MICRO Flashcards by Joe Cioccio

T/F: garnderella vaginalis will elicit a whiff test with 10% KOH

False, pure G. vaginalis will not; a sample of bacterial vaginosis will though

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What agar can you grow Candida on?

Sauboraud dextrose

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Describe the appearance of Trichomonas vaginalis

4 flagella at the top of the head with one intracellular flagellum giving it a ruffled appearace (or just 4 flagella with ruffled appearance)

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What will you see on microscopy with: A) BV B) Candida and C) Trichomonas

A) clue cells B) hyphae and pseudohyphae and C) MOTILE trichomonads (4 flagella, ruffled body d/t intracellular flagellum)

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What mutation may occur in a person to confer immunity to HIV? What mutation may occur in the virus to lead to a long term survivor?

CCR5 (homozygous = best); nef mutation, since nef is needed to be infectious; NOTE the person is not immune to HIV they can still get superinfection and die. However, the particular strain of HIV they are infected with happens to be noninfectious

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What is the best Tx for chlamydia?

Azithromycin and (for the likely Gonorrhea coinfection) ceftriaxone

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Why culture Gonorrhea on Thayer-Martin agar when you can do NAAT?

To test for antibiotic resistance

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What is the treatment for gonococcus?

Ceftriaxone and (for Chlamydial coinfection) Azithromycin or Doxycycline

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What do you add to a vaginal sample to elicit a whiff test?

10% KOH

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Perianal ulcers from chlamydia would be most likely from which serovars?

L (not D-K)

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What type of virus is HPV?

naked (hearty) dsDNA

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Tx of A) BV B) Yeast and C) Trichomonas

A) Metronidazole B) Fluconazole and C) Metronidazole

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2 bugs suggested by a dysuria/pyuria presentation that has low bacterial count

staphylococcus saprophyticus and Chlamydia trachomatis

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This is the HIV fusion protein

Gp41

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Reservoir for HSV

MAN (lol)

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Which bacteria is predominately responsible for the low pH of the vagina?

lactobacillus

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Buzzword for clinical S/S of trichomonas

Strawberry cervix

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Host for Trichomonas

HUMANS

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Which aspect of N. gonorrhea is responsible for fallopian tube damage?

LOS

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Why aren’t there many AE with acyclovir?

It only kills/works in cells that are expressing VIRAL thymidine kinase

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What is one important way in which (a nuance, really) of the treatments for BV and Trichomonas differ?

No need to treat the partner for BV but need to for trichomonas because often asymptomatic

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What is the cause of most head and neck cancers?

Smoking but HPV causes a good amount

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Most common cause of bacterial vaginosis

Garnderella vaginalis

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How is HPV spread?

direct contact

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What will you find when you check liver enzyme tests for Fitz-Hugh-Curtis?

NORMAL FINDINGS (apparently gonorrhea has some abnormalities but chlamydia wont)

What is the difference in the reasons that you use 10% KOH to Dx candida vs. BV/Trich?

BV and trich will elicit a whiff test; candida it will kill off the normal flora and only show the hyphae

Which bug causes Fitz-Hugh-Curtis syndrome?

BOTH gonorrhea and the clap

How is HPV spread? How is herpes spread?

DIRECT CONTACT

Which bug that causes PID is most likely to cause a fever?

Gonococcus

What does latency really mean, molecularly?

In a latent period of infection, viruses are "living" inside infected cells but there is NO DNA replication and there is NO protein expression

How is Gardasil dosed?

1st dose, then 2 months, then at 6 mos

What is the relationship of estrogen and glycogen?

The higher the the estrogen, the higher the glycogen; so as one ages, there will be less glycogen

What is the epithelial cell receptor for gonorrhea?

CD66

This is the HIV attachment protein

Gp120

What are the oncogenic proteins of HPV?

E6 binds to p53, and E7 binds to Rb

Where does HSV-1 go latent?

Trigeminal ganglion

What is unique about the strain of gonococcus responsible for Diseminated gonoccocal infection?

it contains low molecular weight protein A1 and it grows on Auxotype AHU agar

2 reasons that antibodies in AIDS patients are usually IgM?

1) the virus undergoes a lot of antigenic drift so that new antibodies (i.e. IgM) need to be produced; 2) the lack of functioning T cells leads to the inability to class-switch when they have AIDS (i.e. later in the course) and so they have a functional Hyper-IgM syndrome

T/F: BV results in many PMN's

false it is not a true infection

What are the top 3 (in that order) causes of vaginitis?

