26 - 175 - GONORRHEA, MYCOPLASMA, AND VAGINOSIS

Question 1

most common cause of pelvic inflammatory disease in women.

Answer 1

chlamydia

Question 2

currently the most common reported STD.

Answer 2

chlamydia

Question 2

common presenting symptom of STDs in both men and women

Answer 2

Urethritis

Question 3

causative agent of gonorrhea

Answer 3

Neisseria gonorrhoeae

• gram-negative, aerobic coccus-shaped bacterium found in pairs
• The organisms are usually visualized intracellularly, located** within polymorphonuclear leukocytes**

Question 4

most common manifestation of gonococcal infection in men

Answer 4

urethritis, characterized by a spontaneous, often profuse, cloudy or purulent discharge from the penile meatus

Question 5

triad of disseminated gonorrhea

Answer 5

dermatitis, migratory polyarthritis, and tenosynovitis

Question 6

description of the concurrence of some degree of hemorrhage and necrosis of the cutaneous lesions of disseminated gonoccocal infection

Answer 6

“gun metal gray”

Question 7

inflammation of the liver capsule, is associated with genitourinary tract infection and may be present in up to one fourth of women with PID caused by either N. gonorrhoeae or C. trachomatis

Answer 7

Fitz-Hugh–Curtis syndrome

Question 8

Prophylaxis for Gonococcal Infection in Neonates

Answer 8

\

Question 9

considered diagnostic for infection with N. gonorrhoeae in symptomatic men

Answer 9

Gram stain of a urethral specimen that demonstrates polymorphonuclear leukocytes with intracellular gram-negative diplococci

Question 10

culture medium of N. gonorrhiae

Answer 10

modified Thayer-Martin medium

Question 11

Treatment of Localized, Uncomplicated Gonococcal Infection of the Cervix, Rectum, Pharynx, or Urethra

Answer 11

Question 12

Treatment of Disseminated Gonococcal Infection

Answer 12

Question 13

Treatment of Gonococcal Infection in Neonates

Answer 13

Question 14

genital mycoplasmal organisms

Answer 14

Mycoplasma spp. and other Ureaplasma spp.

Question 14

most common cutaneous disease in men with mycoplasma infection

Answer 14

urethritis

Question 15

most common cutaneous disease in women with mycoplasma infection

Answer 15

cervicitis

Question 16

adhesion proteins of mycoplasma

Answer 16

M. genitalium (P110 and P140) and M. hominis (P100)

Question 17

preferred method of testing for mycoplasma

Answer 17

NAAT

• the most sensitive tests available and are almost as specific as culture
• They are approved by the FDA for the diagnosis of urogenital infections caused by C. trachomatis
• noninvasive and easy to perform
• expensive and unable to differentiate among different serovars of C. trachomatis

Question 17

preferred specimen to submit when the reference laboratory plans to use NAAT

Answer 17

First-voided urine

Question 18

T/F

Gram stain can be used to detect Mycoplasma spp.

Answer 18

False

Mycoplasma spp. do not possess a cell wall, Gram stain will not detect these organisms.

Question 19

Treatment of Mycoplasma Urethritis

Answer 19

Question 20

remains the most frequently reported STI

Answer 20

C. trachomatis

Question 21

most common manifestations of C. trachomatis infections

Answer 21

Urogenital infections

Question 22

most common site of chlamydia in men

Answer 22

urethra ## Footnote * In men, urethritis is the most common manifestation of infection and is characterized by dysuria and a watery or mucoid discharge from the urethra. * The discharge may be scant, and some patients may only complain of stained underwear. * In comparison, the discharge in gonococcal urethritis is more purulent and profuse.

Question 23

most common site of chlamydia in women

Answer 23

urethra and cervix

Question 24

most common causes of epididymitis in male patients younger than 35 years of age

Answer 24

C. trachomatis and N. gonorrhoeae

Question 25

overarching clinical presentation encompassing combinations of

Answer 25

endometritis, salpingitis, and peritonitis ## Footnote * PID is a complication of C. trachomatis infection as well as gonococcal infections. * patients present with fever; lower abdominal pain; vomiting; and cervical, uterine, and adnexal motion tenderness

Question 26

C. trachomatis strains that cause** urogenital tract infections**

Answer 26

Serovars D to K

Question 26

C. trachomatis strains that cause **chronic conjunctivitis and trachoma**

Answer 26

Serovars A through C

Question 27

C. trachomatis strains that cause **lymphogranuloma venereum**

Answer 27

Serovars L1 though L3

Question 28

first-line treatment of chlamydial infections

Answer 28

doxycycline 100 mg orally twice daily for 7 days or azithromycin given orally as a single 1-g dose

Question 29

most common vaginal infection in women ages 15 to 44 years

Answer 29

Bacterial vaginosis (BV)

Question 30

most common risk factors for BV infection

Answer 30

Having sex at an early age and new or multiple sex partners

Question 31

Amsel criteria for diagnosing BV

Answer 31

1. Profuse milky vaginal discharge 2. A positive whiff test result (presence of a fishy odor when secretions are exposed to 10% or 20% potassium hydroxide) 3. A vaginal fluid pH greater than 4.5 4. Presence of clue cells greater than 20% on microscopic examination

Question 32

squamous epithelial cells covered by coccobacilli that give the cytoplasm a ground-glass appearance and obscure the crisp margins of the cell, leaving ragged borders

Answer 32

Clue cells

Question 33

the most reliable indicator of BV

Answer 33

presence of clue cells representing at least 20% of the epithelial cells on saline wet mount

Question 34

Treatment of Bacterial Vaginosis

Answer 34