E6 Flashcards

1
Q

What is the most common bacterial STI in the US?

A

Chlamydia

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2
Q

What serotypes of chlamydia are responsible for trachoma?

A

ABC

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3
Q

What serotypes of chlamydia are responsible for ocular and genital infections?

A

D-K

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4
Q

What serotypes of chlamydia are responsible for lymphogranuloma venereum?

A

L1-L3

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5
Q

What is the classificiation of chlamydia trachomatis?

A

gram -, obligate intracellular cocci

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6
Q

What is the pathology of chlamydia?

A

Reticulate and elementary bodies

  • tropism for epithelium of mucous membranes
  • disease caused by destroying cells causing release of proinflammatory cytokines
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7
Q

What is the leading cause of preventable blindness?

A

Eye trachoma

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8
Q

What does adult and neonate chlamydial inclusion characterize as?

A

mucopurulent discharge

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9
Q

What are the characteristics of male urogential chlamydia?

A
  • most symptomatic
  • urtheritis: dysuria, and mucopurulent discharge
  • complications: epididymitis and prostatiists, Reiter syndrome
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10
Q

What are the characteristics of female urogential chlamydia?

A
  • 80% asymptomatic
  • mucopurulent discharge
  • pelvic inflammatory disease= fibrosis = sterility and ectopic pregnancy
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11
Q

What is lymphogranuloma venereum?

A

chlamydia starts off as primary painless papule with inflammation and swelling of lymph nodes that can rupture and cause fistulas

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12
Q

How is chlamydia diagnosed?

A
  • culture with iodine shows reticulate bodies
  • ELISA shows elementary bodies
  • nucleic acid amplification from urine
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13
Q

How is LGV chlamydia treated?

A

doxycycline for 21 days

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14
Q

How is ocular/genital chlamydia treated?

A

Azithromycin or doxycyline for 7 days

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15
Q

How is newborn chlamydia treated?

A

Erythromycin for 10-14 days

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16
Q

Does infection confer immunity with chlamydia?

A

No, safe sex practices needed

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17
Q

What are the classifications of neisseria gonorrhea?

A

Gram -, aerobic diplococci, oxidase +, catalase +, nonspore forming, non maltose oxidizing

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18
Q

When is gonorrhea common?

A

Persons with C5-C8 or membrane attack complex issues

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19
Q

Does infection confer immunity with gonorrhea?

A

No, safe sex practices needed

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20
Q

What are the three pathological aspects of gonorrhea?

A
Pilin = attachment
Porin = survival
LOS = endotoxin
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21
Q

What is the pathogenisis of gonorrhea?

A
  • Attach to cells with pili, enter and multiply
  • Pass through to subendothelial space
  • LOS stimulates TNF-a for inflammation
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22
Q

What are the characteristics of normal gonorrhea?

A

Mucopurulent dischrage, and dysuria

-pharyngitis with genital

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23
Q

What are the complications of gonorrhea?

A

Men: rare, epididymitis and prostatitis
Women: abcess and inferitility

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24
Q

What are the characteristics of disseminated gonorrhea?

A

Septicemia and infection of skin and joints, pustular rash and purulent arthritis

  • large grey necrotic ulcer with erythemus base
  • purulent conjunctivitis = newborn with vaginal delivery
  • anorectal in MSM
  • perihepatitis (Fitz-Hugh-Curtis)
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25
Q

How is gonorrhea diagnosed?

A
  • smear with gram - bean diplococci neutrophils (4+ men, 2+ women)
  • culture if appropriate
  • NAAT combined test with chlamydia
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26
Q

How is gonorrhea treated?

A

ceftriaxone and doxicycline/azithromycin (treat chlamydia presume gonorrhea)

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27
Q

How is neonate gonorrhea treated?

A

Prophylaxis with erythromycin

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28
Q

How is occular gonorrhea treated?

A

Ceftriaxone

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29
Q

What is the classification of T pallidium (syphilis)?

A

gram negative sphirochete, mobile, microaerophilic, sensitive to heat and disinfectant

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30
Q

What is characteristic of primary syphilis?

A

-1+painless indurated skin lesion at entry with inflammation that lasts weeks to 2 months

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31
Q

What is characteristic of secondary syphilis?

A

Flu-like symptoms, prominant skin lesions over body as well as raised condyloma lata at skin folds

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32
Q

What is characteristic of latent syphilis?

