UGI 3 Flashcards

1
Q

common site of gonorrhea infection in men and women and associated symptom

A

men: urethra; purulent urethral discharge
women: cervix; vaginal discharge

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2
Q

clinical presentation of gonorrhea

A

vaginal and urethral discharge, erosive vesiculobullous lesions, mucopurulent gonococcal cervicitis

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3
Q

features of neisseria gonorrhea

A

gram neg diplococci, non motile non spore forming, fastidious, oxidase positive,

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4
Q

virulence factor of neisseria gonorrhea

A

pili, Opa, por protein, LOS, iron binding protein

LIPOP

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5
Q

pathogenesis of neisseria gonorrhea

A

it binds to columnar epithelial cells of distal cervix or urethra using PILI and outer surface proteins then multiplies

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6
Q

in women gonorrhea spreads to the fallopian tube. how does it spread if its not motile?

A

uterine or urethral contractions

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7
Q

what can chronic infections of neisseria gonorrhea lead to

A

scarring and stricture of fallopian tube or urethra

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8
Q

how do you diagnose gonorrhea

A
  1. intracellular gram neg diplococci for women only
  2. non culture lab test
  3. thayer martin or chocolate agar with oxidase pos colonies
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9
Q

treatment of gonorrhea

A

250mg single dose of ceftriaxone together with 1g oral azithromycin

-there is resistance to fluoroquinolones so can only see cephalosporin (beta lactamase resistant)

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10
Q

when treating gonorrhea what else do you treat for

A

chlamydia since a good portion of people have both

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11
Q

increases the transmission of HIV

A

bacterial vaginosis, trichomoniasis, gonorrhea, chlamydia

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12
Q

most commonly reported notifiable disease

A

chlamydia

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13
Q

chlamydia trachomatis is associated with what disease

A
conjunctivitis, infant pneumonia, urogenital disease (D-K)
lymphogranuloma venerum (LGV1, 2, 3)
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14
Q

since chlamydia is mostly asymptomatic, it often goes untreated. What could happen if chlamydia goes untreated in women

A

they can develop PID (pelvic inflammatory disease) which leads to infertility, ectopic pregnancy, chronic pelvic pain

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15
Q

what happens if men have chlamydia that goes untreated (though this is rare)

A

epididymitis and urethritis

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16
Q

features of chlamydia

A
  • gram neg but atypical bacteria
  • infectious form - elementary bodies
  • replicative/non infectious form - reticulate bodies
  • obligate intracellular
  • gains entry via ulceration and laceration
17
Q

why can’t you view chlamydia with a gram stain although it is gram neg

A

it is atypical in that it is intracellular

18
Q

receptors for elementary bodies

A

– mucous membranes of the urethra
– endocervix, endometrium, fallopian tubes
– anorectum
– respiratory tract and conjunctivae

19
Q

specimen used for testing in chlamydia

A
  • urine or swab from urethra if male and vagina or endocervix if female
  • for those that engage in anal or oral sex, rectum and oropharynx swab
20
Q

best test for chlamydia

A

NAAT (like in trichomoniasis)

21
Q

why are swabs and not exudate used as specimen for chlamydia

A

because it is an intracellular parasite

22
Q

treatment for chlamydia

A
  • azithromycin 1g orally, single dose

- doxycycline 100mg orally 2x/day for 7 days