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Microbiology COPY > Exam #6: STDs I > Flashcards

Exam #6: STDs I Flashcards

1
Q

What are the most common bacterial STDs in the US?

A

1) Chlamydia

2) Gonorrhea

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2
Q

What is an important distinction between bacterial & viral STDs?

A

Bacterial can be “cured” with medications; viral cannot–they can only be treated

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3
Q

What patient population traditionally have the highest & lowest incidence of STIs?

A

MSM= men who have sex with men have the HIGHEST

WSM= women who have sex with women–LOWEST

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4
Q

How does Chlamydia differ from other bacteria?

A

1) Lack peptidoglycan
2) Replicates within cells (obligate intracellular parasite)

*Unable to make its own ATP.

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5
Q

What types of infections can chlamydia cause?

A

Genital infections

Conjunctivitis

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6
Q

List the characteristics of the Chlamydiaceae family.

A
  • Gram (-) like envelope BUT does NOT stain well
  • NO peptidyglycan
  • LPS with weak endotoxin activity
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7
Q

Describe the lifecycle of the Chlamydiaceae family

A

Elementary Body=”Enfectious”

Reticulate Body= Replicative form

Elementary body infects the cell & converts to the metabotically active reticulate body in roughly 12 hours. These form “inclusions” and revert to elementary bodies. Elementary bodies escape from the cell within ~72 hours.

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8
Q

List the characteristics of C. trachomatis.

A

Human is the only known host
Two biovars: Trachoma & LGV
Multiple serovars

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9
Q

What infections does C. trachomatis cause?

A

Eye infections

Urogenital infections

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10
Q

What are the two C. trachomatis biovars? What is the difference between the two?

A 
LGV= more invasive 
Trachoma= less invasive
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11
Q

What are the different C. trachomatis serovars? What are serovars?

A

Different Major Outer Membrane Protein (MOMPs), lead to different immune responses that can be detected by serologic analysis.

Trachoma= A, B, Ba, C
D-K= Urogenital tract disease
LGV= L1, L2, L2a, L2b, & L3
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12
Q

What does C. trachomatis have a trophism for?

A

Nonciliated, columnar, cuboidal, & transitional epithelial cells of the:

  • Urethra
  • Endocervix
  • Endometrium
  • Fallopian tubes
  • Anorectum
  • Respiratory Tract
  • Conjunctivae
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13
Q

How does C. trachomatis cause infection (pathophysiolgy)?

A
  • Reticulate bodies cause destruction of the cell & cause:
  • Pro-inflammatory reactions that when prolonged, leads to fibrosis & potentially infertility
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14
Q

What is trachoma?

A

A chronic inflammatory granulomatous process of the eye, leading to corneal ulceration, scarring, pannus formation, & blindness

“Leading cause of preventable blindness in the world” caused by C. trachomatis infection

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15
Q

What is adult inclusion conjunctivitis? What is neonatal conjunctivitis?

A

“Acute conjunctivitis in sexually active adults”

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16
Q

What are the symptoms of adult inclusion conjunctivitis?

A

Mucopurulent discharge
Dermatitis
Corneal infiltrates
Corneal vascularization in chronic disease

17
Q

What are the symptoms of Chlamydia, or C. trachomatis urogenital infections?

A

Men

  • Dysuria
  • Thin mucopurulent discharge

Women

  • Mostly ASYMPTOMATIC (80%, which has important implications for disease spread)
  • PID
18
Q

What complications can be seen from C. trachomatis urogenital infection in men?

A

Epididymitis
Prostatitis
Reiter Syndrome

19
Q

What is Reiter Syndrome?

A

1) Uretheritis
2) Conjuncitivitis
3) Polyarthritis
4) Mucocutaneous lesions

20
Q

What are the symptoms if PID?

A

Pelvic inflammatory disease

  • Inflammation of the uterus, fallopian tubes, & other reproductive organs
  • Abdominal pain, adnexal tenderness, & cervical motion tenderness (CMT)
  • Can cause scarring & sterility, or ectopic pregnancy
21
Q

What patient population is at risk for LGV?

