T. vaginalis and sexually transmitted arthropods infections Flashcards by Iseoluwa Ojo

T. vaginalis infect only women.

T/F

T. vaginalis despite it name, infect both men and women.

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Trichomonas vaginalis

Etiological agent of trichomoniasis

In females, it inhabits the _______ and ______

In males it is found in the _______,________ or, _____________.

vagina and urethra

urethra, prostate

seminal vesicles

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Trichomonas vaginalis

Etiological agent of trichomoniasis

Other 2 species of trichomonads (___________ ———- and ________ ———- ) found in human are normally harm______

Pentatrichomonas hominis

T. tenax

harmless.

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Epidemiology of T.vaginalis

________ transmitted disease of worldwide importance

________% in Women , ________% in Men

T. vaginalis infections are commonly associated with other STDs and is a marker of _____-risk sexual behavior

Sexually

20-40%

15%

high-risk

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Life cycle of T.vaginalis

______________
– the only stage present in the lifecycle
– Characteristic ______ motility
– Multiplies by __________________

______ stage is absent

Incubation period- about ———— days

Trophozite; jerky

longitudinal binary fission

Cyst

4-28

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Morphology of the Trichomonas trophozoite

______ shaped

______ in length

______ flagella extend anteriorly
______ flagella extends posteriorly along the cell membrane to form _______________

Pear

7 – 23

1 ; an undulating membrane

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Morphology of the Trichomonas trophozoite

Costa

________ runs down the middle of the body & ends in a ________ like extremity

_______ nucleus in the (anterior or posterior?) portion

Costa

Axostyle ; pointed tail

Round ; anterior

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Trichomonas vaginalis

It lives in the __________ and __________ system of people.

It is a/an (obligate or facultative?) parasite)

reproductive ; urinary

obligate parasite

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Trichomonas vaginalis

Obligate parasite – cannot _____ without close association with ________ , ________ or ________ tissues

Infects ________ epithelium but not ________ epithelium

live ; vaginal

urethral ; prostatic

squamous

columnar

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Pathogenesis of Trichomoniasis

Normal flora (bacteria ) keep the pH of the vagina at 4-4.5 and ordinarily this discourages infections
T. vaginalis can survive at a low pH and once established it causes a shift toward alkalinity (pH 5-6) which further encourages its growth.
creates micro-ulcerations/ erosion
Zinc and other inhibitory substances probably inhibit their growth in men

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Pathogenesis Of T.vaginalis

Normal flora (bacteria ) keep the pH of the vagina at ____ and ordinarily this discourages infections

T. vaginalis can survive at a ______ pH and once established it causes a shift toward (acidity or alkalinity?) (pH ____) which further encourages its growth.
creates micro-______/ ______

______ and other inhibitory substances probably inhibit their growth in men

4-4.5

low

alkalinity ; 5-6

micro-ulcerations/ erosion

Zinc

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Clinical features of T.vaginalis

T. vaginalis causes different manifestation in men and women.

Women are more likely to exhibit symptoms which tend to persist (shorter or longer?)

In female ranges from _________ , to mild or moderate ________, to _____________

___-_____%: asymptomatic

The commonest symptoms: vaginal ________, vulval _______, ________, or offensive ______ , rare _________________________

longer

asymptomatic ; irritation

extreme vaginitis

10 - 50%

vaginal discharge ; vulval itching

dysuria ; offensive odor

abdominal discomfort

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Clinical features of T.vaginalis

Vaginal discharge: up to _____% - varying in consistency from ____ and _____ to _______ and _______ ; the classical discharge of ______________ occurs in ______% of women

70% ; thin ; scanty

profuse ; thick

frothy yellow

10-30

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Clinical features of T.vaginalis

Extreme cases associated with _______ and _______

2%: ___________ cervix appearance to the naked eye.

Higher rates are seen on _________ examination.

5-15%: _______________ on examination.

In male 50-90 % are (asymptomatic or symptomatic?)

mild dysuria or pruritus
minor urethral discharge

vulvitis and vaginitis

strawberry cervix

colposcopic examination.

no abnormalities

asymptomatic

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Clinical features of T.vaginalis in Men

Usually asymtomatic
Nongonococcal urethritis
Purulent to mucoid discharge

Pain in urethra

Testicular pain Epididymitis
Prostatis
Superficial penile ulcerations

Clinical features of T.vaginalis in Men

Usually asymtomatic
Nongonococcal urethritis
Purulent to mucoid discharge

Pain in urethra

Testicular pain Epididymitis
Prostatis
Superficial penile ulcerations

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Clinical features of T.vaginalis in Men

Usually (asymtomatic or symptomatic?)

