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Urogenital/HIV Flashcards

1
Q

Pol gene

A

Polymerase

  • Reverse Transcriptase
  • Integrase
  • Protease
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2
Q

T. pallidium pertenue

A

Yaws

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3
Q

Immune Reconstructive Inflammatory Syndrome (IRS)

A

Paradoxical worsening of pre-existing infectious process following initiation of HAART in HIV pt

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4
Q

Streptococcus saprophyticus

A

Non-motile
Coagulase-ve, catalase -ve
Novobiocin resistant
Urease +ve (contributes to struvite formation)
ROS: uncomplicated UTI in young sexually active women aka “Honeymoon cystitis”

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5
Q

Kaposi’s Sarcoma

A

CD4 < 500
Etiology: HHV-8
Pathogenesis: tumor of blood vessel walls
ROS: pink/red/purple lesions on skin and mouth (can affect GIT and lungs too)

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6
Q

HPV

A 
Condylomata acuminatum (6 and 11) mucosal membranes
Oncogenic subtypes (16 and 18 via e6 and e7 inactivating RB and P53 respectively)
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7
Q

Env gene

A

Envelope glycoproteins

  • gp41 - transmembrane glycoprotein (facilitates co-receptor binding w/ CCR5 on MΦ or CXCR4 on Th cells)
  • gp120 - surface glycoprotein (binds to CD4)
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8
Q

UPEC virulence factors

A

Type I fimbriae: attach to mannosylated proteins (can detach by exposure to mannose aka mannose sensitive)
P adhesin: attach to glycophospholipids, assoc. w/ pyelonephritis

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9
Q

CD4 < 50

A

MAC (mycobacterium avian complex)

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10
Q

HSV-2

A

2 cause of cervicitis

Pathogenesis: cytolytic, fast replicating, latency in sacral ganglion, virus shed during replication
ROS: cluster of tender/painful lesions w/ tender lymphadenopathy
Diagnosis: Tzanck smear w/ multinucleated giant cells and Cowdry bodies (intranuclear inclusions)

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11
Q

HIV Pathogenesis

A

Syncytia formation, tropism for CD4 T-cells and MΦ, transported to LNs by MΦ or dendritic cells, downregulation of MHC, ag variation, masking of target epitopes

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12
Q

Leismhmania donovani

A

Transmission: usually sandfly vector but could be via needle sharing or blood transfusion too
ROS: disseminated visceral leishmaniasis (wt loss, fever, hepatosplenomegaly, anemia/pancytopenia)

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13
Q

Vulvovaginal Candidiasis

A

2 cause of vaginitis

Pathogenesis: directional hyphae growth (thigmotropism), dimorphism, biofilm formation, adhesins (Als3), hydrolases, siderophores
ROS: puritis, curdlike d/c, satellite lesion
Dx: KOH prep, pH in nml range

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14
Q

Trichomonis vaginalis

A

Flagellated protozoa w/ undulating membrane
Pathogenesis: lacks mitochondria (has hydrogenosome for anaerobic metabolism/fermentation)
ROS: usually asymptomatic; frothy d/c, gray or yellow-green color, strawberry cervix
Dx: motile trophozoites on microscopy
*increased susceptibility for HIV infection

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15
Q

Bacilliary angiomatosis

A

Etiology: Bartonella hensleae
Pathogenesis: obligate intracellular triggers proliferation and persistent infection of endothelial cells and RBCs
ROS: initially appears as purplish to bright red skin patches (resembles Kaposi’s Sarcoma)

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16
Q

CD4 < 100

A 
Toxoplasma gondii 
Cryptococcus neoformans
Cryptosporidium parvum 
CMV
*CD4 from 50-100
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17
Q

Neisseria gonorrhoeae

A

Pathogenesis: Type IV pili for adhesion(ag variation for recurrent infection), IgA protease, β-lactamase, LOS (PMN infiltrate)
ROS (cervicitis): purulent d/c, dysuria, dyspareunia, PID
Dx: modified Thayer-Martin agar (DON’T refrigerate swabs); G-ve diplococci in dead PMNs

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18
Q

AIDS definition

A
  • CD4 < 200

* 2 AIDS defining illnesses regardless of CD4 count

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19
Q

Non-specific Treponemal Screening tests?

