Urethritis and Cervicitis

Question 1

Reiter Syndrome

Answer 1

Clinical triad = urethritis, conjunctivitis, arthritis

Question 2

Most common

Answer 2

Chlamydia>Gonorrhea>HPV (Ag recomb common)

Question 3

Neisseria Gonorrhea

Answer 3

ureth/cerv, PID

gram neg diplococci, faculatative anaerobe, glucose fermentor, oxidase +, catalase +

VF:pili, siderphores, IgA1 protease, facultative intracell, LOS (LPS w/o O antigen - IC disease)

Culture = chocolate agar (Thayer-Martin = spec for neis), NAATS (PCR) - for STDs

Mucopurulent discharge (with neutrophiles), cervix tender, partuition (neonatal conjunc)

VCN: Vancomycin, colistatin, nystatin

Question 4

Chylamidia Trach (D-K)

Answer 4

NGU/cerv, PID, thin discharge

Gram neg diplococci, lacks peptidoglycan and muramic acid, non motile with pili, acid from glucose

Causes inclusion conjunctivitis - corneal scar and blind

Obligate IC bact = no ATP prod

2 forms: EB (enters cell) RB (reps)

Diag - no stain - DFA

Tx: tetracyclin and macrolides

Question 5

Ureaplasma spp.

Answer 5

Ureth with thin discharge and renal calculi
Cell wall less bact, non gram stainable
Diag: brown colonies on A8 agar, urease +, precipitates Mg, needs cholesterol to grow
Part of local flora so rule out trach and NG

Question 6

Fitz Hugh Curtis Syndrome

Answer 6

Extension of PID - acute periphitis and perihepatitis spreads from f tubes. violin string adhesions btwn peritoneum and liver capsule