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Microbiology > Ulcerative lesions > Flashcards

Ulcerative lesions Flashcards

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Biology 101 flashcards
1
Q

What are the 2 groups STD are divided into?

A
  1. Mucopurulent discharge (gono/chlamydia)
  2. ulcerative lesions (for these travel history is a good diagnostic tool because many of the signs and symptoms are similar)
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2
Q

LGV characteritics

A

rare in US

  • common in developing countries (africa, asia, south america)
  • person is often infected with another STD (co-infection)

swollen lymph nodes of groin area

  • painless ulcer (primary stage)
  • painful bubo forms (secondary stage)
  • genital ulcers (tertiary stage - rare)
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3
Q

Diagnosing LGV

A

(since its a chlamydia bacterium) its obligate intracellular and won’t appear on gram stain
*use nucleic acid amplification assay

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4
Q

causative agent of klebsiella granulomatis

A

gram negative rod

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5
Q

virulence/pathogenic factor klebsiella granulomatis

A

Donovan bodies

vacuole within PMN or plasma cell (where the organism multiplies)

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6
Q

what is the ulcer like in klebsiella granulomatis

A
  • painless
  • bleeds on contact
  • beefy red, granulomatous heaped ulcer

(would not be like herpes ulcers - bc those are painful)

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7
Q

complications of klebsiella granulomatis

A

if lesions are advanced - carcinoma can develop

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8
Q

4 progressive phase of presentation - klebsiella granulomatis?

A
  1. ulcerogranulomatous
  2. hypertrophic
  3. necrotic foul smelling ulcer
  4. sclerotic – formation of fibrous and scar tissue
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9
Q

What organism can cause a Chancroid infection?

A

Haemophilus ducreyi

predominantly a male disease - MSM

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10
Q

characteristics of Haemophilus ducreyi?

A
  • gram (-) rod
  • oxidase positive (like Neiserria)
  • humans are the reservoir
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11
Q

Describe the Ulcers seen in someone with Chancroid

A
  • VERY PAINFUL! after 3-5 weeks (not initially though)
  • ragged boarder
  • could be covered in yellow or gray necrotic exudate - it’s highly contagious)
  • if it spreads to the inguinal lymphnodies, they can become so swollen that they can rupture upon touch
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12
Q

Diagnosing Chancroid

A

unless you can isolate the H. ducreyi from lesion,

use negative deduction: rule everything else out and determine that they were not traveling

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13
Q

Chancroid epidemiology

A 
Probably underreported
Minority populations
African-American
Hispanics
Heterosexuals
Female prostitutes and clients
-on the decline (high when aids was prevalent)
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14
Q

Describe the syphilis ulcer?

A
  • PAINLESS (so silent transmission is an issue)
  • chancre (sore/ulcer at site of entry of pathogen)
  • indurated (hardened)
  • well circumscribed
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15
Q

What organism causes syphilis and what are its characteristics?

A

Treponema pallidum
-spirochete (thin, can’t see on gram stain, need to use silver stain)
-cannot culture (needs host to survive)
-

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16
Q

How is syphilis transmitted?

A
  • CONTACT (through sexual contact)

- CONGENITAL (during birth)

17
Q

Can you discuss the epidemiology of syphilis?

A
  • trending up, more males affected than females
  • highest incidence in 20-24 year old males/females
  • blacks have the highest incidence
  • Spike in secondary syphilis in men sexing men
18
Q

Are there different stages of syphilis?

A

YES.

Primary, Secondary, Latent, and Tertiary

19
Q

Primary syphilis

A
  • ulcers develop at the site where the organism landed
  • incubation is 3 weeks
  • regional lymphadenopathy (swollen glands)
  • heals in 1-6 weeks after incubation
20
Q

Secondary syphilis

A
  • infection has entered the blood stream
  • flu like symptoms
  • highly infectious at this point (but it can resolve spontaneously in a few weeks so they may never seek any treatment
21
Q

what are symptoms associated with secondary syphilis?

A
  • characteristic rash (not raised) found on soles of feet and palms of hands (DON’T SHAKE THEIR HAND!) - rash could even cover entire body
  • usually the rash resolves on its own in a few weeks and this indicates the patient has entered the latent (recovery phase)
  • alopecia (hair falls out in chunks)
  • condylomas: soft, fleshy papules (elevations of the skin), these are infectious, found in genital region
  • lymphadenopathy
22
Q

How long could the latent stage last?

A

-recovery phase could last from 3 years to 30 years

the phase usually begins anytime from 3 weeks to 3 months *after the *secondary phase

23
Q

Tertiary syphilis

A
  • it’s a delayed hypersensitivity reaction?
  • one third of people not treated progress to this phase 3 to 15 years later
  • Not infectious at this point (its the body’s reaction causing the symptoms), so no congential transmission (very rare)
24
Q

Tertiary syphilis complications

A

Neurological symptoms:

  • destruction of parenchyma (demenia
  • meningitis
  • optic atrophy (going blind)
  • meningovascular damage (spinal column damage)

Cardiovascular symptoms:

  • *-thoracic aortic aneurysm
  • aortitis
  • aortic endocarditis
  • can see the aortic calcification on an x-ray!

Gummas:

  • soft tumor-like balls of inflammation in bones, skin and other tissue
  • granulomatous lesions
25
Q

Congenital syphilis?

A

oh man :(
-the mother can infect her child during birth if she isn’t treated before giving birth

Early congenital syphilis:
(you will start noticing symptoms before 2 years old):
-extensive skin lesions
-snuffles (rhinitis)
-teeth and bone malformations
-Anemia, hepatosplenomegaly, CNS disease
* - early evidence of infection - bullae and vesicular rash (bottom of foot!!)

Late congenital syphilis (baby is older than 2 years):

  • deafness (8th nerve)
  • raspberry molars
  • sabre shins
  • saddle nose
  • cutaneous gummas
26
Q

How can one diagnose syphilis?

A

(its tough to detect early on: use visual id of symptoms or blood tests (wont tell you which stage)

blood tests are divided into non-treponemal and treponemal

  1. non-treponemal test (used initially):
    RRR (rapid plasma reagin), VDRL (venerial disease research lab)
  • only give you a hint, must further confirm
  • many causes of false positives (autoimmune disease, heart issues, little old ladies,
  • cheap, quick, easy
  1. Treponemal test
    treponemal pallidum particle agglutination (TPHA)
    fluorescent treponemal antibody absorption test (FTA-Abs)
  • use for confirmation (antibody tests take 2-5 weeks)
  • a positive result is NOT an indication of an ACTIVE infection
  • 99% right, but there are false positives (1%): HIV, AIDS, pregnant females, narcotic addicts, lyme disease, neonate of infected mother (has the IgG)
27
Q

Could you treat syphilis?

A

Yeah give penicillin at any stage!

Microbiology (9 decks)

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