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Flashcards in Genital ulcers and genital lesions Deck (11):
1

Syphilis pathology: Name; evasiom; CMI??; disease due to?

Treponema pallidum: spirochaete (spiral shape)
Evades immune system: is in immunologically privileged sites, intracellular, surface is inert
-CMI is critical and to the control of proliferation of bacterium
-Disease is the immune response: vasculitis, destruction and fibrosis

2

Syphilis early manifestations

onset: 9-90 days
Anogenital ulcers; rash; ocular lesions; CN 3,6,7 and 8 signs

3

eary confirmation of Syphillis diagnosis

Dark field microscopy: non specific
Direct fluorescent antibody test

4

Primary and secondary syphilis

Primary: 14-21 days after inoculation. papular rash that ulcerates.
Secondary: 4-10 weeks after primary lesion, haemtogenous spread. A rash that can vary and mucus membrane lesions

5

Tests for syphilis

___ test: overall pretty good, although might have to wit some timeas for primary syphilis not perfect
____: detects an AB against _____ Ag. Positive 3-5 weeks post exposure
_____: confirmatory, in early and late disease.

EIA test: overall pretty good, although might have to wit some timeas for primary syphilis not perfect
RPR: detects and AB against lipoidal Ag. Positive 3-5 weeks post exposure
TPPA: confirmatory, in early and late disease.

6

Early syphilis treatment

-Infected <2 years, benzathine penicillin IM
- Contacts are treated
-Allergy: doxycycline
-Pregnant: benzatine penicillin

7

Herpes infection

Transmission: mucosa more vulnerable
Replicates in epidermis
Travels via unmyelinated sensory neurons, where it can enter a latent phase
HSV1 and HSV2

8

Herpes treatment (Aciclovir facts)

Aciclovir- 15-20% _____
-Activation involves viral _______ ____
- host cell metabolises to ACV triphosphate
-This competitively inhibits ____ ____, incorporates into ___ chain and terminates chain
-HSV resistance uncommon
-L-valine ester makes _____, more bioavailable

Aciclovir- 15-20% bioavailability
-Activation involves viral thymidine kinase
- host cell metabolises to ACV triphosphate
-This competitively inhibits DNA polymerase, incorporates into DNA chain and terminates chain
-HSV resistance uncommon
-L-valine ester makes valaciclovir, more bioavailable

9

Chlamydia trachomatis and serovars L1,L2 and L3 (most common here is L2)

Presentation depends on site, and gender: transient anogenital ulcer, cervicitis , proctitis
Causes lymphogranuloma vereneum

10

HPV features

-DNA virus
-needs differentiating epithelial tissue to grow
-Anogenital warts it can cause, with some association with anogenital neoplasia
-E6 and E7 gene target TS genes and drive replication

11

HPV complications

Intraepithelial neoplasia
Most are benign, small number can cause anogenital cancer.
Smoking and immune status important co-factors
cervical cancer well described
oro-pharyngeal cancer and anal cancer becoming important theme