A

Asymptomatic continued transmissable infection

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33
Q

What is characteristic of tertiary or late syphilis?

A

diffuse and chronic destruction of tissues

-gummas

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34
Q

What is congential syphilis?

A
  • newborns born with rhinitis and maculopapular rash

- teeth and bone malformation, blindness, deafness, cardiovascular issue

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35
Q

What is ocular syphilis?

A

any eye structure infected that can result in permanent damage

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36
Q

How is syphilis diagnosed?

A
  • nontreponemal test: measure Ab to cardolipin RPR, and VDRL

- treponemal: Ab to t palidium

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37
Q

How is syphilis treated?

A

penicillin or doxycycline/azithromycin for allergic

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38
Q

What are the symptoms for urthertitis in males?

A
  • blood in urine and semen
  • burning with urination
  • polyuria
  • itching and tenderness
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39
Q

What are the symptoms of urethritis in women?

A
  • abd and pelvic pain
  • burn with urination
  • fever and chills
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40
Q

What are the most common non-gonoccocal urethritis?

A

most = chlamydia

-m. genitalium and u. urealyticum

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41
Q

What must be kept in mind when treating non-gonococcal urethritis?

A

Resistant to penicillin, cephalosporin, vancomysin

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42
Q

What are the characteristics of m. gentialium and u. urealyticum?

A

sterol in membrane

-smallest free living with no cell wall

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43
Q

What does mycoplasma hominis resemble?

A

Fried egg

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44
Q

What is used to treat m. genitalium?

A

resistant to doxcycline/azithromycin

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45
Q

what is used to treat men with non-gonococcal urethritis?

A
  • doxcycline

- recurrent - azithromycin or quinolones

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46
Q

What disease is associated with haemophilis ducreyi?

A

Chancroid

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47
Q

What classifications is haemophilis ducreyi?

A

gram negative, pleomorphic coccobacilius, facultative anaerobe

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48
Q

What is the characteristic of chancroid?

A

Painful papule with erythemous base 5-7 days post exposure

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49
Q

How is chancroid diagnosed?

A

1+ painful ulcers, No T palidum, positive lymphadenopathy, and negative HSV

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50
Q

How is chancroid treated?

A

Macrolide azithromycin or erythromycin

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51
Q

What bacteria is associated with Donovanosis/Granuloma inguinale?

A

Klebsiella granulomatis

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52
Q

What are the classifications of Klebsiella granulomatis?

A

gram negative encapsulated intracellular

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53
Q

What are the characteristics of Donovanosis?

A

primary lesions painless and wart-like but bleed easily

-significant gential damage if untreated

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54
Q

How is Donovanosis diagnosed?

A

Rule out other, Donovan bodies in specimen

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55
Q

How is Donovanosis treated?

A

Prolonged tetracycline, sulfamethoxazole, gentamicin, ciproflaxacin, or erythromycin

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56
Q

What should be done about genital ulcers?

A
  • all tested for syphilis, herpes, or ducreyi

- treat with suspected before labs return

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57
Q

What is bacterial vaginosis?

A

overgrwoth of anaerobic species and reduction of lactobacillus

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58
Q

What are the symptoms of bacterial vaginosis?

A

Discharge, odor, pain, burning, itching

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59
Q

How is bacterial vaginosis diagnosed?

A
  • Amsel: grey/white discharge clue cells, fishy odor with KOH4.5
  • Nugent: based on ratio of lactobacillus, G vaginalis, and mobiliunus (7-10 =BV)
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60
Q

What are the complications of bacterial vaginosis?

A
  • increased susceptibility to hIV and passing it
  • increased infection post-surgery
  • preterm deliver, miscarriage, and infection after delivery
  • increased susceptibility to STD
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61
Q

How is bacterial vaginosis treated?

A
  • anaerobe/parasite = metronidazole

- gram+/anaerobe = clindomycin

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62
Q

What is vulvovaginal candidiasis?

A

common fungal infection with candida albicans in women of childbearing age

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63
Q

What are the classical symptoms of vulvovaginal candidiasis?

A

thick, odorless, white vaginal discharge

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64
Q

What is uncomplicated versus complicated vulvovaginal candidiasis?

