STIs I Flashcards by tcarlso 3

What are the most common STIs, in order?

Chlamydia

Gonorrhea

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What is trachoma? What is this caused by?

chronic, inflammatory granulomatous process of eye surface, leading to corneal ulceration, scarring, pannus formation and blindness. Caused by C. Trachomatis

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What is adult inclusion conjunctivitis? What is this caused by?

acute process with mucopurulent discharge, dermatitis, corneal infiltrates, and corneal vascularization in chronic disease. Caused by C. Trachomatis

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What is neonatal conjunctivitis?

acute process characterized by a mucopurulent discharge. Caused by C. Trachomatis

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What is infant pneumonia caused by? Symptoms? What is this caused by?

C. Trachomatis

after a 2- to 3- week incubation period, the infant develops rhinitis, followed by bronchitis with characteristic dry cough.

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What are the 5 major symptoms of cystitis caused by chlamydia?

Cloudy or bloody urine, which may have a foul or strong odor
Low fever (not everyone will have a fever)
Dysuria
Pressure/cramping in the lower abdomen
Polyuria

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True or false: most people with chlamydia infections are asymptomatic

true

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What does chlamydia stain with? Why?

Nothing-lack a cell wall (peptidoglycan)

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Why is chlamydia an obligate intracellular parasite (what does it need from the host)?

Cannot make their own ATP

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What is the gram stain and morphology of chlamydia? Does it have LPS?

Gram - Cocci without a peptidoglycan layer

Has LPS, but weak

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What are the two forms that chlamydia takes? Which is infectious?

Elementary body = infectious

Reticulate body

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Which has a rigid cell wall: the elementary bodies or the reticulate bodies of chlamydia?

Elementary body

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What are the inclusions of a cell infected with chlamydia made of?

Reticulate bodies

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What are the 3 clinically important species of chlamydia?

Trachomatis
Pneumonia
Psittaci

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What is the route of transmission for chlamydia?

Sexually (no other)

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What is the only host for C. trachomatis?

Humans

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What are the two biovars of C. trachomatis? Which is more invasive?

Trachoma

LGV -more invasive

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What are the serovars of chlamydia based on?

Major outer membrane proteins (MOMP)

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What is the tropism for C. trachomatis?

Nonciliated columnar/cuboidal/transitional cells of urethra, eyes, respiratory tract etc

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How does C. trachomatis cause disease?

Destruction of epithelial cells and proinflammatory response

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What is the major consequence of untreated chlamydia?

Fibrosis and inflammation, leading to infertility

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What is the most invasive form of chlamydia? What do they cause? Why?

L types b/c they replicate in mononuclear phagocytes

Lymphogranuloma venereum

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How is chronic conjunctivitis caused by chlamydia transmitted?

Transmitted by droplets, flies.

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What are the symptoms of acute conjunctivitis caused by chlamydia?

Mucopurulent discharge, keratitis, corneal vascularization

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Why do we use erythromycin in the eyes of newborns?

Prevent neonatal conjunctivitis

Are men and women equally symptomatic with chlamydia?

