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Repro/Endo FInal > Ulcerative STDs and Non-ulcerative STDs > Flashcards

Ulcerative STDs and Non-ulcerative STDs Flashcards

1
Q

characteristics of spirochetes

3 kinds

A

spiral shaped
corkscrew mobility
don’t gram stain
grow slowly or not at all in vitro

treponema
borrelia
leptospira

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2
Q

haemophilus ducreyi

A

gram - coccobacilli
needs chocolate agar
causes CHANCROID

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3
Q

chancroid

A

soft chancre caused by h. ducreyi

– ragged ulcer on genitalia with swelling and tenderness; regional LN are often enlarged and tender

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4
Q

treponema

A

spirochete w no cell wall!
susceptible to penicillin

cannot grow in culture and cannot gram stain
-causes SYPHILLIS

see w darkfield microscopy, fluorescent antibody staining (DFA-TP), or silver stains

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5
Q

borrelia

A

zoonotic spirochete
visualize with giemsa or wright stain
CAN be cultivated!

causes lyme disease

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6
Q

leptospira

A

zoonotic spirochete
use darkfield or silver stains
can be grown

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7
Q

primary syphilis

A

primary lesion is a chancre due to treponema
 heals spontaneously without treatment but the systemic infection persists in an asymptomatic form
 Increased risk of HIV

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8
Q

secondary syphilis

A

lesions weeks later –> papulosquamous rashes (palms and soles), mucous patches (tongue), and genital lesions (condyloma lata)
 heal spontaneously without treatment, but the systemic infection persists in an asymptomatic form

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9
Q

tertiary syphilis

A

lesions develop years after infection
 targets include the CNS (neurosyphilis, meningovascular syphilis), CV system (syphilitic aortitis), and late benign syphilis (gummas)

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10
Q

diagnosing syphilis

A

Darkfield microscopy and Direct fluorescent antibody staining
o **CULTURES ARE NOT USEFUL for syphilis

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11
Q

treatment for syphilis (T pallidum)

A

penicillin G

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12
Q

distinguishing three bacterial STDs

gonorrhoeae, chlamydia, and mycoplasma/ureaplasma

A 
Neisseria gonorrhoeae (gram negative diplococci)
Chlamydia (obligate intracellular)
Mycoplasma/ureaplasma (no cell wall)
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13
Q

neisseria gonorrhoeae

A

gram - diplococci
requires CO2
high antigenic variation allows rapid antibiotic resistance

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14
Q

neisseria gonorrhoeae virulence factors

A

colonization pili
transferrin, lactoferrin, and hemoglobin binding proteins
IgA1 protease
Opa (opacity) protein ligands

down regulate complement activation due to lack of capsule!

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15
Q

• Gonococcal Urethritis

A

frequent, urgent and painful urination with a yellow mucopurulent discharge

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16
Q

• Opthalmia Neonatorum

A

purulent conjunctivitis in newborn, can cause blindness; acquired during passage through birth canal

17
Q

Curtis-Fitz-Hugh Syndrome

A

gonococcal dissemination into the peritoneum from the fallopian tubes and lead to perihepatitis

18
Q

Gonococcal Upper reproductive Tract Infections (Male)

A

o Epididymitis; unilateral pain and swelling with low grade fever and chills; can also have painful urination, discharge from urethra, and blood in semen; pain on ejaculation

19
Q

• Disseminated Gonococcal Infection (DGI)

A

hematogenous spread to skin and joints causing dermatitis, gonococcal arthritis, and endocarditis

20
Q

what is a risk factor for disseminated gonoccoccal infection?

A

complement deficiency

21
Q

• How can gonococci disseminate through bloodstream without a capsule?

A

o Porin-mediated serum resistance (2 porin types: P1A and P1B)

o Sialylation of gonococcal lipooligosaccharide (LOS) – by gonococcal sialyltransferase

22
Q

How does gonorrhoeae damage the fallopian tubes?

A

o They adhere and directly damage w LOS and peptidoglycan

23
Q

• Gonococci can REVERSIBLY ADAPT with varying surface molecules due to….

A

variable expression of 3 surface molecules

  • -colonization pili
  • -opacity (opa) proteins
  • -LOS (lipooligosaccharide)
24
Q

antigenic variation of colonization pili in gonorrhoeae

A

changes in pilin expression –> immune evasion; pilin variation is due to recombination

antigenic variation allows repeated infections!

25
Q

gonorrhea incubation requirements

A

chocolate agar
37 degrees
5% CO2

26
Q

gonorrhea treatment

A

ceftriaxone and azithromycin

27
Q

three types of chlamydia

A

o C. pneumoniae – community acquired pneumonia
o C. psittaci – atypical pneumonia, endocarditis
o C. trachomatis — serovars are based on antigenic differences in the major outer membrane protein (MOMP)
–Serovars A-C = conjunctivitis, trachoma
–Serovars D-K = urethritis, cervicitis, inclusion conjunctivitis
–LGV serovars L1-L3 = lymphogranuloma venereum

28
Q

chlamydia

  • description
  • forms
A 
obligate intracellular bacteria
cell envelope similar to gram negative bacteria BUT no detectable peptidoglycan
o	EB (elementary body) – small, extracellular infectious form; metabolically inactive
o	RB (reticulate body) – large, intracellular replicative form; metabolically active
29
Q

• Chlamydial Urethritis – Nongonococcal Urethritis (NGU)

A

frequent urgent and painful urination

Usually asymptomatic with clear discharge (not purulent) in men

30
Q

most common cause of non-gonococcal urethritis?

2nd most common?

A

Most common cause of NGU = Chlamydia trachomatis D-K (DicK)

second most common cause is ureaplasma urealyticum

31
Q

reiters syndrome

A

urethritis, conjunctivitis, and polyarthritis

d/t chlamydia

32
Q

o Infant inclusion conjunctivitis

A

acquired at birth from mother; acute mucopurulent discharge, erythema, and edema; silver nitrate prophylaxis is NOT effective

33
Q

• Chlamydia trachomatis LGV infection (ulcerative STD)

A

tropism for lymphoid cells rather than epithelial cells; painless primary lesion  regional lymphadenopathy 1-6 weeks later  abscess formation necrotic foci =

34
Q

treatment for chlamydia

A

azithromycin or tetracycline/doxycycline

o Infant conjunctivitis: oral erythromycin

35
Q

mycoplasma / ureaplasma

A

cause nongonococcal urethritis (NGU)
• Mycoplasma has no cell wall!
• Lab diagnosis: inoculate medium (PPLO)  colonies appear

36
Q

nonoxynol-9

A

a spermicide that kills HIV but damages tissues so increases risk of STI!!!! BAD

37
Q

• Gonorrhea increases transmission of HIV

how?

A

increases HIV viral load
and
inflammatory response brings in susceptible immune cells

38
Q

vaccine for gonorrhea or chlamydia?

A

no

Repro/Endo FInal (23 decks)

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