1) BV 2) Candida (monilial) and 3) Trichomonas vaginalis

What is the main reservoir for HIV (in the body)? What is the early reservoir?

CD4 T cells; MO

Aside from Herpes, what other major virus family leads to syncytia or giant cells?

paramyxovirus

Gp120 attaches to this co-receptor on macrophages

CCR5

Which bug mostly has a watery discharge?

da clap

What is the CD4:CD8 ratio in a healthy adult?

2:01

T/F: you can kill Gardnerella vaginalis with metronidazole

False, you can treat bacterial vaginosis with it but it does not actually kill pure G. vaginalis

Odor in candida vaginitis

NONE just looks like a nightmare

pH in monilial vaginitis

NORMAL (diff from trich and BV)

What bug uses Opa proteins to enter cells? What receptor is it binding to?

Gonorreah; CD66

This genital infection is Tzank positive?

Herpes

What happens to people with heterozygous CCR5 mutations? Homozygous?

If heterozygous it is a slower course to AIDS with an HIV infection, if homozygous it is IMMUNITY; this is because of the difficulty for HIV to enter the MO

T/F: herpes can only be spread from a vesicle

false, herpes can be spread when it is latent/ no clinical s/s

Where does HSV-2 go latent?

Sacral ganglia

Why do they call 'em cold sores?

HSV 1 and 2 both tend to reactivate when the immune system is depressed, i.e. during a cold with zee rhinovirus (attach at ICAM-1, if you remember)

T/F: HIV is a haploid virus

ACTUALLLYYYY, no. It has 2 copies of ssRNA

What does lactobacillus use to create lactic acid (don't say pyruvic acid)

GLYCOGEN

Describe the normal discharge of the vagina

clear to white, odorless and high viscosity

Tx of herpes

acycovir or prodrug valacyclovir = better oral admin

Umbilicated lesions are essentially pathognomonic for \_\_\_\_\_\_\_\_\_\_\_

Poxviruses (MCV-1 and MCV-1, and smallpox but we don?t care about that)

Screening and diagnostic tests for AIDS

Screen: ELISA; Diagnostic = Western blot

What is the Chandelier response in PID?

When you palpate the cervix and they shoot their arms up as if to grab a chandelier because apparently that?s what you grab when you are in pain

How is the structure of herpes virus different from HPV?

HPV = dsDNA and NAKED; Herpes = dsDNA and enveloped

What is the Tx of molluscum?

curettage and liquid nitrogen

What is the laboratory diagnosis of Chlamydia?

Nucleic Acid Amplification Test

Tx of Candidal vaginitis

FLUCONAZOLE

What is the neonatal ophthalmic ointment for Chlamydia infections?

Erytrhomycin droplets

What is the structure of the poxviruses?

DS DNA genome

What are the obstetric complications of BV?

preterm labor and therefore, low birthweight infants

What antigen is detected earliest in HIV infections?

P24 , antibodies are made very early to it, it is the capsid protein

Gp120 attaches to this co-receptor on CD4 T-cells

CXCR4

What will you see when you gram stain for chlamydia?

nothing, just PMNs

What is a major clinical characteristic of herpes viruses?

LATENCY

Microscopy for bacterial vaginosis =

clue cells

T/F: both HPV and herpes remain in the host for the entirety of his/her life

false, herpes stays for life and HPV will eventually (usually) be taken care of by host CMI

What are 5 risk factors for BV?

Recent antibiotics, bubble baths, decreased estrogen production, and douching

What 2 bugs have a postive whiff test?

Bacterial vaginosis (multiple) and Trichomonas vaginalis (protist)

How do you treat BV?

Metronidazole

What herpes viruses go latent in WBC's?

EBV (via CD21) and CMV

Why would a newborn have laryngeal HPV?

aspirated from delivery

Which HPV types are associated with warts? With cancer?

6 and 11; 16 and 18

What is the pH of both BV and trichomonas infections?

greater than 4.5

Why are young females more susceptible to gonococcal infections than older females?

they have more stratified columnar epithelial cells which is the cell that gonorrhea infects

Characteristic cell from HPV on pap smear?

Koilocyte

MICRO Flashcards

(83 cards)