A

uncomp: sporadic, infrequent in otherwise healthy individ
comp: recurrent or severe or non-albicans or pt has uncontrolled diabetes, debilitation, or immunosuppression

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65
Q

What are the characteristics of candida albicans

A
  • frequent after antibiotics

- immunocompromised - esophagitic disseminated

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66
Q

What are the classifications of candida?

A

oval yeast-like that produce buds and pseudohyphae and hyphae
-germ tubes

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67
Q

What are the risk factors for vulvovaginal candidiasis?

A

local or generalized immunosuppression: oral contraceptive, pregnancy, diabetes, corticosteroids, HIV infection, antibiotics

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68
Q

How is vulvovaginal candidiasis diagnosed?

A

culture iwth 10% KOH = hyphae and budding

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69
Q

What is the treatment for Vulvovaginal candidiasis?

A
  • 1-3 day topical azole = uncomplicated

- 7-14 day topical or 2 fluoconazole = complicated

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70
Q

What is the most common curable STD?

A

Trichomonas

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71
Q

What are the symptoms of female trichomonas?

A
  • asymptomatic or scant watery discharge

- severe vaginitis, with dysuria and yellow-green frothy foul smelling discharge

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72
Q

What are the symptoms of male trichomonas?

A

Asymptomatic carriers

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73
Q

What are the classifications of trichomonas?

A

small pear protozoa (motile) with axostyle for attachment (only trophozoite)

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74
Q

What is the pathogenisis of trichomonas?

A
  • destructionof epithlail, netrophilial influx and petechial hemorrages
  • no clinically significant immunity so possible reinfection
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75
Q

How is trichomonas diagnosed?

A

swimming T vaginalis in exudate, asymptomatic PAP smear

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76
Q

How is trichomonas treated?

A

Metronidazole for both partners

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77
Q

What is the infecting bacteria with toxic shock syndrome?

A

S. aureus

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78
Q

What are the classifications of S aureus?

A

gram + cocci, catalase +, coagulase +

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79
Q

What is TSST-1?

A

heat and proteolytic resistant exotoxin of s aureus

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80
Q

How does TSST-1 function?

A

-can penetrate mucosal barrier and is responsible for systemic effects
-superantigen stimulate T cell activation and release of cytokines
-macrophage release IL-1B (fever), and TNF-a (shock)
t cell release IL-2 and IFN-g

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81
Q

What are the symptoms of toxic shock syndrome?

A

diarrhea, ill-feeling, fever and chills, nausea and vomiting

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82
Q

How is TSS diagnosed?

A

must have all major symptoms and 3 minor

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83
Q

How is TSS treated?

A

remove tampon, supportive measure, stop tampon use

-beta lactamase resistant penicillin or vancomycin

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84
Q

What are the classifications of the HIV virus?

A

ssRNA, reverse transcriptase polymerase

  • nucleocapsid with p24 capsid protein
  • envelope with gp41 (fusion) and gp120 (attachment)
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85
Q

What is the concentration of CD4+ cells associated with AIDS?

A

<200uL

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86
Q

Where is HIV-1 found?

A

predominant worldwide and in the US

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87
Q

Where is HIV-2 found?

A

W. Africa, less likely to progress to AIDS

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88
Q

What are the steps of the HIV lifecycle?

A
  1. Attachement: gp120 binds CD4 on T lymphocyte, monocyte, and macrophage cuasing conformational change in gp120 so can bind CCR5 or CXCR4
  2. Fusion: gp41 mediates b/w viral envelope and plasma membrane
  3. Reverse transcription: produce linear dsDNA, most error prone of all retroviruses = rapid evolution = need for multidrug treatment
  4. Integration: dsDNA moves into nucleus where viral integrase causes incorporation =provirus
  5. genome replication
  6. Trasncription
  7. Budding: at lipid rafts
  8. Maturation: protease cleaves gags to ensure infectivity of virion
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89
Q

What types of drugs are used to inhibit HIV at entrance?

A
  • chemokine receptor antagonist that bind coreceptor and prevent binding with gp120 (maraviroc)
  • fusion inhibitor bind gp41 and prevent conformational change
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90
Q

What types of drugs are used to inhibit HIV reverse transcriptase?

A
  • NRTI: incorporate n growing DNA chain during provirus synthesis and cause chain termination (Azidothymidine)
  • NNRTI: bind to reverse transcriptase and inhibit (Nevirapine)
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91
Q

What type of drugs are used to inhibit HIV integration?

