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T2 Endo/Repro > IID 1 > Flashcards

IID 1 Flashcards

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1
Q

Which main STIs produce sores? vs discharge?

A

sores- syphilis, HSV

discharge- gonorrhea, chlamydia, trichomonas vaginitis, candidiasis

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2
Q

which one produces painless sores?

A

syphilis

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3
Q

tests for syphilis

A

RPR, VRDL, darkfield fluorescence to find spirochetes
treponemal would be FTA-ABS
tests stay +

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4
Q 
primary syphilis
secondary
tertiary 
congenital
sx
A
  • prim- painless ulcer chancre
  • second- maculopapular rash and condyloma lata
  • tert- granulomatous gummas, neurosyphilis (w tabes dorsalis pupils dont react w light), CV aorta tree barking
  • congen- hutchinsons teeth, high mort, ocular issues
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5
Q

Tx for syphilis

A

PCN (purple pencil)

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6
Q

Haemophilis Ducreyi
sx
appearance on slides

A

PAINFUL chancroid genital ulcer, dis of tropics, satellite lesions, may be asymp in women

  • gram neg coccobacilli, needs hematin X factor and NAD V factor to culture on chocolate agar
  • histo: school of fish appearance
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7
Q 
Donvanosis/ granuloma inguinale
org
sx 
histo
pop
A
  • klebsiella (gram neg encaps rod)
  • bacteria looks like SAFETY PIN, intracellular donovan bodies in smear preps for dx
  • endemic to tropics/travelers
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8
Q

Genital herpes simplex (usu HSV2)

A

latency in neural ganglia, reactivation infxn, torches
-histo: tzanck smear with multinucl giant cells and COWDRY bodies in skin biopsies
(“Hermes”)

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9
Q

Neisseria gonnorhoeae
VFs
sx

A

pili, igA protease, with lots of ag variation, abx res, no capsule

  • sx: PID, neonatal conjunctivitis (Tx with abx), dx with smear and naats, tx with 3rd gen cef (and tx with azithro for chlam)
  • discharge
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10
Q

Chlamydia Trachomatis
VFs
dx
tx

A
  • vf: intracell, lacks peptidoglycan thus no muramic acid, biphasic rep cycle (elementary enters)
  • dx with NAAT, pcr etc, look for incl bodies
  • tx with Azithro and doxy
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11
Q

chalmydia sx

A
  • PID, infert/ectopic etc

- L serovar causes LGV painless ulcer, and boboes (lymph swelling)

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12
Q

Trichomonas vaginalis
sx
tx
histo

A

“Tricks for Money” –trophozoite transm

  • higher pH, frothy greenish yellow discharge, STRAWBERRY CERVIX!
  • tx: metronidazole
  • histo: wet mount will show trophozoites (puddle shape, these teardrop shaped creature things w/ motility)
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13
Q

Which HPV types are higher risk and can cause cervical cancer?

A

16 and 18

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14
Q 
Bacterial vaginosis
org
dx
histo
sx
A

“The Fish Garden”
Gardnerella and other anaerobes
-FOUL SMELLING discharge due to anaerobes, ph 4.5 and up, Clue cells from vag epith with bacteria (blue looking spots where missing fish were in sketchy_
-can cause PID and preg issues

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15
Q

Candida albicans
risks
ph
sx

A

Germ tubes at higher temp, yeast/pseudohyphae at lower temp, imbalance of normal vaginal

  • risks: fem hygeine products, ABX, DM
  • ph LESS than 4.5
  • cottage cheese white discharge, itching etc
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16
Q

Pubic lice tx

Scabies sx and tx

A
  • lice- permethrin
  • scabies- skin rash in folds, itch gets worse at night, tx with topical pesticides etc

both can be from sexual contact

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17
Q

which STI can lead to meningitis and stiff neck?

A

HSV!

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18
Q

other HPV sx, histo

A

small painless lesions that bleed after sex, koilocytes (blue sunny side up eggs from sketchy) on histo

  • vax: gardenesil
  • E6 and 7
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19
Q

haemophilis d tx

A

CEF and AZITHRO (like gon/chlam)

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20
Q

klebsiella tx

A

tetracyline (donovanosis, tropical)

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21
Q

Main TORCH infections

A 
Toxoplasmosis
Other (syphillis, varicella zoster, parvovirus b19)
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22
Q

Toxoplasmosis

A

org is toxoplasma gondii, cats are hosts, cat poop has oocysts which need to sit out for a few days to become infective (humans can also get it from meat this way etc or eating stuff off the floor)

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23
Q

Toxo in pregnancy and dev countries etc

A
  • preg women can get it from changing cat litter
  • in developing countries, congenital infxn is less likely bc kids get it so become immune, congen toxo only occurs if preg woman gets infxn for first time (ppl exposed in childhood cant pass it on)
  • the earlier preg woman gets infection, the less likely to pass it on yet the more severe!
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24
Q

Classic triad of congen toxo?