•Nongonococcal urethritis
-________ to _______ discharge
-_____ in urethra

__________ pain
____________itis
______tis
Superficial penile ___________

asymtomatic

Purulent to mucoid

Pain

pain

Epididymitis

Prostatis

ulcerations

Diagnosis of T.vaginalis

Physical Examination

Pelvic examination: Inspection of _____________.

Speculum examination:
– insertion and visualization of _______ and _________, obtaining _____ and slide specimens.

external genitalia

vagina and cervix

swabs

Vaginitis - Trichomoniasis

– Profuse, _______ discharge, _______-_______ in color , _______ odor, vulvar _______

– Patchy vaginal _______ and (_______ cervix)

frothy

yellow-greenish

foul odor ; pruritus

erythema and (strawberry cervix)

Laboratory Diagnosis

Samples in women
-Vaginal discharge
____,______,___________
– __________ specimen

•Samples in men
•________ discharge
– __________ fluid
– _______________ voided urine sediment
-Semen

pH, Whiff test, microscopy

Endocervical specimen

Urethral discharge

Prostatic fluid

Early morning first

Laboratory Diagnosis of T.vaginalis

Microscopy Culture
Antigen detection ( ELISA )
Serodiagnosis- limited value
Molecular diagnosis
____________ – more sensitive & highly specific

_______- highly sensitive & specific

DNA probes

PCR

Microscopy of T.vaginalis

Wet mount
(Easy or Difficult?) , useful & economic
____% sensitivity in symptomatic females

T. vaginalis trophozoites seen with characteristic _______ & _______ motility

_________ stain
(Slow Or Rapid?) & accurate method Sensitivity same as wet mount Direct fluorescent antibody staining Rapid & more sensitive
Requires a fluorescent microscope

Easy

80%

jerky &twitching

Acridine orange

Rapid

Gold standard for lab diagnosis of T.vaginalis is ????

Culture

Treatment of T.vaginalis

____________ 2g stat – highly effective

___________ 2g stat

Metronidazole

Tinidazole

Complications of T.vaginalis

Premature ____________
_______ birth
_______ births
spontaneous ________

rupture of membrane

Preterm

Stillbirths

abortions

Prevention of T.Vaginalis Detection & treatment of cases ____________ Safer sex Avoidance of sexual contact with infected partners Use of ________

Contact tracing condoms

Sexually transmitted arthropods Phthirus pubis Pubic or crab louse usually live on __________ In rare cases, can be found in ________, _________, and ________ transmission is ________________ by _____ contact with someone who is already infested and rarely _______ may play a minor role

pubic hair eyelashes, armpit hair, and facial hair person to person sexual contact ; fomites

Life cycle of Phthirus pubis Phthirus pubis have _______ stages: __________________. Eggs (_____) are laid on a _______ Females will lay approximately _____ eggs during their ________ life span. Eggs hatch after about _______ and become __________, which look like (smaller or larger ?) versions of the adults and these undergo ______ molts ( ________ ) before becoming adults

three egg, nymph and adult. nits; hair shaft 30 eggs ; 3-4 week a week ; nymphs smaller ; three molts 2, 3, 4

Life cycle of Phthirus pubis Adults are ___-____ mm long and (rounded or flattened?) . They are much (narrower or broader?) in comparison to head and body lice. Adults are found only on the _______ host and require __________ to survive. If adults are forced off the host, they will die within _________ without a blood feeding.

1.5-2.0 mm flattened ; broader human ; human blood 24-48 hours

Clinical Presentation of Phthirus pubis Asymptomatic Symptomatic a ________ feeling of something moving in the hair itching, caused by the ___________ to louse _____ _________ rash irritability _______ caused by the bites of pubic lice may be very intense _________ of the skin may occur if the infestation is left untreated for an extended length of time.

a tickling allergic reaction ; saliva Papular ; Pruritis Discoloration

Lab diagnosis of Phthirus pubis —————— to visualize the organism or the nits

Light microscopy

Treatment of Phthirus pubis application of 1% ______________ ointment or lotion ________ , 1% Synthetic pyrethrins evaluate for other STIs.

gamma benzene hexachloride Lindane

Other parasites Oral-anal and oral-genital sexual practices predispose male homosexuals to infection with many enteric pathogens, including parasitic protozoans and helminths. Most common of these parasitic infections are __________ (______ _______) and ______ (_______ ______)

amebiasis (Entamoeba histolytica) Giardiasis(Giardia lamblia)