A

integrase inhibitor: block DNA entrance to cell (Raltegravir)

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92
Q

What type of drugs are used to inhibit HIV protease?

A

Protease inhibitor: protease inhibition causes immature and defective HIV (squinavir)

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93
Q

What is the common standard for drug treatment of HIV?

A

1PI + 2NRTI or 1II + 2NRTI with prophylactics for opportunistic infections

94
Q

What is R5 tropic HIV?

A
  • uses CCR5 coreceptor
  • transmitted person to person and is predominant in early disease
  • infects monocytes/macrophages and microglia
95
Q

What is X4-tropic HIV?

A
  • uses CXCR4 receptor
  • 40% transfer over to this during disease progression
  • associated with rapid progression to AIDs
96
Q

What is CCR5 deletion?

A
  • subset of population with deletion in CCR5 affecting binding to gp120
  • heterozygous = longer asymptomatic phase
  • homozygous = no infection with R5 tropic virus
97
Q

How is HIV transmitted?

A
  • sexual: male->female most effective, heterosexual most common, increased risk with genital lesion from STD
  • mother to child: 1/4 risk overall, but can be reduced at every step
  • accidental exposure health care: 0.3% with skin puncture, 0.09% with mucous membrane, and can be reduced further with prophylactic
98
Q

What is the acute syndrome of HIV?

A
  • 3-6weeks following infection
  • symptoms: fever, malaise, arthralgia, lymphadenopathy, sore throat, rash
  • may no have detectable levels of Ab at this time
99
Q

What is the immune response phase of HIV?

A

-following initial viral burst, Ab rise and virus decreases

100
Q

What is chronic phase of HIV?

A
  • low viremia, gp120 genetic drift, inactivation of immune response, cell to cell fusion
  • asymptomatic median time 10years
101
Q

What is characteristic in progression to AIDs?

A
  • reduced CD4+ and inability to fight other infections
  • oral hairy leukoplaia from ebstein barr, pneumonia from pneumo carinii and mycotuberculosis, thrush from candida albicans, cytalomegalovirus, Karposi sarcoma, B cell lymphoma, diarrhea from cryptosporidium and isospora beli
102
Q

How is HIV diagnosed?

A
  • HIV 1/2 Ag/Ab immunoassay: screen test for HIV
  • HIV 1/2 Ab differentiation: difference between the 2
  • HIV nucleic acid test: detect genome before ab produced and follow antiretroviral treatment
103
Q

What is the first stage of Herpes Simplex Virus?

A
  • inital gential/priary infection
  • lesions progress from macules, papules, veiscles, pustules to ulcer
  • fever and inguinal adenopathy
  • lesion lasts around 3 weeks and symptoms are more severe in women
104
Q

What is the recurrent stage of Herpes Simplex Virus?

A
  • 3-5 discreet lesions
  • vulvar irritation
  • heal every 7-10 days
105
Q

When is neonatal HSV most dangerous?

A

Highest risk to infants born to mother in primary infection

-most dangerous if encephalitis with skin or disseminated

106
Q

What are the complications in neonate skin, eye, and mouth HSV?

A
  • non-lethal prevent 10-11 days postnatal

- blind, microcephaly, and quadraplegia without treatment

107
Q

What are the complications in neonate HSV encephalitis with skin involvement?

A

50% fatal if untreated

  • survivor have neurological impairment
  • disseminated = visceral organs and skin 80% mortality
108
Q

What are the virological classifications of HSV?

A

enveloped dsDNA that encodes its own enzymes for genome replication

109
Q

What disease is associated with HSV 1 and 2?

A

1 =oral lesions

2 = genital lesions

110
Q

How is HSV transmitted?

A

-direct contact with lesions, saliva, sex

111
Q

How is HSV diagnosed?

A
  • clincal lesion 1-2 mm diameter in groups

- virological tests: PCR to detect genome and immunocytochemistry for Ag

112
Q

How is oral HSV treated?

A

not treated

113
Q

How is genital HSV treated?

A

primary outbreak = oral acyclovir

recurrent = long term acyclovir

114
Q

How is neonatal HSV treated?

A

IV antiviral

115
Q

How is occular HSV treated?

A

topical

116
Q

What are considerations when treating HSV?

A
  • drugs dont work on latent stage of infection

- if nonnucleoside infection or allergic to acyclovir = foscarnet

117
Q

What virus is responsible for genital warts?

