Week 4 - GU Infxns Flashcards
Herpes simples virus (HSV)
large double strand DNA, encapsidated
has lytic and latent cycles, is for life
HSV-2 is the genital one, has a 25% chance of shedding on any given day
can get neonatal herpes, which is super bad, but rare
dx: vesicles, ulerations, pcr, antibodies, etc
Tx: famciclovir
Molluscum contagiosum
poxvirus, double strand DNA, replicate only in cytoplasm
usually cleared in less than 12mo
dx: small nodular wart-like lesions, large eosinophilic cytoplasmic inclusions (molluscum bodies)
non-painful, limited to skin
Tx: remove nodules physically, wait
Human papillomavirus (HPV)
small double stranded DNA, capsid, many subtypes
replication is in the skin, basal layer of epithelium
integration into host DNA, viral E6, E7 genes causes high risk strain into cancer
dx: warts, pap spear
Tx: wart destruction, vaccine
Haemophilus ducreyi
pleomorphic G- rods
dx: chancroid, tender papules that progresses to painful ulceration and lymphadenopathy
Tx: azithromycin, ceftriaxone, cipro
Gardnerella vaginalis
pleomorphic G- rods
part of normal vaginal flora, disruption can lead to overgrowth
dx: vaginitis, pruritis, dysuria, fishy odor, copious discharge
clue cells
Tx: metronidazole, clinda
Ureaplasma urealyticum
mycoplasma, no cell wall, produces urease
dx: carried frequently, dysuria, yellow mucoid discharge, PCR,, diagnostic ammonia SMELL
Tx: erythromycin, doxycycline
Treponema pallidum
Syphilis
G- spirochete, flagella
primary: painless chancre, highly infxious
secondary: hematogenic spread, rash, fever, lyphadenopathy, CNS infxn, etc, condyloma latum, palmar lesions
Latent: asymptomatic, can relapse into secondary
tertiary: caused by immune rxn, cardiovascular, CNS sx
also can have congenital syphilis, real bad, not harmful until 4th month of preg,
dx: darkfield microscopy, serologic testing
Tx: penicillin
Chlamydia trachomatis
G- intracellular, hard to see on gram stain
Elementary body: infectious but not divide
Initial body: intracellular, can divide
non-gonococcal urethritis: many asymptomatic, dysuria, mucoid discharge, similar to gonorrhea
can cause PID, scrotal swelling, lymphogranuloma venereum, reiter’s syndrome
dx: PCR (along w gonorrhea)
Tx: azithromycin, ceftriaxone, doxycycline
most common bacterial STD in US
Neisseria gonorrheae
G- oxidase+ diplococci, no capsule males: urethritis, painful urination, purulent discharge, epididymitis, prostatitis, urethral strictures females: urethritis, endocervitis, PID can have bacteremia, septic arthritis infants: ophthalmia neonatorum dx: pcr Tx: ceftriaxone reinfection is posible
Trichomonas vaginalis
protozoa, 4 flagella
most males are asymptomatic, mild watery discharge in females, can also lead to vaginitis, painful urination
dx: microscopic exam of vaginal discharge
Tx: metronidazole
Candida albicans
yeast vaginitis= overgrowth of endogenous population vaginal itching and thick discharge dx: KOH prep of scraping Tx: imidazole or fluconazole
TORCH
perinatal infections toxoplasma other: syphilis, parvo B19 rubella CMV herpes (HSV)
Toxoplasma gondii
parasite, reservoir in cats,, also undercooked meat
usually asymptomatic or mild
acute infxn during pregnancy: 1st trimester= abortion, later= many bad sx in the infant- micro or hydrocephaly
dx: serology
Tx: pyrimethamine(teratogen), clindamycin
Rubella
single strand RNA togavirus respiratory transmission, rash is caused by immune complexes "slapped cheek" dx: PCR, serology Tx: none can be congenital which can be bad
Parvovirus B19
erythema infectiousum, fifth disease
small single strand DNA
viremia, flu-like, rash caused by immune complexes, causes temporary halt in erythroid mitosis
pt is no longer infectious when rash appears
dx: PCR or serology
Tx: none
can be congenital
