7 STDs Flashcards
1
Q
what causes syphilis?
A
treponema pallidum
2
Q
what is treponema pallidum
A
a spirochete that has never bee ncultured
3
Q
primary syphillis
A
localized disease
4
Q
secondary syphillis
A
systemic disease
5
Q
tertiary syphillis
A
long-term inflammation of the CNS, aorta, brain, skin, spine, eye
6
Q
congenital syphillis
A
systemic, chronic, inflammation
7
Q
those with syphillis often have
A
HIV, other STDs
8
Q
can syphilis go through skin if someone shakes your hand?
A
yes
9
Q
transmission of syphilis
A
humans are only known hosts
-transmission almost always by direct contact with infectious lesions
10
Q
highest incidence of syphillis
A
20-29 year olds, sexually active adults
11
Q
what percent of exposed people contract the disease
A
30%
12
Q
how many cases of primary or secondary syphilis diagnosed per year in US
A
30,000
13
Q
how many cases of early latent syphilis, diagnosed per year in US
A
30,000
14
Q
primary syphillis
A
- chancre appears 10-90 days (3 wks) after exposure at inoculation site; heals in 3-6 weeks (up to 26 weeks)
- regional adenopathy (painless, rubbery)
- larger the inoculum, larger the chancre
- serological testing during this stage is negative and the disease is essentially local
15
Q
chancre
A
hard, indurated, highly infectious, painless (genitalia or orally)
16
Q
primary syphillis can be diagnosed with what kind of microscopy
A
darkfield
17
Q
secondary syphilis
A
lesions begin 6-8 (“2-24”) weeks after initial chancre, may overlap with time when chancre is present, especially with HIV
- systemic disease
- lasts 2-6 weeks
18
Q
skin + mucous membranes are sites of
A
- principal manifestations
- macular to papular
- occasionally pustular or nodular rash
- palms and soles
- patchy alopecia
- mucous patches
19
Q
-alopecia
A
bald spot
20
Q
systemic syphillis
A
malaise, anorexia, headache, sore throat, arthralgias, low fevers, adenopathy
21
Q
adenopathy
A
enlargement of lymph nodes anywhere in your body
22
Q
secondaria syphillis
A
high bacteremia + very
contagious
23
Q
nicekl/dime lesions
A
secondary syphilis
24
Q
verrucous papules
A
syphillis
25
latent syphilis---> tertiary syphilis
-25% experience a relapse of secondary syphlis
26
duration of latent syphilis
variable
27
how many people with secondary syphilis will progress to tertiary syphilis
1 in 3, 1 to 30 years later
28
hallmark of latent syphilis
positive serological test in the absence of any clinical disease or symptoms
29
spirochetes
syphillis
30
tertiary syphilis contagious?
no, but highly destructive and usually takes years to occur
31
tertiary syphilis: late benign or gummatous syphilis
develops in 15% of cases 1-10 years after infection
32
gummas
nodular lesions with granulomatous inflammation , can be any organ
33
cardiovascular tertiary syphili
10% of cases develop this 10-40 years after infection
34
what occurs during cardiovascular tertiary syphii
arteritis (vasuclitis) results in thickening/hardening of the vasa vasorum; aortic regurgitation; aneurysms, obstruction
35
neurosyphilis during tertiary syphilis
8% untreated cases, 5-25 y after infection; dementia, general paresis, tabes dorsal
36
ulcerating gumma occurs in
late syphilis
37
if mother infective with syphilis, , child will be
still born or present with fulminant syphilis
38
fulminant syphilis
rhitinis, snuffles followed by skin lesions
- osteochondritis (inflamed bone, cartilage)
- hepatosplenomegaly and adenopathy
- immune complex glomerulonephritis
39
congenital syphilis death in infant
in first 2 years with pulmonary hemorrhages, bacterial infecitons, hepatitis
40
Hutchinsons's teeth**
- occurs in congenital syphilis
- notched, narrow edged permanent incisors
- mulberry molars
41
congenital syphilis
develop lesions similar to tertiary syphilis
- symmetric hydrarthrosis of knee joins
- deafness
- hutchinson's teeth
- saddle noses
- saber shinsrhagades
42
rhagades
fissures, cracks, fine linear dermal scars especially around the mouth, and areas subjected to frequent movement
43
perforation of the hard palate caused by
- syphilitic gumma
| - gummas are granuloma like lesions seen in tertiary syphilis
44
screwdriver shaped incisors with notching
hutchinson's teeth-congenital syphillis
45
saddle nose
deformities of the nasal cartilage due to congenital, untreated syphilis
46
diagnosis + treatment of primary syphillis
- presenting signs and symptoms, history
- dark field examination of exudate in lesion, direct fluorescent antibody
- seronegative
47
diagnosis + treatment of secondary syphlis
screenig test using nontreponemal antigen (cardiolipin lecithin)
48
what percentage develops relapses of secondary syphilis
25%
49
what percent develops late syphilis
30%
50
treatment during what stages of syphilis cures the disease
primary or secondary
51
changes of what stage of syphilis are not reversible after treatment, except for gummas
tertiary
52
penicillin
if latent, 2-3 weekly doses, primary or secondary 1 dose; tertiary 3 doses; congenital 10 days
53
mothers with congenital syphilis
before 16th week, no congenital syphillis in child; after 16th week, cannot prevent all manifestations with peniillin
54
what causes gonorrhea
neisseria gonorrhoeae
55
neisseria gonorrhoeae gram stain
-gram negative diplococcus
56
neisseria gonorrhoeae infects
-mucus secreting epithelial cells
57
neisseria gonorrhoeae evades host thorugh
alteration of cell surface
58
men with neisseria gonorrhoeae
>95% symptomatic
59
women with neisseria gonorrhoeae
no symptoms
60
skreet
urethral scarring in men with gonorrea
61
pelvic inflammamtory disease with abscesses, subsequenct ectopic pregnancies or sterility in
women with gonorrhea
| -can be lethal
62
more gonorrhea symptoms
- dissemintated bacteremia occurs with rash and arthritis
| - gonorrheal pharyngitis
63
what is common with gonorrhea?
gonorrhea pharyngitis
64
twists?
