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PHARM 232 Final > STD's & other genital tract infections > Flashcards

STD's & other genital tract infections Flashcards

1
Q

Differentiate between exogenous infections and endogenous

A

Exogenous: acquired through sexual activity STI

Endogenous: caused by normal genital flora

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2
Q

Role of normal flora?

A
  • prevent adherence of pathogenic organisms
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3
Q

What can strep. agalactiae lead to in neonates?

A

Bacteremia
Sepsis
Meningitis
Pneumonia

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4
Q

In lower genital tract infections what bacteria can cause dysuria (3)

A
  • N. gonorrhoea
  • Chlamydia
  • Herpes simplex virus
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5
Q

In lower genital tract infections what bacteria can cause urethritis

A

N. gonorrhoea
Non-gonococcal
- can be caused by chlamidya, trichomonas vaginalis, & mycoplasma genitalium

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6
Q

Vaginal candidiasis
Bacteria caused by?
Vaginal discharge properties?
Odour properties?
Microscopy properties?

A

Bacteria caused by?
- Candida albicans

Vaginal discharge properties?
- increased, white, cottage cheese

Odour properties?
- yeasty or no odour

Microscopy properties?
- KOH preparation showing budding yeasts and pseudohyphae

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7
Q

Is Vaginal candidiases considered an STI? why?

A

No, it is an endogenous bacteria
- caused by normal flora (not always infectious)

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8
Q

Trichomononiasis
Bacteria caused by?
Vaginal discharge properties?
Microscopy properties?

A

Bacteria caused by?
Trichomonas vaginalis

Vaginal discharge properties?
- yellow, green, frothy (small bubbles)

Microscopy properties?
- many polymorphonuclear leukocytes (PMNs)

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9
Q

Bacterial vaginosis
Bacteria caused by?
Vaginal discharge properties?
Microscopy properties?

A

Bacteria caused by?
Gardnerella vaginallis
- caused when you kill lactobacteria

Vaginal discharge properties?
- thin, white, grey, fishy odour

Microscopy properties?
- no (PMNs)

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10
Q

Which vaginitis conditions are NOT considered STDs (2/3)

A

Bacterial vaginosis
Vaginal candidiasis

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11
Q

Explain pelvic inflammatory disease

A

infection when cervical microorganisms travel upward to endometrium, fallopian tubes etc… (upper female tract)

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12
Q

Explain post-gynecologic surgery infections

A

Infections caused by patient’s own vaginal flora
- includes pelvic cellulitis or abscesses

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13
Q

What bacteria is syphilis caused by?

A

Treponema pallidum

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14
Q

What are the virulence factors for syphilis

A

TROMPs (t. Palladium Rare outer membrane proteins)
Specific surface antigens: antigenic variation of TprK outer membrane protein aids in immune evasion

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15
Q

Explain the 2 pathogenesis of syphilis:
Penetration
Dissemination

A

Penetration:
- enters body through skin/mucous membranes during sex

Dissemination
- T. palladium accesses circulatory system (before symptoms appear)
- can also invade CNS at any stage

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16
Q

What occurs during stage 1 (primary) of syphilis? When?

A

Chancre develops 2-10 weeks
- Hard, painless, small lesion

  • HIGHLY infectious stage
  • spontaneously heal in 1-6 weeks
17
Q

What occurs during stage 2 (secondary) of syphilis if it overlaps or after primary stage? when?

A

Rash (2-8 weeks after primary stage)
- rash is painless + itch-less –> persists for up to months
- Condylomata lata: very infectious wart-like papules

Symptoms:
- sore throat, headache, mild fever, malaise, myalgia, widespread rash

18
Q

When does condylomata lata occur

A

very infectious wart-like papules in stage 2

19
Q

What occurs during latent syphilis? how long

A
  • no more lesions
  • SYMPTOMLESS period (patient is not contagious) (1-20 years)
  • relapse may occur (still not contagious)
20
Q

What kind of test is an indication for syphilis infection?

A

a positive serologic test

21
Q

What occurs during tertiary syphilis (stage 3)?

A

Symptoms:
- granulomatous lesions, CV lesions
- neurosyphilis
- congenital syphilis
- Reappear either 1 year after primary infection of 10-30 years

22
Q

What is the first line treatment of syphilis for all 4 stages?
Second line?

A

1st line: Long acting penicillin IM injection

2nd line: macrolides

23
Q

What laboratory diagnosis is used for syphilis? (2)

A

Darkfield microscopy
Immunofluorescence

24
Q

What are advantages of darkfield microscopy? disadvantages?

A

Adv
- definitive immediate diagnosis (useful for primary/secondary syphilis but can’t differentiate between the 2)
- rapid

Disadv
- not useful for latent or tertiary syphilis
- Sensitivity decreases as lesion heals
- False negatives: due to soap, antibiotic oint etc..

25
Q

What are advantages and disadvantages of of immunofluorescence?

A

Adv
- sensitivity and specificity are higher than darkfield microscope

Disadv
- needs a fluorescence microscope

26
Q

What are examples of serologic NON-treponemal tests (2)

A
  • Rapid plasma region test (RPR)
  • Toluidine red unseated serum (TRUST)
27
Q

How do non-treponemal test work (4)

A
  1. T. Pallidum infects cell
  2. Cells become damaged and produce cardiolipin –> make anti-lipoidal antibodies (antibody to cardiolipin)
  3. RPR/TRUST tessts detect reagin (IgM and IgG antibodies + anti-lipoidal antibodies)
  4. Syphilis infection diagnosis
28
Q

What are advantages of non-treponemal tests? disadv?

A

Adv
- Can give quantitative results using serial 2-fold dilutions
- can be used to follow efficacy of therapy (falling titer = effective treatment)
(showing progression of disease)

Disadv
- Not very sensitive in certain stages (particularly early primary, late latent, and tertiary syphilis)
- False positives results can occur with other diseases

29
Q

What do serologic treponemal tests measure?

A

measure antibodies directed SPECIFICALLY against T. palladium

30
Q

What are test examples of treponemal tests? (2)

A

TP-PA (T. pallidum particle agglutination)
EIA (enzyme immunoassay)

31
Q

What are treponemal tests used for?

A

Used with non-treponemal tests to confirm if result is truly positive or falsely positive.

32
Q

What are advantages of treponemal tests? disadvantages?

A

Adv
- higher specificity (since it directly measures antibodies against T. palladium)

Disadv
- does not show progression of disease
- test will continue to remain positive
- more costly

33
Q

What are other tests of T. pallidum (2)

A

nuclein acid amplification tests
western blot

34
Q

Describe chancroids (different than chancre).
What bacteria is it caused by?

A

Soft, PAINFUL ulcers
Caused by: H. ducreyi
- requires special culture
- low sensitivity and specificity

35
Q

Describe genital warts. What bacteria is it called? What does it cause?

A

Called condylomata acuminate

Caused by human papilloma virus (HPV)

PHARM 232 Final (5 decks)

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