post-exposure

69
Q

What is the typical treatment for genital warts?

A

treatment is topical and patient applied, TCA (trichloroacetic acid)

70
Q

What is HPV a predisposing factor of?

A

cervical cancer; types 16&18 are responsible for 70% of all cervical cancers

71
Q

What is the screening procedure of HPV?

A
  • screening programs to detect cervical abnormalities, precancerous lesions and cervical cancer due to HPV infection in women
  • begin screening at 21 years (if sexually active); if cytology is normal, then every 3 years, if abnormal, annually
72
Q

What are cofactors of developing HPV?

A

smoking, long term use of oral contraceptives (> 5years), higher number of pregnancies, other STIs, poor nutrition, multiple sex partners, sex at a young age, immunosuppression, genetic factors

73
Q

What prevention is out there for HPV?

A

Immunization - Gardasil

  • targets genotypes 6,11,16,18
  • 3 doses over a 6 month period, for males in females in grade 7
  • Gardasil is NOT effective in females with abnormal cytology or HPV infection
74
Q

What are 3 examples of UTIs?

A
  • Urethritis
  • Cystitis
  • Prostatitis
75
Q

What is an upper UTI?

A

acute pyelonephritis (infection has spread to the kidneys)

76
Q

What is a common cause of illness in hospitalized and elderly patients?

A

UTIs

77
Q

What are common symptoms of someone who has a UTI?

A

fever, dysuria, frequency, urgency, incontinence, abdominal pain, flank tenderness (show its reached the kidneys), sepsis

78
Q

Who is at risk of developing a UTI?

A
  • females, pregnancy, sexual activity, catheters, obstruction/ neurogenic bladder
79
Q

When diagnosis of UTI what is looked for in the urinalysis?

A
  • leukocyte esterase (active infection)
  • WBCs
  • Bacteria (1000 bacteria/ml) 90% pyelonephritogenic E. coli
  • Nitrites
  • Protein levels
80
Q

What are some complications associated with UTIs (in relation to pyelonephritis)?

A
  • ascending infection
  • severe abdominal, flank and back pain
  • fever (>39), that persists for more than 2 days
  • chills, n&v, fatigue
  • pyuria
  • sepsis & kidney damage
    “

Microbiology (17 decks)

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