- antigenic variation via gene rearrangement
- protease cleaves IgA1 but not IgA2
- can attach to, and invade, nonciliated epithelial cells, where they can multiply and either cause local inflammation or disseminated disease
- in contrast, GC LPS kills epithelial ciliated cells, which might otherwise "sweep" them away
65
GC
the clap
66
GC= the clap
-1 million reported cases/year but 2/3 mill per year
| -
67
1/3rd of all urethritis in US males have
THE CLAP= GC
68
after a single exposure, risk for women and men
50% risk of acquisition for women, 20% for men after a single exposure
69
pharyngeal infection with GC common cause of sore throat
pharyngitis, tonsillitis, gingivitis- in men who have sex with other men and is principle origin of gonococcemia
70
epipidiymis enlarges in
gonorrhea
71
gonoccocal ophtlamia
eye is red
72
GC rash
lesions are not raised, but instead are depressed and not bullous
73
GC in women
30% GU tract infected with with GU are completely asymptomatic; others have vague symptoms that are nonspecific, treatment not sought (if pharynx may have sore throat)
74
usual site of infection for women with GC is in the
cervix, which gets inflamed; contiguous spread to rectum, urethra, bartholin's glands
75
10-20% GC women develop
pelvic inflammatory disease (PID)- endometritis, salpingitis, tubovarian abscesses, peritonitis
76
tubo-ovarian abscess secondary to
gonorrhea in females
77
gonorrhea tx
- cetriaxone + other agent
- quinolones nor cefixie alone are acceptaple therapy
- there is increasing resistance to antibiotics
78
neisseria gonorrhea located i
cervix, urethra, rectum
79
do not use these drugs in pregnant women
quinolones or tetracyclines
80
principle origin of gonococcemia
men who have sex with other men
81
bacteria of chlamydiae
C. trachomatis, psittaci, pneumoniae
82
chlamydiae bactera are
intracellular
83
two stages of chlamydiae
reticulate body (Active metabolism) and the elementary body (transit form that goes from one cell to another)
84
what are the most common causes of urethritis and cervicitis in the US
chlamydiae
| ->50% in males
85
what causes PID
chlamydiae
86
what causes trachoma, which leads to blindness
trachomati
87
3rd most common STD in the US
chlamydiae
88
genital C. trachomatis uses what as a precursor for Trp
indole
89
C. trachomoatis servovars D-k causes (chlamydiae)
urethritis, cervicitis, endometritis, salpingitis, pelvic inflammatory disease, epididymitis, prostatitis, proctitis, arthritis, conjunctivitis, pneumonoitis
90
C. trachomoatis servovars L1, L2, L3 cause
lympgranuloma vernereum (LGV), abscesses of the inguinal lymph nodes, and painful genital lesions
91
C. psittaci causes
pneumonia in humans and birds
92
C. pnuemonieae causes
upper and lower respirtaroy tract infections in humans, very comong (1/2 young adults have had)
93
chlamydia genome
```
small
15% size of E.coli
-encodes 500 proteins
-cannot generate ATP
-no oxidative enzymes, flavoproteins, or cytochromes
-can make their own proteins
```
94
chlamydia genome endocytosis leads to
colonies within phagosomes (intracytoplasmic inclusions)
| -lysosomes do not fuse with phagosomes and so bacteria survive
95
evidence for chlamydia type III secretion
inject proteins into cytoplasm avoiding lysosomes
96
chlamydia diagnosed more in women than men because
women get screened often
97
lymphogranuloma granuloma LGV serovars L1, L2, L3
- primary sore small, painless
- swellign 1-4 weeks later
- LNs may ulcerate, go undetected if in urethra, vagina, or rectum (proctitis)
- scarring in rectum, abscesses in perineum
98
diagnosis of chlamydia
direct fluorescent assays used; gene probe methods like nucleic acid ammplicfication tests (NAAT)
99
tx of chlamydia
tetracylcines, macrolides, quinolones, sulfonamides, - are all active against active form (Reticulate bodies)-must penetrate the host cell and make their way to the intracellular bacteria
100
*what are the tx of choice
doxycycline or azithromycin
| -erythromicin is alternative for children or pregnant women
101
tx LGV
doxycycline 100mg 2x a day for 21 days
102
clamydia urethritis/cervitis
1g azithromycin 2x daily doxy 100mg for a week
103
Papillomavirus
noneveloped, shed with skin, hearty
- cutaneous and ano-genital warts and cervical cancer
- juvenile onset recurrent respiratory papillomatosis (JORRP) + focal oral hyperplasia
104
respiratory pap
death by suffocation-during vaginal delivery, infant's oropharynx infected
105
papilloma virus vaccine
prevents HPV6, 11, 16, 18
106
complications of genital infection
- aseptic meningitis
| - rare complicatoins
107
-aseptic meningitis-of herpes
- more common in primary than recurrent infection
| - generally no neurological sequelae
108
rare complications of genital infection- herpes
stromatitis, pharyngitis
- radicular pain
- sacral parathesias
- transverse myelitis
- autonomic dysfunction
109
oral herpes
soft palate
110
first clinical episode of genital herpes
may become severe or prolonged
| -antiviral therapy should be used-especially if symptoms