A

Sexually active individuals that travel to Africa, Asia, & South America

22
Q

What are the symptoms of LGV?

A
  • Small, painless ulcers on genitals that become swollen

- Painful inguinal lymph nodes that ulcerate

23
Q

How is C. trachomatis diagnosed?

A

Need a SCRAPING of the location

  • Giemsa stain with cytoplasmic inclusions
  • Iodine that stains reticulate bodies
  • Immunoflouresecence (ELISA) of EBs

NAAT or PCR is the most common diagnostic test

24
Q

How is C. trachomatis prevented?

A

1) Safe sex, early detection, & treatment of symptomatic pateints
2) Control of re-infection; infection does NOT confer immunity

25
Q

How is C. trachomatis treated?

A

Doxycycline
Macrolide (Azithromycin)

50S ribosome inhibitors–> disrupt protein synthesis

26
Q

What is the mechanism of action of Doxycycline & the Macrolides?

A

Inhibition of protein synthesis (via inhibtion of the 50S subunit)

27
Q

List the characteristics of Neisseria gonorrhoeae.

A

Gram (-) diplococci
Maltose (-)

vs. Meningitidis that is Maltose (+)

28
Q

What virulence factors are associated surface of N. gonorrhoeae?

A

Pilin= attachment & anti-phagocytic
Por protein= promotes intracellular survival
Opa protein= attachment to eukaryotic cells
LOS= Lipid A & core oligosaccharide without O-antigen–>endotoxin
*all undergo antigenic variation to avoid immune response

IgA protease
B-lactamase

29
Q

How does N. gonorrhoeae antigenically vary?

A

Neisseria LOS, Pilin, porin, & Opa protein can be antigenically altered; thus, the immune response is generated does not prevent reinfection

30
Q

Describe the pathophysiology of N. gonorrhoeae?

A
  • Gonococci attach to mucosal cells (Pili, PorB, Opa mediated)
  • Penetrate into cells & multiply (primary site is cervix in women)
  • LOS stimulates inflammation; TNFa & chemokines are responsible for symptoms
31
Q

Who is most at risk for N. gonorrhoeae infection?

A 
Africa American 
15-24 year-olds 
Southeastern US 
Multiple sex partners
Late complement (MAC C5-C9) mutations
32
Q

What are the symptoms of N. gonorrhoeae infection?

A

Mucopurulent discharge
Dysuria

*Most men have symptomatic infection; 1/2 of women

33
Q

What are the complications of N. gonorrhoeae infection?

A

Men:

  • epididymidis
  • prostatitis
  • periuretheral abscess

Women:

  • salpingitis
  • tubovarian abscess
  • PID
34
Q

How does disseminated N. gonorrhoeae present?

A 
Septicemia 
Skin infection 
Joint infection
Suppurative arthritis 
Pustular rash

*Note that disseminated N. gonorrhoeae is the leading cause of purulent arthritis in adults

35
Q

What is purulent conjunctivitis?

A

Purulent ocular infection in newborns infected during vaginal delivery

Note that this is also called “Opthalmia Neonatorum”

36
Q

How is N. gonorrhoeae diagnosed?

A

1) Direct smear= Gram (-), bean-shaped diplococcus in neutrophils
2) Culture & growth of uretheral (men) or cervical (women) scrapings
3) NAAT

37
Q

What type of agar needs to be used for culture of N. gonorrhoeae?

A

Chocolate

38
Q

How is N. gonorrhoeae treated?

A

Ceftriaxone (N. gonorrheae)
Doxycycline or azithromycin*

*To treat chlamydia (prophylactically)

39
Q

How is opthalmia neonatrorum prevented & treated?

A
  • Prophylaxis with erythomycin ointment

- Ceftriaxone for opthalmia neonatorum

Microbiology COPY (49 decks)

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