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Clinical Cases > T2 > Flashcards

T2 Flashcards

1
Q

Differential Diagnosis - Ulcerative lesions

A

Herpes simplex virus, syphilis and tuberculosis

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2
Q

General causes - genital tract infections

A

Syphilis caused by (Treponema pallidum),
Granuloma,
Chancroid (caused by hemophyllus ducreyi),
Trachomonas vaginalis,
scabies ( using same towel/clothes),
Herpes,
HPV,
Chlamydia trachomatis (caused by klebseilla granuloma)

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3
Q

Syphilis - lab tests

A 
VDRL test and CSF VDRL test
NAAT (viruses)
Immunofluorescence test 
Staining (rapid) not specific
Culture in tissue (viruses)
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4
Q

Immunofluorescence test

A

Clonal antibodies (commercially produced) reacts with antibodies in patients producing complex which is then stained with immunofluorescent material (rapid)

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5
Q

Symptoms: 4 day history of -fever, chills, myalgia, painful genital lesions 2 days prior (this didn’t concern her enough to go to ER), (headache, photophobia & stiff neck on day of admission) -

A
  • flu, dengue, ecephalitis, west nile virus, malaria, leptospirosis, meningitis
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6
Q

Gold standard for STD test

A

Culture

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7
Q

Screening test CSF VDRL doesn’t confirm diagnosis for Syphilis (T or F)

A

True; test can be +ve in absence of syphilis

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8
Q

Purpose of lumbar puncture

A

Obtain CSF

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9
Q

Indications to not take CSF

A

Abnormal opening pressure - liquid flow rate fast

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10
Q

Cause of abnormal pressure

A

Scoliosis, fracture of skull,
Subarachnoid hemorrhage (SAH) ( bleeding into the subarachnoid space),
Unconscious with high pressure

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11
Q

Bacterial causes of STDs

A

-Neisseria gonorrhea, treponema pallidum,
Chlamydia trachonapis,
Chancroid (caused by hemophyllus ducreyi,
Klebsiella grandomatis -> donovan disease

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12
Q

Complication - HSV

A 
Aseptic meningitis (from external genitalia it -> nerve and cause inflamed meninges) 
Symptoms - neck pain, photophobia
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13
Q

STORCH

A 
Infections passed from mother to child 
Syphillis
Toxoplasma gondii
Rubella 
Cytomegalovirus
Herpes, HIV, Hepatitis B, C
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14
Q

Neonatal effect of Syphilis

A

Stillbirth, miscarriage, congenital syphilis (Deformed bones, severe anemia, meningitis)

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15
Q

Neonatal effect of HSV

A

Neonatal herpes.
< 0.1% of babies in US develop neonatal herpes
20-25% pregnant women have genital herpes.
Risk is low

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16
Q

Stages of Syphilis

A

Primary stage

  • Painless sore ( chancre) at bacteria entrance site.
  • Commonly occurs within 3 weeks of exposure
  • Highly infectious

Secondary stage
-Rash 2 - 8 weeks after chancre develops; sometimes before it heals

Latent (hidden) stage
-If untreated, progress to the latent stage
-No symptoms
(Immune system fights off pathogen and it goes into hiding. Any lapse in immune system due to illness can cause reemergence of the bacteria)

Tertiary (late) stage

  • Gummata (large sores inside the body/on skin)
  • Cardiovascular syphilis (heart, BVs)
  • Neurosyphilis (nervous system)
17
Q

Serotype

A

Distinct variation within a species of bacteria or virus or among immune cells of different individuals

18
Q

Serotypes of Herpes

A

Type 1 - affects oral originally (HSV-1)
Type 2 - affects genital area originally (HSV-2)
Now affects both areas.

19
Q

Trichomonas vaginalis

A

Parasite (virulence factor - heavily flagellated)

Specimen - urine, vaginal + urethral swab

20
Q

Swab samples - immediate processing

A

Cotton material at tip of swab - can destroy organisms (not proper environment to be viable); must process quickly

21
Q

Vaginitis

A

Vaginal inflammation; may be due to vaginosis

22
Q

Wet mount procedure for vaginal infections (vaginosis)

A

Sample of vaginal discharge is placed on a glass slide and mixed with a salt solution.
Slide is looked at under a microscope for bacteria, yeast cells, trichomoniasis (trichomonads), white blood cells that show an infection, or clue cells that show bacterial vaginosis.

23
Q

Vaginosis etiology

A

Gardnerella vaginalis and Mycoplasma hominis - bacteria
Candida albicans (candidiasis) - yeast
Trichomonas vaginalis infection (trichomoniasis) - parasite (sexually transmitted)

24
Q

Gold standard for vaginosis diagnosis

A

Direct examination via wet mount/gram stain

25
Q

Wet mount procedure

A

Sample of vaginal discharge is placed on a glass slide and mixed with a salt solution.
Slide is looked at under a microscope for bacteria, yeast cells, trichomoniasis (trichomonads), white blood cells that show an infection, or clue cells that show bacterial vaginosis.

26
Q

Wet mount results

A

Bacterial vaginosis

  • “clue cells,” cells from vaginal lining coated by bacteria.
  • few to no white blood cells (WBCs)

Candida
-budding yeast and/or tube or branch-like structures (pseudohyphae)

Trichomonas
-oval bodies with flagella that move.
> WBCs may also be seen

27
Q

Gram stain - vaginosis procedure

A

Vaginal fluid is placed on a glass slide and stained with a special dye (Gram stain)
Evaluation is based on the quantity of each type of bacteria.

28
Q

Gram stain - vaginosis results

A

If 20% or more of the cells from the vagina lining are covered by bacteria (“clue cells”), -bacterial vaginosis

Yeast cells detected with a Gram stain

Trichomonas is not detected by this method.

29
Q

Syphilis tests - Diagnosis

A

Rapid plasma reagin (RPR), a syphilis blood test that looks for antibodies to the syphilis bacteria.
(VDRL) test, which also checks for syphilis antibodies. A VDRL test can be done on blood or spinal fluid.

30
Q

Syphilis - Treatment

A

Penicillin
Tetracycline
Erythromycine - if patient sensitive to penicillin

31
Q

Gonorrhea - etiology

A

Neisseria gonorrhoeae

32
Q

Neisseria gonorrhoeae - lab ID

A

Gram neg cocci
chocolate agar
Glucose test +ve
Motile

33
Q

Gonorrhea - Treatment

A

Azithromycin

Ceftriaxone - if resistant

34
Q

CPE

A

Cytopathogenic effect (CPE) - structural changes in host cells caused by viral invasion.

35
Q

CPE is used to culture Herpes (T/F)

A

True

Clinical Cases (2 decks)

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