Micro

Question 1

how do ongoing STIs facilitate the transmission of HIV?

Answer 1

create small mucosal lesions where CD4 T cells and macrophages are so it gets easy access

Question 2

which cause of vaginal discharge is strictly STI?

Answer 2

protozoal, the other two can also be from overgrowth of normal microbiota

Question 3

what is the cause of bacterial vaginosis?

Answer 3

decreased lactobacilli

overgrowth of gardnerella vaginalis

Question 4

what is seen on wet prep for bacterial vaginosis?

Answer 4

clue cell

Question 5

what are the criteria for diagnosis for bacterial vaginosis?

Answer 5

pH >4.5
thin white (milky) discharge
fishy odor with "whiff test"

Question 6

Discuss gardnerella vaginalis?

Answer 6

Gr + rod
non motile, non encapsulated
beta hemolytic
creates biofilms -> vaginosis
resistant to lactic acid h2O2

Question 7

risk factors for fungal vulvovaginitis

Answer 7

diabetes
antibiotics
pregnancy
inc. exposure to moisture

Question 8

what are the criteria for dx of fungal vulvovaginitis

Answer 8

pH

Question 9

Discuss candida albicans

Answer 9

dimorphic fungus
ubiquitous
pseudohyphae in vivo
true hypae in environment
dx with germ tube test

Question 10

risk factors for candida albicans infection

Answer 10

antibiotics, dec. CMI, diabetes, elderly, catheter

Question 11

what are the criteria for diagnosis of trichomoniasis

Answer 11

pH >4.5
yellow greeen frothy discharge
fishy odor on "whiff test"
microscopy: trichomonads, >10 WBCs per high powered field
strawberry cervix

Question 12

Discuss trichomonas vaginalis

Answer 12

flagellated protozoan
motile
trophozoite (no cyst)
facultative anaerobe
proteases, toxins-VF
dx with NAAT and other molecular tests

Question 13

what are the trichomonas 5 Fs?

Answer 13

flagella
frothy discharge
fishy odor
fornication
flagyl (metronidazole)

Question 14

Discuss lactobacillus

Answer 14

Gr + rod
non endospore forming
acidophilic (produces lactic acid)
makes hydrogen peroxide

Question 15

Discuss mycoplasma

Answer 15

prokaryotes
CM contains sterols
pleopmorphic-> lacks cw
tiny fried egg colonies

Question 16

discuss strep. agalactiae (GBS)

Answer 16

Gr + coccus, chains
sialic acid capsule
leading cause of meningitis  in kids
beta hemolytic
bacitracin resistant
catalase -
\+ CAMP and hippurate hydrolysis

Question 17

what is the main cause of NGU urethritis?

Answer 17

chlamydia trachomatis

Question 18

what are the characteristics of NGU discharge vs gonococcal discharge?

Answer 18

NGU- clear and serous

GU- purulent

Question 19

general characteristics of Neisseria gonorrhoeae

Answer 19

gr - diplococcus
kidney beans
human reservoir
LOS
oxidizes glucose
oxidase +
catalase +
chocolate/thayer martin agar`\

Question 20

what can infections from childbirth manifest as?

Answer 20

conjunctivitis, pharyngitis, arthritis, sepsis, meningitis

Question 21

what are the virulence factors for Neisseria gonorrhoeae

Answer 21

opa 
pilli
IgA1 protease
facultative intracellular
LOS
bind host sialic acid
outer membrane blebbing

Question 22

general characteristics of chlamydia trachomatis

Answer 22

gr -
obligate intracellular
lack peptidoglycan
human reservoir
elementary body in environment
reticulate body (actively replicating)

Question 23

what can infections during childbirth cause?

Answer 23

inclusion conjunctivitis, pneumonia

Question 24

what are the signs of a disseminated gonococcal infection?

Answer 24

migratory polyarthralgia
septic arthritis
petechial skin lesions

Question 25

what do you see on gram stain for gonorrhea?

