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Microbiology > E3- STIs > Flashcards

E3- STIs Flashcards

1
Q

What STIs are ulcerative?

A
  • Syphilis
  • Chancroid
  • Genital hepes
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2
Q

What STIs are nonulceative?

A
  • Gonorrhea
  • Trichomoniasis
  • Chlamydia
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3
Q

What genus includes nonpathogenic species that are normal flora on mucosal surfaces, species that cause non-STD diseases, and species that produce STD diseases?

A

Treptonema

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4
Q

How are non-STD treptonema infections spread?

A

Person-to-person via direct contact (occur in developing countries)

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5
Q

What is the etiology of syphilis?

A

Treptonema pallidum

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6
Q

Is Treptonema pallidum (syphilis) gram positive/negative? What shape?

A

Gram negative spirillum

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7
Q

What type of pathogen is Treptonema pallidum (syphilis)?

A

Obligate intracellular parasite (requires mammalian host)

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8
Q

What are Treptonema pallidum’s (syphilis) virulence factors?

A
  • Outer membrane proteins (promote adherence to host cells)
  • Hyaluronidase (facilitates perivascular infiltration)
  • Fibronectin coat (antiphagocytic)
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9
Q

What are Treptonema pallidum (syphilis) lesions primarily the result of?

A

The host’s inflammatory response

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10
Q

How is Treptonema pallidum (syphilis) transmitted?

A 
Usually via direct sexual contact with a person who has active primary or secondary lesions
Can also occur via:
-Lesion near mouth
-Needle sharing
-Transplacental
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11
Q

Treptonema pallidum enters into subepithelial tissues and undergoes local multiplication and dissemination to ___ via ___.

A

Nearby lymph nodes via circulation

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12
Q

What is the name of the primary/principal lesion associated with Treptonema pallidum (syphilis)?

A

Chancre

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13
Q

Chancres typically begin as a what?

A

Papule

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14
Q

How long does it take an untreated primary Treptonema pallidum (syphilis) lesion to heal?

A

3-8 weeks with fibrosis

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15
Q

What is the disease progression of Treptonema pallidum (syphilis)?

A
  • Primary syphilis
  • Dormancy period
  • Secondary syphilis
  • Latent syphilis
  • Spontaneous cure, seropositive w/o disease, or tertiary syphilis
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16
Q

What is typically seen clinically with secondary syphilis?

A
  • Development of superficial lesion of high infectivity (Maculopapular rash)
  • Mucosal warty lesions (condylomata lata)
  • Immune complexes
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17
Q

What is typically seen clinically with latent syphilis?

A

Absense of clinical signs and symptoms

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18
Q

What is considered an “early” latency syphilis?

A

Within 1 year of infection

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19
Q

What is considered an “late” latency syphilis?

A

More than 1 year after infection

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20
Q

What is typically seen clinically with tertiary syphilis?

A
  • Neurosyphilis
  • Cardiovascular syphilis
  • Granulomata (gummas)
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21
Q

When does tertiary syphilis manifest?

A

5-30 years after infection

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22
Q

What is the typical progression of congenital syphilis?

A

Most infants are born apparently healthy and develop symptoms at ~3 weeks of age

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23
Q

What does earlier onset of congenital syphilis symptoms suggest?

A

Poor prognosis

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24
Q

What is the clinicial presentation of congenital syphilis?

A
  • Maculopapular cutaneous lesions
  • Nasal obstruction with mucoid discharge (infectious)
  • Osteitis of nasal bones
  • Neurosyphilis
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25
Q

What is Hutchinson’s Triad and what disease is it associated with?

A

Congenital syphilis

  • Notched incisors
  • Interstitial keratitis
  • 8th nerve deafness
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26
Q

What should every genital lesion be considered until proven otherwise?

A

Syphilis

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27
Q

How is syphilis dx?

A
  • Darkfield microscopy

- Serology (nontreponemal vs. treponemal)

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28
Q

What syphilis serological test is non-specific and used for screening?

A

Nontreponemal test

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29
Q

What syphilis serological test is specific for antibodies and used for confirmation?

A

Treponemal test

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30
Q

What is the causative agent of gonorrhea?

A

Neisseria gonrrhoeae

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31
Q

Is Neisseria gonrrhoeae gram positive/negative? What shape?

A

Gram negative diplococcus

32
Q

What are the virulence factors of Neisseria gonrrhoeae? (5)

A
  • Antigenic variation of pili
  • Nonpiliated phase variants
  • Porin protein
  • IgA protease
  • Plasmid and chromosome mediated resistance to abx
33
Q

What age group has the highest incidence of Neisseria gonrrhoeae?

A

Adolescents

34
Q

What is the function of antigenic and nonpiliated phase variations of pili in N. gonrrhoeae?

A

To confuse the hosts immune system so we don’t made antibodies

35
Q

What is the function of porin proteins?

A

Aid in attachment

36
Q

Who are major reservoirs for Neisseria gonrrhoeae?

A

Asymptomatic patients

37
Q

What is the first step of Neisseria gonrrhoeae infection?

A

Attachment to the epithelium via pili and surface proteins

38
Q

How does Neisseria gonrrhoeae cause injury to cells?

A

Releases Lipooligosaccharide and peptidoglycan

39
Q

What kind of discharge is seen with Neisseria gonrrhoeae infections in males?

