T. vaginalis and sexually transmitted arthropods infections Flashcards
T. vaginalis infect only women.
T/F
F
T. vaginalis despite it name, infect both men and women.
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
Trichomonas vaginalis
Etiological agent of trichomoniasis
Other 2 species of trichomonads (___________ ———- and ________ ———- ) found in human are normally harm______
Pentatrichomonas hominis
T. tenax
harmless.
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
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
Morphology of the Trichomonas trophozoite
______ shaped
______ in length
______ flagella extend anteriorly
______ flagella extends posteriorly along the cell membrane to form _______________
Pear
7 – 23
4
1 ; an undulating membrane
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
Trichomonas vaginalis
It lives in the __________ and __________ system of people.
It is a/an (obligate or facultative?) parasite)
reproductive ; urinary
obligate parasite
Trichomonas vaginalis
Obligate parasite – cannot _____ without close association with ________ , ________ or ________ tissues
Infects ________ epithelium but not ________ epithelium
live ; vaginal
urethral ; prostatic
squamous
columnar
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
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
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
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
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
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
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
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)
