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Flashcards in 7 STDs Deck (110):
1

what causes syphilis?

treponema pallidum

2

what is treponema pallidum

a spirochete that has never bee ncultured

3

primary syphillis

localized disease

4

secondary syphillis

systemic disease

5

tertiary syphillis

long-term inflammation of the CNS, aorta, brain, skin, spine, eye

6

congenital syphillis

systemic, chronic, inflammation

7

those with syphillis often have

HIV, other STDs

8

can syphilis go through skin if someone shakes your hand?

yes

9

transmission of syphilis

humans are only known hosts
-transmission almost always by direct contact with infectious lesions

10

highest incidence of syphillis

20-29 year olds, sexually active adults

11

what percent of exposed people contract the disease

30%

12

how many cases of primary or secondary syphilis diagnosed per year in US

30,000

13

how many cases of early latent syphilis, diagnosed per year in US

30,000

14

primary syphillis

-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

chancre

hard, indurated, highly infectious, painless (genitalia or orally)

16

primary syphillis can be diagnosed with what kind of microscopy

darkfield

17

secondary syphilis

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

skin + mucous membranes are sites of

-principal manifestations
-macular to papular
-occasionally pustular or nodular rash
-palms and soles
-patchy alopecia
-mucous patches

19

-alopecia

bald spot

20

systemic syphillis

malaise, anorexia, headache, sore throat, arthralgias, low fevers, adenopathy

21

adenopathy

enlargement of lymph nodes anywhere in your body

22

secondaria syphillis

high bacteremia + very
contagious

23

nicekl/dime lesions

secondary syphilis

24

verrucous papules

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