No- men symptomatic | Women not

What are the symptoms of urogential infections with chlamydia in men?

``` Urethritis Conjunctivitis Urethral **mucopurulent** discharge Dysuria Polyarthritis (reitrs syndrome) ```

What are the symptoms of urogential infextions with chlamydia in women? (3)

**Mucopurulent discharge** PID Cervical motion tenderness

What is the major consequence of untreated C. trach infx in the urogenital tract?

Infertility | Fibrosis

Where is LGV usually found?

In africa, asia, and south america

What are the major symptoms of LGV infx? (3)

Inguinal lymph node swelling Painless lesion at the site of infection Proctitis

How do you diagnose C.trach? (3) What is needed in a culture?

1. Staining with iodine to id the RBs 2. ELISA 3. NAAT from urine or urethral discharge Need live cells for culture

What is necessary to get a sample of chlamydia infex for diagnosis?

Scrapings of epithelial cells

What is the treatment for C. trach? What does this depend on?

Doxy or macrolides Depends on pregnancy, age etc

Do you generate a secondary immune response to chlamydia?

What is the prevention technique for chlamydia?

Safe sex practices

Why isn't chlamydia susceptible to beta lactams?

No cell wall

What is the gram stain, morphology, and aerobic/anerobic properties of neisseria gonorrhea? How about N.Meningitidis?

Gram negative diplococci

How do you differentiate N. Gonorrhea vs meningitits?

Maltose fermentation

What are the vectors for N. Gonorrhea?

None-Humans only

What are the virulence factors for N. Gonorrhea? (7)

1. Pilin 2. Por protein 3. LOS 4. OPA protein 5. IgA protease 6. B-lactamase 7 .outer membrane Blebs (P.P. Bilbo)

What is the function of the pilin virulence factor on Gonorrhea?

Attachment, antiphagocytic

What is the function of the por protein (porin) on N.Gonorrhea?

Promotes intracellular survivial

What is the function of LOS that N. Gonorrhea?

Endotoxin

What is the function of Opa protein on N. Gonorrhea?

Attachment to eukaryotic cells

Are men or women usually symptomatic with N.Gonorrhea?

Men

How is N. Gonorrhea transmitted?

Sexually

N. Gonorrhea is susceptible to what?

C5b -C9b attack complex generated by complement

What are the three places that N. Gonorrhea infections take place?

Mouth Eye Dodads

How does N.Gonorrhea infect cells? What part of the bacteria generates the inflammatory response

Pass through cells to subepithelial space LOS stimulates inflammation via chemokines (TNF-alpha)

Does N.Gonorrhea have a capsule? What is the consequence of this?

No, thus can by uptaken by macrophages much more readily. Not cause systemic disease readily.

What are the symptoms of N.Gonorrhea?

Mucopurulent discharge | Dysuria

What are the complications of untreated Gonorrhea?

Epidiymitis/prostatitis Salpingitis PID

What is associated with sepsis caused by Gonorrhea?

Infection of the skin and joints (suppurative arthritis) **Diffuse pustular rash**

What are the pharyngitis infections symptoms of gonorrhea?

Mild to asymptomatic Accompanied by genital infections

How do you diagnose Gonorrhea? How is this different in men vs women?

Gram stain/culture from urethral scrapings NAAT Men much more accurate than females

What is the agar needed for N.Gonorrhea?

Chocolate agar

What is the treatment for N.Gonorrhea?

Ceftriaxone + Doxy or az to treat chlamydia

How do you prevent infections of N.Gonorrhea?

Pt edu | Condoms

What is the prophylaxis for neonates?

Erythromycin in eyes

Why can you not grow Chlamydia in a broth culture?

Need cells--they are intracellular parasites

Which serovars of Chlamydia cause trachoma?

A, B, Ba, C

Which serovars of Chlamydia cause urogenital tract disease?

D-K

Which serovars of Chlamydia cause lymphogranuloma venerum (LGV)?

L1, L2, L2a, L2b, L3

What is Reiter syndrome that is caused by C. trach infections in men?

Urethritis Conjunctivitis Polyarthritis (Can't see, can't pee, can't climb a tree)

How long does it take for chlamydia to replicate?

72 hours

What type of discharge is seen with C.trachomatis infections?

Thin, mucopurulent

What is the MOA of macrolides?

Binds to 50s ribosome, preventing protein synthesis

Which four of the seven virulence factors for N.Gonorrhoeae undergo antigenic variation?

Pilin Porin Opa LOS

What is the function of the outermembrane blebs of N. Gonorrhea?

Enhance toxicity and shield the bacteria from antibodies

Which bacteria has LOS in its cell wall? What effect does this have on the immune response?

N.Gonorrhoeae Antigenic variation prevents immune resposnes

Why is it significant that N.Gonorrhea has IgA protease?

It is found in mucosal sites

People who lack the C5b-9 complement proteins (that form the attack complex) are susceptible to which infection?

N.Gonorrhoeae

The discharge associated with N.Gonorrhea has what cells? What is inside them?

PMNs with gram negative diplococci

Which has a capsule, N. Gonorrhea or N. Meningiditis? What is the function of this?

N.Meningiditis Prevents phagocytosis and allows it to spread

What does N.Gonorrhoeae associated with?

Chlamydia infectons

What is Lymphogranuloma venereum?

a painless ulcer develops at the site of infection that spontaneously heals, followed by inflammation and swelling of lymph nodes draining the area, then progression to systemic symptoms. Caused by C. Trachomatis

What is the most common cause of preventable blindness?

C. Trachomatis infection

Why is it that in diagnosing C.trachomatis you should take a sample from the cervix, and not the vagina?

Chlamydia infects columnar cells, NOT squamous

Are Neisseria species oxidase positive? Catalase?

Both positive