Microbiology of Reproductive Health/STI’s

Question 1

Neisseria gonnorhoeae common ages affected?

Answer 1

Infection mostly found in people ages 15-49

Question 2

Neisseria gonorrhoeae is sexually transmitted. True/false?

Answer 2

True

Question 3

What type of bacteria is Neisseria gonorrhoeae?

Answer 3

Gram negative diplococci

Question 4

How is Neisseria gonorrhoeae screened?

Answer 4

Screen by PCR

Question 5

What can Neisseria gonnorhoeae cause?

Answer 5

Urthritis (urethral inflammation)
Cervicitis
Pelvic inflammatory disease (PID)
Pharyngitis
Proctitis (anal inflammation)
Disseminated disease (entry of pathogen into host, multiplication and spread leading to disease)

Question 6

Antibiotic treatment for Neisseria gonorrhoeae?

Answer 6

Ceftriaxone
Azithromycin

Question 7

Most common people affected by chlamydia trachomatis?

Answer 7

Most common in women ages 15-24

Question 8

Is chlamydia trachomatis sexually transmitted?

Answer 8

Yes

Question 9

Chlamydia trachomatis infections can never resolve on its own. True/false?

Answer 9

False

Up to 50% of infections resolves untreated after ~ 12 months

Question 10

Clinical features of chlamydia trachomatis?

Answer 10

Increased vaginal discharge
Post-coital bleeding
Dysuria (painful/difficult urination)
Dyspareunia (painful sexual intercourse)
Rectal pain

Question 11

Complications of chlamydia trachomatis?

Answer 11

Pelvic inflammatory disease
Salpingitis (fallopian tube inflammation)
Endometritis (inflammation of endometrium)
Ectopic pregnancy
Reactive arthritis

Question 12

Testing for chlamydia trachomatis?

Answer 12

NAAT (nucleic acid amplification testing)

Question 13

Treatment of chlamydia trachomatis?

Answer 13

Doxycycline or azithromycin

Question 14

What is contact tracing?

Answer 14

Required in cases involving chlamydia trachomatis and others.

Process of identifying, assessing and managing people who have been exposed to a disease to prevent additional transmission

Question 15

What is lymphogranuloma venereum (LGV)?

Answer 15

A sexually transmitted disease/infection involving lymph glands of the genital area and is caused by particular strand of chlamydia

Question 16

What particular strain of chlamydia causes LGV?

Answer 16

Mainly Serovar L2 (can also be caused by L1 and L3)

Question 17

Clinical features of LGV?

Answer 17

Painless ulcers and/or haemorrhagic proctitis (anal inflammation)
Pharyngitis
Lymphadenopathy (often unilateral)

Question 18

Are anaerobes STI’s?

Answer 18

No

Question 19

Main anaerobe bacteria?

Answer 19

Gardnerella vaginalis
Prevotells sp
Mobiluncus sp
Atopobium sp

Question 20

Testing of anaerobe bacteria?

Answer 20

Gram stain

Question 21

Treatment of anaerobe bacteria?

Answer 21

Metronidazole oral or gel
Clindamycin cream

Question 22

Mycoplasma genitalium is not stainable. Why?

Answer 22

Lacks cell walls

Question 23

Mycoplasma genitalium is sexually transmitted. True/false?

Answer 23

True

Question 24

Testing of mycoplasma genitalium?

Answer 24

NAAT

Question 25

Clinical conditions that can be caused by mycoplasma genitalium?

Answer 25

Pelvic inflammatory disease (PID)
Urethritis

Question 26

Treatment of mycoplasma genitalium?

Answer 26

Doxycycline or moxifloxacin

Question 27

Ureaplasma is sexually transmitted. True/false?

Answer 27

True

Question 28

Clinical conditions caused by ureaplasma?

Answer 28

Urethritis
Epididymitis
Prostatitis

Question 29

Best investigation for ureaplasma?

Answer 29

PCR

Question 30

Treponema pallidum causes what condition?

Answer 30

Syphilis

Question 31

Is treponema pallidum sexually transmitted?

Answer 31

Yes

Sexually transmitted via blood transfusion or during pregnancy

Question 32

Treponema pallidum can’t be seen during routine microscopy. Why?

Answer 32

Dark background on microscopy

Question 33

Testing for treponema pallidum?

Answer 33

PCR from lesion sample

Question 34

Clinical features caused by treponema pallidum (syphilis)

Answer 34

Primary: Chancre, resolves over 3-8 weeks

Secondary in 25% of untreated primary:
* Rash including palms and soles
* Mucous pathes
* Condylomata lata
* Hepatitis, slenomegaly, glomerulonephritis

Question 35

Treatment for treponema pallidum?

Answer 35

Benzathine penicillin

Question 36

How many types of herpes simplex?

Answer 36

2 types

HSV-1 and HSV-2

Question 37

Main transmission for HSV-1?

Answer 37

Mainly transmitted via oral-to-oral contact = “cold sores”

Question 38

Main transmission for HSV-2?

Answer 38

Mainly sexually transmitted = genital herpes with lesions

Question 39

Most HSV infections are asymptomatic. True/false?

Answer 39

True

Question 40

Complications of HSV-2?

Answer 40

Increases risk of HIV transmission
3x
Severe disease in
immunocompromised people:
• Frequent recurrences
• HSV-1 - keratitis
• HSV-1 - encephalitis
• HSV-2 - Meningoencephalitis
• Dissemintated infection

Neonatal herpes
• Globally 10/100 000 births
• Primary herpes in mother late in pregnancy => highest risk

Question 41

Treatment for HSV-2?

Answer 41

Aciclovir and valaciclovir

Prevention is key

Question 42

What HPV types cause 70% of cervical cancers?

Answer 42

HPV 16 and 18

Question 43

What HPV types cause genital warts?

Answer 43

HPV 6 and 11

Question 44

What virus causes chickenpox in <10 yr old children?

Answer 44

Varicella zoster

Question 45

Is varicella zoster an sti?

Answer 45

No

Question 46

Varicella zoster complications?

Answer 46

Complications of primary infection:
• Pneumonia
• Encephalitis
• Pregnancy: fetal injury
Complications of recurrent infection:
• Lasting nerve damage
• Visual impairment

Treatment for sever cases with aciclovir
Vaccination available (attenuated “live” vaccine)