Answer 25

PMNs with intracellular gram - diplococci in the cells

Question 26

what is reiter syndrome in associate with chlamydia?

Answer 26

urethritis, arthritis, conjunctivitis, mucocutaneous lesions

Question 27

the most frequent cause of bacterial STI in the US is?

Answer 27

chlamydia

Question 28

actinomyces israelii PID is associated with waht?

Answer 28

IUDs

Question 29

the causes and effects of PID CAN be EPIC

Answer 29

``` Chlamydia actinomyces Neisseria Ectopic Pregnancy Infertility Chronic pain ```

Question 30

what is the cardinal presenting symptom of PID

Answer 30

lower abdominal pain

Question 31

what causes the complication Fitz hugh curtis syndrome

Answer 31

PID due to chlamydia and neisseria | adhesions similar to violin strings found between abd wall and liver

Question 32

what is seen with PID on pelvic exam?

Answer 32

CMT purulent endocervical discharge tender adnexal mass

Question 33

how should PID be treated

Answer 33

treated as a mixed infection

Question 34

Discuss actinomyces israelii

Answer 34

gr + filamentous bacillus human reservoir non acid fast characteristic sulfur granules

Question 35

describe HPV

Answer 35

naked dsDNA, circular replicates in nucleus

Question 36

what types of HPV cause genital warts and laryngeal papillomas

Answer 36

types 6 and 11

Question 37

what is condylomata acuminata

Answer 37

genital warts

Question 38

what type of HPV is most common in malignancy and can spontaneously regress?

Answer 38

type 16

Question 39

what are the two types of HPV that can cause malignancy?

Answer 39

type 16 and 18 | 16 most common

Question 40

what early HPV gene products are implicated in malignancy

Answer 40

E6 and E7 interact with pRB (tumor suppressor) degradation of p53 (tumore suppressor protein)

Question 41

which genital ulcers are painful?

Answer 41

genital herpes | chancroid ulcers

Question 42

which genital ulcers are painless?

Answer 42

syphilitic lymphogranuloma venereum granuloma inguinale

Question 43

characteristics of genital herpes

Answer 43

``` enveloped dsDNA nucleus HSV2 mc recurrent painful vesicular lesions ```

Question 44

where does herpes lay dormant?

Answer 44

sacral ganglia

Question 45

what test do you use to test for genital herpes?

Answer 45

tzanch test showing multinucleate giant cells

Question 46

what does haemophilus ducreyi cause?

Answer 46

chancroid ulcers

Question 47

characteristics of haemophilus ducreyi

Answer 47

``` gr - coccobacillus strictly human pathogen facultative anaerobe chocolate agar cytotoxin, pili, LOS lymphadenopathy with bubos ```

Question 48

what is seen on gram stain with chancroid ulcers?

Answer 48

school of fish | gr - coccobacillus

Question 49

what does treponema pallidum cause?

Answer 49

syphillis

Question 50

characteristics of treponema pallidum?

Answer 50

``` gr - spiral human reservoir extremely labile very motile (axial filaments) penicillin sensitive ```

Question 51

characteristics of primary syphillis

Answer 51

highly infectious hard chancre painless

Question 52

characteristics of secondary syphillis

Answer 52

high infectious rash on skin may see condyloma lata

Question 53

characteristics of tertiary syphillis

Answer 53

noncontagious gummatous cardiovascular neurosyphilis

Question 54

what are the 2 serological tests for syphilis?

Answer 54

treponemal tests use pallidum as antigen nontreponemal tests (VDRL and RPR)

Question 55

what causes lymphogranuloma venereum

Answer 55

chlamydia trachomatis | invades lymphatic tissue

Question 56

what are the signs of lymphogranuloma venereum

Answer 56

tropical bubo | groove sign

Question 57

what causes granuloma inguinale

Answer 57

``` klebsiella granulomatis (gr - rod, capsule, nonmotile) donovan bodies subcutaneous nodules ```

Question 58

what is a normal microscopic test on syphilis?

Answer 58

dark field microscopy