STIs + genital infections

Question 1

Exogenous infection

Answer 1

infection from bacteria from outside body

Question 2

Endogenous infection

Answer 2

infection caused by natural flora

Question 3

What are the normal microflora

Answer 3

coagulase - staph , corynebacteria, lactobacillus

• help prevent adherence of pathogenic bacteria

Question 4

Cause of syphilus

Answer 4

Treponema pallidum

Question 5

Cause of chancroid

Answer 5

Haeomphilus ducryei

Question 6

Cause of gonorrhoea

Answer 6

Neisseria gonorrhoeae

Question 7

Cause of chlamydia

Answer 7

Chlamydia trachomatis

Question 8

Causes of vaginitis

Answer 8

Trichomonas vaginalis, C. albicans, Gardenalla

Question 9

Dysuria

Answer 9

painful peeing
- common in gon, chlamydia, HSV

Question 10

Urethritis

Answer 10

infection of the urethra; frequent need to pee, pin with pee

• can be caused by N. gonorrhoeae or non-gonoccocal

Question 11

Vaginitis

Answer 11

inflammation of vagina
- main causes: VVC, BV, and tricho

Question 12

VVC

Answer 12

normally caused by C albicans (KOH : budding yeast + pseudohyphae)
not STI
normally endogenous origin

Question 13

Trichomoniasis

Answer 13

infection with Trichomonas vaginalis (parasite) - motile + PMNs

exogenous

• may cause strawberry cervix

Males: itching inside penis + discharge

Question 14

BV

Answer 14

Cause: Gardnerella vaginalis (club + adherent bacillus)

Not STI but being sexually active increase risk

Question 15

Pelvic Inflammatory Disease

Answer 15

microbe travels up from cervix to endometrium, tubes etc

Question 16

Infections after Gynecologic Surgery

Answer 16

• post operation infections such as pelvic abscesses or cellulitis
• normally endogenous origin

Question 17

Male Upper tract infections

Answer 17

epididymis
prostatitis
orchitis: inflammation of testes

Question 18

What is T. pallidum

Answer 18

spirochete (small corkscrew)

motile + can’t culture

visual with special stains

Question 19

Stages of Syphilis

Answer 19

Primary: enter of B, multiple here
- some leaves + goes into BS or lymph nodes
- formation of chancre 2-10 wks later: hard + painless at site of entry (bacteria chilling)
- super infectious stage, may heal itself

Secondary: systemic features (sore throat, fever, headache, rash )
- Condylomata lata: form on some in the intertriginous areas (butt folds)
- super infectious

Latent: immune suppresses + lesions gone
- only way know have is with positive serological test
- can reactivate + go back to 2 (relapse)
- if no more relapses: not contagious via contact

Tertiary: some progress to this
- gummas: lesions on bone + liver
- CV lesions
- neurosyphilis

Question 20

Modes of transmission of syph

Answer 20

Vertical or via sexual contact (stage 1 + 2)

Question 21

Pathogenesis of Syph

Answer 21

Penetration: enters skin via abrasions or transmit vertically to baby

Dissemination: before gets SS, already in circulatory system

Question 22

Types of lab diagnosis of symphonic

Answer 22

DFM : dark field microscopy

DFA: Direct Immunofluoro

Question 23

Virulence of T. pallidum

Answer 23

Don’t fully know
- flagella is hidden: periplasmic space
- spiral shape to penetrate
- variable Ags

Question 24

DFA

Answer 24

prep sample with fluoro-labelled Ab for B
- specific + sensitive

-: need trained tech

Question 24

DFM

Answer 24

Mech: visualize if spirochete present (not specific though) + : get diagnosis right away if primary or secondary -: doesn’t work for tertiary + less sensitive if lesions decrease/heal

Question 25

Types of serological tests for syph

Answer 25

1) Non-treponemal: RPR test 2)Treponemal: TPPA, or EIA -

Question 26

Rapid Plasma Regain Test

Answer 26

screen for mito Ag using Ab - mito Ag released when cells damaged +: easy to do, low cost, + can tell bacteria load/ follow efficacy of therapy - : doesn’t work if early or late latent, or tertiary (not enough damage) , false + from different diseases ** takes 2-3 wks to get + result**

Question 27

TPPA

Answer 27

T. pallidum particle agglutination - measure Ab directly against B

Question 28

EIA

Answer 28

use enzyme immunoassay (ELISA or western)

Question 29

+ and - Treponemal tests

Answer 29

+: specific -: can’t tell difference bw old and new infection (active or latent) ** used only be used to confirm non-trep test results

Question 30

Syphilis Treatment

Answer 30

Primary+ Secondary : 1 injection of pen G Tertiary: 1 injection of pen G x 3 wks Neurosyphilis: constant IV for 14 days

Question 31

Chancroid vs chancre

Answer 31

chancroid: caused by H. ducreyi - soft+ painful - diagnosis via gram stain chancre: hard + painless

Question 32

T or F: N. gonorrhoeae is an obligate human parasite

Answer 32

T

Question 32

How to treat Chancroid

Answer 32

1 dose of azithro or cephalosporin

Question 33

Gonorrhoeae SS

Answer 33

yellow/green discharge - pain with peeing - swollen testes or vaginal bleeding

Question 34

Diagnosis of Gon

Answer 34

NAAT or gram stain (if have tissue with pathogen)

Question 35

Gon treatment

Answer 35

1 dose ceph OR one dose gentamicin + azithro

Question 36

2 forms of chlamydia B

Answer 36

Elementary bodies : spore + infectious forms (outside host) Reticulate bodies : reproductive form inside host

Question 37

Mycoplasma genitalium

Answer 37

- organism has no cell wall (no gram stain) - 2nd most common cause of urethritis (non- gon) after chlamydia - diagnosis via exclusion

Question 38

Genital warts cause

Answer 38

HPV infects SS epithelia types: 6, 11, 16, 18 ( 16 + 18 oncogenic)

Question 39

Treatment of HSV

Answer 39

removal

Question 40

Genital herpes cause

Answer 40

HSV 2 ( 1 normally cold sores) SS: itching, fever, headache + lesions + site of infection Treat: antivirals

Question 41

AIDS

Answer 41

caused by HIV (invade T CD4 cells) - HIV: flu like symptoms for weeks diagnosis: blood + NAAT Treat: HAART

Question 42

T or F : All STIs (B) can be treated with azithro

Answer 42

F: almost all can Chancroid, Gonorrhoeae, Chlamydia all can Mycoplasma genitalium: FQ or Doxycycline