STIs by Unrein Flashcards
generalized macular rash, patchy hair loss, generalized lymphadenopathy and flat grey white lesions in the perianal area. In order to diagnose his disease, you should order which test first? He relates having unprotected sex two months ago.
A) Culture in a high CO2 environment B) PCR for HPV types 6 and 11 C) Urethral DNA probe D) RPR E) Gram stain
RPR is a test for syphilis (secondary). Incubation time for 2ndary is 3-8 weeks after; tertiary is years later. Primary- 3 weeks
Neisseria gonorrhoeae- 2-6 days accute, up to 2 weeks for disseminated
7-21 days for Chlamydia trachomatis
2-20 months highly variable incubation period for HPV
what do we culture in high CO2 environment?
neisseria gonorrhoeae
testing for herpes
PCR for HPV types 6 and 11- these types are for condylomata acuminata.
HPV 16 and 18 –> 70% of cervical cancers. Vaccines var from 2-4 strains, but all contain subtypes 16 and 18. The 9 valent strains vaccine is near 100% effective in prevention of disease transmission.
Urethral DNA probe
used to ID neisseria gonorrhoeae and chlamydia trachomatis
testing for syphilis
RPR or the VDRL are initial antibody test screenings for 2dary syphilis but have fals positive results associated with SLE, mono, malaria, leprosy, hep A, HIV and even pregnancy.
FTA- is confirmatory test after screening test for syphilis.
Primary syphilis can also be dxed by dark field microscopy, but not widely available.
gram stain could ID
gram negative intracellular “coffee-bean shaped” diplococci organisms (neisseria gonorrhoeae)
syphilis signs
condylomata lata
and painless chancre
as opposed to chancroid- hurt, moth-eaten border, raised
treatment for syphilis
penicillin
IM- Bicillin
one dose for having it less than a year
multiple doses over time (usually 3) if the pt has had the condition more than one year
A 26 y/o female presents with right lower quadrant tenderness equivocal for rebound tenderness, a low grade fever, normal bowel sounds, and exudative and tender cervical examination. Her white blood cell count is 15,000 (4,000-10,000/L). You suspect which organisms?
A) GI tract coliforms B) Treponema pallidum C) Human papillomavirus D) Human Immunodeficiency Virus E) Chlamydia trachomatis
Chlamydia trachomatis
this is PID
acute appendicitis
can be caused by GI tract coliforms
HIV
often presents as a nonspcific viral syndrome with a fever, sore throat, swollen lymph nodes and a transient maculopapular rash
chlamydia trachoomatis
symptom of salpingitis adn/or endometritis often referred to as pelvic inflammatory disease
Fitz-Hugh-Curtis syndrome- inflammation of the liver capsule adn adjacent peritoneal surfaces and an advanced presentation of PID. C. trachomatis is a common cause of PID– most are asymptomatic.
Cervicitis may present with vaginal discharge and lower abdoinal pain. Symptoms of urethritis can include urinary frequency and dysuria.
causes lymphogranuloma venereum, genital ulceration and lymphadenopathy. Fleeting, often missed, common in sub-saharan africa.
when evaluating chlamydia trachomatis, what other diseases must be considered?
gonorrhea syphilis HIV HBV HCV CMV trichomonas vaginalis others (zika)
treatment for chlamydia
azithromycin
if allergic to macrolides- tetracycline
chlamydia is an obligate intracellular pathogen (thus antibiotics that work to disrupt cell wall synthesis will not be effective- enicillins, cephalosporins.
treathment for gonorrhea?
ceftriaxone