A

Human Papilloma Virus

118
Q

What are the characteristics of genital wart lesions?

A

Hyperkeratoic firm exophilic 1mm-2cm

119
Q

What are respiratory papillomatosis?

A

-nodules on ciliated and squamous epithelium at junction of larynx resulting in altered cry, hoarse, stridor and respiratory distress

120
Q

What is the treatment for respiratory papillomatosis?

A

Surgical removal

121
Q

What are the classifications of HPV?

A

papaoviridae, nonenveloped dsDNA where replication is tied to tissue infected

122
Q

What strains of HPV are linked to cervical cancer?

A
E6 = prevent p53 which stops apoptosis and stops inhibition of cell cycle progression
E7 = prevents Rb inhibition of cell cycle progression
123
Q

How is HPV transmitted?

A

sex, cuts

124
Q

How is HPV diagnosed?

A

clinical presentation, PCR to ID HIV type

-pap smear with koilocytes with hyperchormatic nucleus and halo

125
Q

What are the guidelines for pap smear?

A
  • start at 21 Q3y
  • Q5y at 30
  • stop at 65 if adequate
126
Q

How is genital HPV treated?

A

podophyllotoxin, sinectacins, imiquimol, cryotherapy and laser

127
Q

How are cervical neoplasms from HPV treated?

A

low grade = remove

high grade = chemo and hysterectomy

128
Q

What is the standard in HPV prevention?

A

HPV 9 vaccine for both genders

129
Q

What are lower UTI symptoms?

A

-dysuria, polyuria, back pain, cloudy urine and positive urine test

130
Q

What are prostatitis symptoms?

A

lower back pain, high fever, chills, positive urine test

131
Q

What are pyelonephritis symtpoms?

A

pain in flank, high fever, diarrhea, vomiting, positie uirne

132
Q

What lab values are associated with UTI?

A

> 10 WBC/mm3

-at least 1 bacteremia

133
Q

What is community acquired UTI?

A

Colonization of fecal flora 80-95% E Coli, Staph saporphyticus

134
Q

What is hospital acquired UTI?

A

Catheter = Klebsiella, enterobacteria, serratia, pseudomonas

135
Q

What are classifications of E Coli?

A

Gram -, pili for adherence, ferment lactose

-hemolysin A to lyse RBC and other cells for immune response

136
Q

What is the reservoir for UTI causing E Coli?

A

intestinal flora

137
Q

What are the two types of pili of E Coli?

A

Type 1 = bind mannose on epithelium

-P that bind sugar on uroepithlail

138
Q

How is an E Coli UTI treated?

A

fluoroquinolones

139
Q

What two bacteria are associated with Coagulase negative staphylococci UTI?

A

S epidermidis and S saprophyticus

140
Q

What are the classifications of CoNS UTI?

A
  • catalase + gram + nonmotile

- saprophyticus = novobiocin resistant

141
Q

What are the two diseases of CoNS bacteria?

A
epidermidis = infection of implant and prosthesis
-saprophyticus = normal GI = UTI (hemagglutinin/adhesin)
142
Q

How is a CoNS UTI treated?

A

Amoxicillin

143
Q

What enteric bacteria is associated with kidney stones?

A

Proteus mirabillis (catheter associated UTI)

144
Q

Why is proteus mirabillis associated with kidney stones?

A

Has urease that causes alkalinization of urine so that Mg and Ca precipitate out and form stones

145
Q

What enteric bacteria is associated with UTI from long term cathetraer use?

A

Pseudomonas aeruginosa

146
Q

What are the classifications of P aeruginosa?

A

gram - aerobic oxidase + nonfermenting that grows at wide temperatures and minimal nutrition

147
Q

What are the classifications of enterrococcus?

A

gram + coci, catalase - group D wall Ag, that tolerates high salt and bile content but not sensitive to optochin

148
Q

What are the two strains of enterrococcus associated with UTI?

A

faecalis and faecium

149
Q

What is associated with increased risk for enterrococcus UTI?

A

indwelling hospital catheter on broad spectrum antibiotics

150
Q

How is enterrococcus UTI treated?

A

amoxicillin

151
Q

How are enteric UTI treate?

A

fluoroquinolones

152
Q

What is asymptomatic bacteriuria

A

common in elder pop

25-50% ambulatory elder women, and 15-40% men in care facility

153
Q

What is the treatement for uncomplicated cystitis?

