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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
What is Hutchinson's Triad and what disease is it associated with?
Congenital syphilis - Notched incisors - Interstitial keratitis - 8th nerve deafness
26
What should every genital lesion be considered until proven otherwise?
Syphilis
27
How is syphilis dx?
- Darkfield microscopy | - Serology (nontreponemal vs. treponemal)
28
What syphilis serological test is non-specific and used for screening?
Nontreponemal test
29
What syphilis serological test is specific for antibodies and used for confirmation?
Treponemal test
30
What is the causative agent of gonorrhea?
Neisseria gonrrhoeae
31
Is Neisseria gonrrhoeae gram positive/negative? What shape?
Gram negative diplococcus
32
What are the virulence factors of Neisseria gonrrhoeae? (5)
- Antigenic variation of pili - Nonpiliated phase variants - Porin protein - IgA protease - Plasmid and chromosome mediated resistance to abx
33
What age group has the highest incidence of Neisseria gonrrhoeae?
Adolescents
34
What is the function of antigenic and nonpiliated phase variations of pili in N. gonrrhoeae?
To confuse the hosts immune system so we don't made antibodies
35
What is the function of porin proteins?
Aid in attachment
36
Who are major reservoirs for Neisseria gonrrhoeae?
Asymptomatic patients
37
What is the first step of Neisseria gonrrhoeae infection?
Attachment to the epithelium via pili and surface proteins
38
How does Neisseria gonrrhoeae cause injury to cells?
Releases Lipooligosaccharide and peptidoglycan
39
What kind of discharge is seen with Neisseria gonrrhoeae infections in males?
Thick, mucopurulent discharge
40
What are three complications of Neisseria gonrrhoeae in females?
- Acute salpingitis - Pelvic inflammatory disease - Disseminated Gonococcal infection
41
What can present with bacteremia, fever rash, endocarditis, and/or meningitis?
Disseminated Gonococcal infection
42
What is the most common presentation of Disseminated Gonococcal infection?
Purulent arthritis
43
How is Neisseria gonrrhoeae dx?
- Gram stain | - Culture (Nucleic acid amplification/PCR) *GOLD STANDARD
44
What are 3 causative agents of nongonococcal urethritis?
- Chlamydia trachomatis - Mycoplsma spp - Ureaplasma urealyticum
45
What type of pathogen is Chlamydia trachomatis?
Obligate intracellular bacteria (requires mammalian host)
46
Is Chlamydia trachomatis gram positive/negative?
Gram negative
47
What is the infectious form of Chlamydia trachomatis?
Elementary body
48
What is the fragile intracellular form of Chlamydia trachomatis?
Reticulate body
49
What age group has the highest incidence of Chlamydia trachomatis infections?
Teenagers
50
Ascesion of Chlamydia trachomatis in females can lead to what?
- Acute salpingitis | - Pelvic inflammatory disease
51
Infants born to mothers infected with chlamydia usually present with what?
Inclusion conjunctivitis
52
What are the possible presentations of a Chlamydia trachomatis infection? (7)
-Salpingitis -PID -Inclusion conjunctivitis (newborns) -Cervicitis -Urethritis -Lymphogramuloma venereum -Epididymitis (watery discharge) “SPICULE”
53
Certain toxin-producing strains of Chlamydia trachomatis may lead to what?
Chronic inflammation
54
How is Chlamydia trachomatis dx?
- Isolation in cell culture = GOLD STANDARD | - NAAT
55
What is the etiology of Trichomoniasis?
Trichomonas vaginalis
56
What type of pathogen is Trichomonas vaginalis?
- Flagellated protozoan - Extracellular anaerobe - Exists only as a trophozoite
57
What is the typical presentation of Trichomonas vaginalis in males?
- Usually asymptomatic | - Scanty, clear to mucopurulent discharge (yellow-gray)
58
What is the typical presentation of Trichomonas vaginalis in females?
- Usually symptomatic - Profuse vaginal discharge, frothy and malodorous - Creates an environment for bacterial vaginosis
59
How is Trichomonas vaginalis dx?
- Wet mount is commonly used | - Culture is more specific
60
Is bacterial vaginosis an STI?
NO | Caused by an overgrowth of opportunistic pathogen in the vagina die to a change in pH
61
What is the normal vaginal pH?
< 4.5
62
What pH is seen in bacterial vaginosis?
5-6
63
What is the criteria for dx bacterial vaginosis?
- 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
What type of discharge is seen with Trichomoniasis? Vaginosis?
Trichomoniasis: Thin and yellow-gray Vaginosis: Thin and grey
65
What is the most common opportunistic mycoses (fungal infection) world wide?
Candidiases
66
What is the etiology of Vulvovaginal candidiases (yeast infection)?
Majority- Candidia albicans | Minority- Candidia tropicalis, Candidia glabrata
67
What type of discharge is seen with Vulvovaginal candidiases (yeast infection)?
Thick, white, frothy discharge | No odor
68
What is the etiology of chancroid?
Haemophilus ducreyi
69
Is Haemophilus ducreyi gram positive/negative? What shape?
Gram negative coccobacillus
70
How does a typical Haemophilus ducreyi (chancroid) lesion present?
Tender papule on the genitalia that develops into an ulcer with sharp margins and no induration
71
What is a soft chancre?
A lesion associated with Chancroid: - Soft ragged edge - Painful - Pus - Bleeds readily - No induration
72
What is a chancre sore?
A lesion associated with syphilis - Hard raised edge - Painless - Indurated
73
How is Haemophilus ducreyi (chancroid) dx?
- ID from genital ulcer or swollen lymph node | - PCR
74
What can occur when microorganisms ascend into the endometrium, fallopian tubes and contiguous structures?
Pelvic Inflammatory Disease
75
What are the most common etiologies of Pelvic Inflammatory Disease? (2)
- Neisseria gonorrhoeae | - Chlamydia trachomatis
76
How is PID dx?
Evidence of inflammation - Fever - Leukocytosis - Elevated ESR

Microbiology (23 decks)

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