A

Thick, mucopurulent discharge

40
Q

What are three complications of Neisseria gonrrhoeae in females?

A
  • Acute salpingitis
  • Pelvic inflammatory disease
  • Disseminated Gonococcal infection
41
Q

What can present with bacteremia, fever rash, endocarditis, and/or meningitis?

A

Disseminated Gonococcal infection

42
Q

What is the most common presentation of Disseminated Gonococcal infection?

A

Purulent arthritis

43
Q

How is Neisseria gonrrhoeae dx?

A
  • Gram stain

- Culture (Nucleic acid amplification/PCR) *GOLD STANDARD

44
Q

What are 3 causative agents of nongonococcal urethritis?

A
  • Chlamydia trachomatis
  • Mycoplsma spp
  • Ureaplasma urealyticum
45
Q

What type of pathogen is Chlamydia trachomatis?

A

Obligate intracellular bacteria (requires mammalian host)

46
Q

Is Chlamydia trachomatis gram positive/negative?

A

Gram negative

47
Q

What is the infectious form of Chlamydia trachomatis?

A

Elementary body

48
Q

What is the fragile intracellular form of Chlamydia trachomatis?

A

Reticulate body

49
Q

What age group has the highest incidence of Chlamydia trachomatis infections?

A

Teenagers

50
Q

Ascesion of Chlamydia trachomatis in females can lead to what?

A
  • Acute salpingitis

- Pelvic inflammatory disease

51
Q

Infants born to mothers infected with chlamydia usually present with what?

A

Inclusion conjunctivitis

52
Q

What are the possible presentations of a Chlamydia trachomatis infection? (7)

A

-Salpingitis
-PID
-Inclusion conjunctivitis (newborns)
-Cervicitis
-Urethritis
-Lymphogramuloma venereum
-Epididymitis (watery discharge)
“SPICULE”

53
Q

Certain toxin-producing strains of Chlamydia trachomatis may lead to what?

A

Chronic inflammation

54
Q

How is Chlamydia trachomatis dx?

A
  • Isolation in cell culture = GOLD STANDARD

- NAAT

55
Q

What is the etiology of Trichomoniasis?

A

Trichomonas vaginalis

56
Q

What type of pathogen is Trichomonas vaginalis?

A
  • Flagellated protozoan
  • Extracellular anaerobe
  • Exists only as a trophozoite
57
Q

What is the typical presentation of Trichomonas vaginalis in males?

A
  • Usually asymptomatic

- Scanty, clear to mucopurulent discharge (yellow-gray)

58
Q

What is the typical presentation of Trichomonas vaginalis in females?

A
  • Usually symptomatic
  • Profuse vaginal discharge, frothy and malodorous
  • Creates an environment for bacterial vaginosis
59
Q

How is Trichomonas vaginalis dx?

A
  • Wet mount is commonly used

- Culture is more specific

60
Q

Is bacterial vaginosis an STI?

A

NO

Caused by an overgrowth of opportunistic pathogen in the vagina die to a change in pH

61
Q

What is the normal vaginal pH?

A

< 4.5

62
Q

What pH is seen in bacterial vaginosis?

A

5-6

63
Q

What is the criteria for dx bacterial vaginosis?

A
  • Presence of clue cells
  • Release of amine odor when 10% KOH is added
  • Vaginal pH > 4.5
  • Presence of curved gram negative or gram variable rods
64
Q

What type of discharge is seen with Trichomoniasis? Vaginosis?

A

Trichomoniasis: Thin and yellow-gray

Vaginosis: Thin and grey

65
Q

What is the most common opportunistic mycoses (fungal infection) world wide?

A

Candidiases

66
Q

What is the etiology of Vulvovaginal candidiases (yeast infection)?

A

Majority- Candidia albicans

Minority- Candidia tropicalis, Candidia glabrata

67
Q

What type of discharge is seen with Vulvovaginal candidiases (yeast infection)?

A

Thick, white, frothy discharge

No odor

68
Q

What is the etiology of chancroid?

A

Haemophilus ducreyi

69
Q

Is Haemophilus ducreyi gram positive/negative? What shape?

A

Gram negative coccobacillus

70
Q

How does a typical Haemophilus ducreyi (chancroid) lesion present?

A

Tender papule on the genitalia that develops into an ulcer with sharp margins and no induration

71
Q

What is a soft chancre?

A

A lesion associated with Chancroid:

  • Soft ragged edge
  • Painful
  • Pus
  • Bleeds readily
  • No induration
72
Q

What is a chancre sore?

A

A lesion associated with syphilis

  • Hard raised edge
  • Painless
  • Indurated
73
Q

How is Haemophilus ducreyi (chancroid) dx?

A
  • ID from genital ulcer or swollen lymph node

- PCR

74
Q

What can occur when microorganisms ascend into the endometrium, fallopian tubes and contiguous structures?

A

Pelvic Inflammatory Disease

75
Q

What are the most common etiologies of Pelvic Inflammatory Disease? (2)

A
  • Neisseria gonorrhoeae

- Chlamydia trachomatis

76
Q

How is PID dx?

A

Evidence of inflammation

  • Fever
  • Leukocytosis
  • Elevated ESR

Microbiology (23 decks)

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