A

trimethoprim/sulfamethoxazole

154
Q

What is treatement for asymptomatic bacteriuria?

A

Cephalexin or nitrofurantoin

155
Q

What are the arboviruses?

A

dengue, yellow fever, zika, chikunguna, and colorado tick fever

156
Q

What is the vector/reservoir for Dengue?

A
  • urban = aedes mosquito

- sylvatic = monkey

157
Q

Where and how is Dengue transmitted?

A
  • H->H and H-> a
  • mosquito saliva
  • Tropics, Fl and Tx
158
Q

What is the disease onset for Dengue?

A

1 week with 1-2 convalesences

-acute fever, ache, pain, maculopapular rash

159
Q

What is the progression of Dengue?

A

HF/SS: as fever decreases, skin hemorrhage, epistaxis, bleeding gums, and circualtory failure
-shock = thrombocytopenia and hemoconcentration

160
Q

Why does HF and SS occur in dengue?

A
  • hypervirulent strains

- Ab enhanced with 2nd infection = vasoactive

161
Q

How is Dengue diagnosed?

A

Lab isolation of virus or Ab detection

162
Q

How is Dengue treated?

A
  • fever = relieve symptoms

- HF/SS = fluid replacement

163
Q

What is the vector for yellow fever virus?

A

-mosquito

164
Q

What is characteristic for transmission of yellow fever?

A

H-> H H-> M

-S. America and Africa

165
Q

What is incubation time on yellow fever?

A

3-6 days

166
Q

What is disease onset of yellow fever?

A

acute = fever bachache, shivers, anorexia, nausea and vomiting

167
Q

What is disease progression of yellow fever?

A

15% go to toxin within 24 hours

-kidney failure, fever, jaundice, hemorrhages

168
Q

How is yellow fever diagnosed?

A

anti-YFV Ab

-PCR

169
Q

How is yellow fever treated?

A

supportive and rehydration

170
Q

How is yellow fever prevented?

A

vaccine

-1 wk for immunity good for 10 yrs

171
Q

What is vector of Zika?

A

mosquito

172
Q

What is characteristic of transmission of Zika?

A
  • sexual

- Brazil, Tx and Fl

173
Q

What is the incubation time of Zika?

A

1 week

174
Q

What is disease onset of Zika?

A

<20% experience symptoms for a week

-headache, fever, rash, joint pain, conjunctivitis

175
Q

What are the complications of Zika?

A

microcephally, Guillen-Barr Syndrome

176
Q

What is the pathology of Zika?

A

infection = immunity

-pregnant avoid areas, women wati 2 mo post and men wait 6 months

177
Q

What is the vector and reservoir for Chikungunya?

A
  • vector = aedes mosquito

- reservoir = humans

178
Q

What is characteristic of transmission of Chikungunya?

A
  • associated with travel

- Carribean, Fl, and Puerto Rico

179
Q

What is the incubation time of Chikunguna?

A

3-7 days

180
Q

What is the disease onset of chikungunya?

A

acute for 3-10 days

-high fever, joint pain, vomit, conjunctivitiis

181
Q

What is the disease progression of chikungunya?

A

some with joint pain up to 1 month

-some relapse rheumatic sympoms

182
Q

How is Chikungunya diagnosed?

A

specific Ab, molecular probes

183
Q

How is chikungunya treated?

A

relieve symptoms

184
Q

What is the vector and reservoir for Colorado Tick Fever Virus?

A
vector = rocky mountain wood tick
reservoir = squirrel, chipmunk, rabbit
185
Q

What is the disease onset of Colorado Tick fever?

A
  • leukopenia

- biphasic 2-3 day fever, chill, photophobia, myalgia

186
Q

What is the disease progression of Colorado Tick Fever?

A

rare CNS involvement or hemorrhagic

187
Q

What is the pathology of Colorado Tick Fever?

A

infect erythroid progenitor or hemaotprogenitor cells

188
Q

How is colorado tick fever diagnosed?

A

serological or molecular to confirm

189
Q

What is the treatment for Colorado tick fever?

A

supportive

190
Q

What is the vector and reservoir for Ebola?

A

vector - primate and man

reservoir = rodent and bat

191
Q

What is characteristic of transmission of ebola?

A

endemic to africa

192
Q

What is disease onset of ebola?

A

starts flu like and progresses to severe fatal hemorrhage

193
Q

what is the pathology of ebola?