A

Chorioretinitis
Intracranial calcs
Hydrocephalus (CSF accum)
-long term CNS issues incl cog vis motor hearing or seizures

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25
preventing toxo
no regular screning but can dx with sero or pcr | -freeze or smoke/cook food, avoid cat poop contact
26
Syphilis transmission rate
from mother to fetus is 100%
27
some congen syphilis sx
prematureity, spont abortion or stillbirth etc
28
syphilis sx if affected EARLY in preg
``` maculopapular RASH!!! hepatosplen nontender lymphaden anemio/thrombocyto/leukopenia osteo issues neurosphilis snuffles/rhinitis ```
29
syphilis sx if affected LATE in preg
Deafness from CN 8 Interstitial keratitis (inflamed cornea) MR HUTCHINSONS TEETH (adult teeth tho)
30
if untreated, congen syphilis can result in
frontal bossing, saddle nose, saber shins (tibia anterior bowing)
31
Tests for syphilis nontrep and trep
nontrep- RPR, VDRL | trep-TPPA, FTA-ABS etc
32
if testing for syphilis in infant, which test?
RPR on mom and baby, if babys rpr is at least 4x higher than mothers, sus for syphilis
33
tx for syphilis
PEN! | -can screen preg women unlike with toxo
34
Varicella Zoster - is infxn primary? - percent that will get infxn - which trimester most infectious
- infxn must be primary (so shingles aka reactivation will not infect bby) - 25% of cases fetus will get infected tho only 2-3% show up clinically - 1st tirmester most infectious
35
congen varicella sx
skin lesions/scars, atrophied limbs, eye/cns issues, autonomic issues (hydroureter/gastric reflux etc)
36
How to prevent congen varicella? How does it spread
vax mother, give immune globin to primary infected mother and acyclovir, none for infants -spreads as aerosol (inhaled), replicates in lymph nodes
37
when can neonatal infxn of varicella show?
if mother shows infection 5 days before or 4 d after birth
38
neonatal varicella sx
``` GENERALIZED ERUPTION (rash) fever encephalitis pneumonitis hepatitis ```
39
Varicella vax
LIVE so dont give to preg women
40
Parvovirus B19 - percent transmission to fetus - what can happen if transmitted to fetus
30% transmission - can get hydrops fetalis (bone marrow suppression causing severe anemia and cardiac failure, resulting in edema and effusions), or miscarry, can be detected via ultrasound - no specific tx but can use intrauterine blood transfusions
41
Rubella can cause?
congen can cause miscarriage or congen anomalies, bc virus can cause progressive necrotizing vasculitis and focal inflam
42
rate of transmission of rubella early vs late in preg
more likely to get rubella EARLY AND more severe!
43
congen rubella sx
``` Blueberry muffin baby low birth rate, thrombo purpura hepatosplenomeg radiolucent bone lesions (less common are hep, lymphad, pneum, hemo anemia, cloudy corneas) ```
44
how long to babies with congen rubella remain infectios and what can sx progress to?
thru 1 yr | progressive sx affect cv, nervous, and unilateral retinopathy and cataracts
45
congent rubella tx | vax?
no tx! | vax is LIVE mmr, so dont give to preg women bc coudl transm to bby
46
CMV | likelihood of transm
most common! -40% transm to baby, but 90% asymp, soem get CNS issues, but if symp then usu severe disease with 12% mort by 6 mo w intrauterine growth restriction
47
CMV trimester timing, immunity, dev countries
- can occur at ANY point during preg AND with reactivation! (doesn't have to be primary), though much LESS SEVERE if reactivation) - unlike toxo, MORE likley to get it in developing countries
48
Sx of symptomatic CMV
neuro, microceph, lethargy, seizures - hypotonia, poor sucking ability - INTRACRANIAL CALCS - can also have longer term rash/petechia, jaundice and hepatosplen, and blueberry muffin rash (like rubella)
49
which congen infections cause blueberry muffin baby?
rubella and CMV
50
lab values of congen CMV
elev liver eynz, thromobcytopenia, conj hyperbili, hemolysis, incr CSF
51
Which virus is the leading cause of SENSORINEURAL DEAFNESS and second leading cause of dev disability?
CMV!
52
tx of cmv
GANCYCLOVIR | no vax, no routine screen
53
HSV | transmission in preg
The H in torch! (NOT hiv) - happens to bb when born thru vaginal, if mother has primary infx risk is 1/3-1/2, latency is 0-5% - 75% of bby with neonatal HSV are born to mothers with NO history or sx of HSV
54
Neonatal hsv manifestations
- DISSEM infection (1/4) with sepsis liver and cns, 50% mort even with tx, more common if mom has prim infxn at delivery - 35% have solely CNS, 15% mort, and those that survive have neuro issues - some have localized infxn at skin eye and mouth, ,but good outcome if dx and tx early
55
HSV tx
acyclovir for women during preg, or C section
56
Other congenital infections (non torch)
HIV | Neonatal gono and chalm
57
HIV congen transm sx dev countries
thru birht and breastfeeding - sx are intrauterine grwoth restriction, adeno, hepatosplen, opportunistic - still recommend breastfeeding in dev countries bc water contamination higher (diarr)
58
Neonatal gonococcal disease | sx and timing
opthalmia neonatorum with severe purulent CONJUNCTIVITIS 2-5 d after birth (can also happen with chlam, moraxella, or neisseria) -sepsis, arthritis, ifnlam
59
Neonatal chlamydia
ALSO opthalmia neonatorum 5-30 d (LATER and less ssevere conjunctivitis) and infantile pneum motnhs after with tachy and eosin
60
toxo tx
pyramethamine and sulfadiazine
61
neonatal vs congen rubella sx
congen is skin lesions scars atrophy cns and eye autonomics, neonatal is fever and generalized eruption enceph pneumo and hep -tx acyclovir for NEONATAL
62
``` Tx for Toxo Syphilis Varicella Parvo CMV HSV ```
``` toxo- sulf and pyrameth -syphilis- pen varicella - acyclocvir for neonatal CMV- gancyclovir HSV- acyclovir (like neonatal varicella) ```
63
3 dis manifestatiosn of HSV
dissem,solely CNS, localized infxn of skin eye mouth
64
diff in sx between neonatal gono and chlam
gono-2-5 d and has inflam / sepsis | chlam- 5-30 d and has pneum

T2 Endo/Repro (11 decks)

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