A

VDRL and RPR: heterophile Ab’s against cardiolipin-cholesterol-lecithin ag

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20
Q

UPEC Pathogenesis

A

IBC: intracellular biofilm community
Quiescent reservoirs: metabolically inactive organism hiding in epithelial cells, the differentiation of the cell wakes the bacteria and this leads to recurrence of infections

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21
Q

Non-Hodgkin’s Lymphoma

A

Predisposing infections: HTLV-1, HCV, EBV

Pathogenesis: originates in lymphocytes usually in LNs

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22
Q

T. palladum carateum

A

Pinta

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23
Q

Paradoxical IRIS (AIDS pt)

A

Worsening of recognized pre-existing infection

24
Q

Tuberculosis (AIDS assoc.)

A

1/3 of AIDS pt’s have TB too, leading COD in ppl living w/ AIDS

25
Nugent's Criteria
Gram stain of vaginal swab: mixed flora w/ absent or low Lactobacilli indicxates BV *Abnormal Nugent score = 10
26
Specific Treponemal Test:
FTA-ABS: fluorescent Treponemal Ab absorbed test TP-PA TPHA MHA-TP
27
Pneumocystis jirovecii
CD4 < 200 Pathogenesis: CW contains chitin and glucan ROS: interstitial pneumonitis w/ mononuclear infiltrate, dyspnea, nonproductive cough; extrapulmonary lesions in RES Dx: bronchioalveolar lavage (BAL) w/ silver stain or toluidine blue (disc shaped clusters seen on microscopy) CXR: ground glass
28
Klebsiella granulomatis
Clinical manifestation: ulcer Pathogenesis: Donovan bodies (intracellular inclusions w/in macrophages) ROS: beefy red suppurative PAINLESS ulcer w/ expanding borders that tend to bleed easily Diagnosis: Giemsa stain (bc intracellular) or tissue-based culture would show "safety pin" appearance
29
T. paallidum endemicum
Bejel
30
Proteus vulgaris
Hyperflagellate (swarming motility) Urease +ve Phenylalanine delaminates (contributes to struvite stone formation) H2S production Dx: rose-like pattern on agar d/t type of motility
31
CMV (in AIDS pt)
Pathogenesis: est latent infection in mononuclear lymphocytes and stromal cells of BM, activated when CD4 levels drop ROS: retinitis in eyes (can lead to blindness), GIT sx's, pneumonia, other organs affected too
32
Klebsiella pneumoniae
``` #2 cause of uncomplicated UTIs and #3 cause of complicated UTIs Clinical manifestation: UTI, struvite stone (Urease +ve) Pathogenesis: large polysaccharide (mucoid) capsule, pili, LPS, carbapenemase ```
33
Chlamydophila trachomatis (L1-L3)
Clinical manifestation: Lymphogranuloma Venereum (LGV) Pathogenesis: obligate intracellular (EB is infectious, RB is replicative) ROS: painful buboes (nodules that ulcerated), enlarged painful LNs can form fistulas
34
MAC (complex)
AIDS defining illness complex of M. avium and M. intracellularae ROS: cough, RES sx's, night sweats, wt loses, fatigue, diarrhea, anemia *CD4 < 50
35
HBV and HCV (in AIDS pt)
HIV + hepatitis = more likely to develop liver toxicity from meds (bc they're metabolized in the liver)
36
CD4 < 500
Candida albicans Kapok Sarcoma (HHV-8) *CD4 from 200-500
37
Western Blot for HIV
Only used for screening blood from blood donors
38
HIV Lifecycle
1. Binding to CD4 and CCR5 (or CXCR4 later in dz), fusion of membranes and virus injected into cell 2. RT converts HIV RNA to dsDNA then transported to nucleus and integrated into host genome by integrase = provirus 3. Provirus uses host RNA pol to transcribe mRNA makes HIV proteins and new virus self-assembles 4. After budding from host cell protease cuts the proteins into smaller functional proteins