A

replicates and destroys parenchya of liver, lungs, spleen, and lymph

194
Q

How is ebola diagnosed?

A

serological

195
Q

What is the treatment for ebola?

A

none - quarantine important

196
Q

What is the vector for Hantavirus?

A

each strain has different rodent host

197
Q

What is characteristic of transmission of Hantavirus?

A

No person to person to person

-asia, europe, SW US

198
Q

What is disease onset of Hantavirus?

A

3-5 days of fever myalgia, chills, cough, and GI involvement

199
Q

What is disease progression of Hantavirus?

A

In 24 hours get hypotension, pulmonary edema and hypoxia

200
Q

What is pathology of hantavirus?

A

associated with renal failure and disseminated intravascular coagulation

201
Q

what is the treatment for hantavirus?

A

mechanical ventilation and supportive

202
Q

What are the classifications for bacillus anthracis?

A

gram + aerobic spore forming, long chains

203
Q

What are the reservoir for anthrax?

A

Herbivores eating containated pasture

204
Q

What is characteristic of transmission of anthrax?

A

innoculation with spores

205
Q

What are the characteristics of cutaneous anthrax?

A
  • 2-12 day incubation
  • red papule that becomes necrotic ulcer but goes away
  • associated with butchers
206
Q

What are the characteristics of inhalation anthrax?

A

1 wk - month incubation

  • nonspecific inital to fever, dypsnea and cyanosis
  • 50% meningitis
  • 100% fatal without treatment
207
Q

What are the characteristics of GI anthrax?

A
  • 1-7 day incubation
  • upper= fever,oryngopharynx ulcers
  • intestinal = fever, nausea, bloody vomit and diarrhea that lead to sepsis
208
Q

What is the pahtology of anthrax?

A

Poly-D-glutamic acid capsule

209
Q

How is anthrax diagnosed?

A

Clinical sign and bacteria in wound

210
Q

How is anthrax treated?

A
Cutaneous = amoxicilin
Inhalation/GI/bioterror = doxycycline with ciprofloxacin an 2 others
211
Q

How is anthrax prevented?

A

vaccinate high risk humans and animals

212
Q

What are the classifications of brucella?

A

gram - coccobacilli intracellular

213
Q

What are the different strains of brucella?

A
Cattle = abortus
swine = sulis
Goat = meltensus
214
Q

What is characteristic of transmission of brucellosis?

A

ingestion/inhalation of live organsims

-associated with unpasteruized products

215
Q

What is incubation time on brucellosis?

A

1wk-3mo

216
Q

What is disease onset of brucellosis?

A

fever joint pain and headache
=fever in morning but normal by night
-pregnancy = bad

217
Q

What is pathology of brucellosis?

A

in phagosome of monocyte and macrophage

218
Q

How is brucellosis diagnosed?

A

Pt Hx of exposure

-blood bulture and serology

219
Q

How is brucellosis treated?

A

6wk rifampin and tetracyclin

220
Q

What are characteristics of pasteruella multoada?

A

gram - anaerobic coccobacilli

221
Q

What is characteristic of transmission of pasteruellosis?

A
  • reservoir in nasopharynx of domestic animals

- bite/scratch of animal or dog lick wound

222
Q

What is incubation period of pasteruellosis?

A

12-24 hours

223
Q

What is disease onset of pasteruellosis?

A

red swelling pain (abcess) around wound

  • untreated = tendon, bone, joint infection
  • immunocompromised = systemic
  • COPD = pneumonia
224
Q

What is pathology of pasteruellosis?

A

Polysaccharide capsule of hyaluronic acid

225
Q

What is diagnosis of pasteruellosis?

A

clinical exposure and culture

226
Q

What is treatment of pasteruellosis?

A

penicillin

227
Q

What are classifications of leptospira interrogans?

A

mobile gram - spiral with hooks

228
Q

What is associated with transmission of leptospirosis?

A

domestic animal urine

  • tropics, US= hawaii
  • swimming pool or vets
229
Q

What is the disease states of leptospirosis?

A

Phase 1 = fever flulike 1 wk

PHase 2 = weeks of meningitis, eye inflammation, jaundice, and ptechial rash

230
Q

What is pathology of leptospirosis?

A

Invade abraded skin and mucus

231
Q

What is treatement of leptospirosis?

A

penicillin or ampicillin