39
Bacterial Vaginosis
Pathogenesis: overgrowth of anaerobes d/t unbalanced pH bc of imbalance of Lactobacilli + biofilm formation by causative organisms Etiology: Gardernella vaginalis ROS: thin grey/milky white malodorous d/c (fishy smelling) and is adherent to vaginal walls
40
Composition of struvite stones?
Ammonium-magnesium-phosphate
41
Gag gene
Group specific antigens (core and capsid proteins) * P17 - matrix protein * P24 - capsid protein * P7P9 - nucleocapsid protein
42
Treponema pallidum
Spirochete Pathogenesis: endoflagellum (motility), hydrogenosome for fermentation (like Trichomonas), attaches to fibronectin, highly liphilic (immune evasion), immunopathogenic Dx: darkfield microscopy (or screening and specific tests)
43
Clue cells
Sloughed epithelial cells coated w/ bacteria (namely Gardernella)
44
Salmonella
G-ve, motile, produces H2S, encapsulated Transmission: reptiles, poultry, dairy Pathogenesis: invades SI, travel through BM to lamina propria and enters blood stream ROS: inflammatory diarrhea (more severe dz in AIDS pt) Sequelae: chronic carrier state (shed from gallbladder) Prevention: polysaccharide vaccine
45
Amstel Criteria
Diagnoses: bacterial vaginosis Vaginal pH >4.5 Wet mount: clue cells > 20% per HPF +ve amine or "whiff" test
46
Unmasking IRIS (AIDS pt)
Worsening of unrecognized pre-existing infection
47
Haemophilus ducreyi
Clinical manifestation: Chancroid Epidemiology: Asia, Africa, Caribbean Pathogenesis: cytolethal distending toxin kills T cells ROS: ragged/soft PAINFUL ulcer, tender regional lymphadenopathy Diagnosis: Factor X (fastidious growth) on Chocolate agar, "railroad tracks" arrangement of colonies
48
Lactobacilli
Protective against overgrowth of G-ve rods causing BV, produce lactic acid to maintain pH, H2O2 produced to maintain low pH
49
Cryptosporidium parvum
CD4 < 100 Transmission: recreational water Pathogenesis: ingestion of oocyst that releases 4 motile sporozoites when it gets to SI, then it invades the epithelium and develops into trophzoite ROS: profuse watery diarrhea (> 50 BMs per day), severe abd pn Dx: oocysts on modified Ziegler-Neelson
50
Viral Load vs. CD4 Count
Viral load is cheaper and easier to monitor, suggests how rapidly dz occurs (monitors therapy), rises initially upon infection then goes down
51
CD4 < 200
``` Pneumocystis jirovecci (PCP) Histoplasma capsulatum Coccidiodes immitis JC virus (PML) *CD4 from 100-200 ```
52
Chlamydophila trachomatis (D-K)
Clinical manifestation: #1 cervicitis, #2 urethritis (non-gonococcal), #2 PID Pathogenesis: obligate intracellular; EB (infectious) and RB (replicative) ROS: watery d/c, dysuria (burning) [men - itchy penis] Dx: NAATs (or Giemsa? cuz intracellular)
53
Syphilis
Primary: painless chancre Secondary: condylomata lata (highly infectious), copper/bronze rash involving palms and soles Tertiary: tabes dorsalis, CVS and CNS sx's
54
Mycoplasma genitalium
#3 urethritis (non-gonococcal) Structure: lacks CW, has sterols in outer membrane Pathogenesis: MgPa tip adhesins, produces H2O2 and superoxides (damage tissue), lipoproteins (evade host defenses) ROS: urethritis (non-specific sx's)
55
Toxoplasma gondii
CD4 < 100 Transmission: ingestion of oocytes via cats or undercooked meat Pathogenesis: reactivation of cysts ROS: CNS sx's (focal encephalitis w/ HA, fever, confusion, motor weakness) Dx: proliferating tachyzoites surrounded by liquefactive necrosis CT: ring enhancing lesions in brain

Microbiology (14 decks)

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