Flashcards in (Mostly) Sexually Transmitted Diseases Deck (121)
Loading flashcards...
1
Treponema pallidum is commonly referred to as...
Syphilis
2
Describe the structure of Treponema pallidum
Long, thin spirochete
- Unseen in light microscope, seen by silver stain
3
What type of microscope can view Treponema pallidum?
Dark Field Microscope
4
What surrounds every Treponema pallidum cell?
Glycosaminoglycan sheath
5
How is Treponema pallidum made motile?
Endoflagella within the periplasm (3 per end)
6
What is unique about Treponema pallidum's envelope?
No LPS
Cardiolipin in membrane
7
Does Treponema pallidum have many outer membrane proteins? Significance of this knowledge?
Few OM proteins
Makes it hard for immune system to find it and make Abs
8
Method used to culture Treponema pallidum?
None. So far unculturable in lab
Grown in rabbit testes instead
9
Oxygen metabolism of Treponema pallidum?
Microaerophilic
10
What is a chancre?
Defined, Unpainful papule at site of infection
11
Describe the symptoms common to Primary Treponema pallidum infection.
Ulcerated, Chancre, Regional LN swelling
Heals spontaneously, but organisms remain in blood
12
Describe the clinical presentation of secondary Treponema pallidum infection.
Red macular/macropapular rash anywhere
Condylomas in mount areas
13
What is unique about the red macular/macropapular rash of Treponema pallidum?
One of few to appear on soles and palms
14
What is a condyloma?
Raised, White, wart-like papule (seen in Treponema pallidum)
15
Difference between the early and late latent period?
Early -- Within a year of secondary
Late -- 1-20+ years
16
What is tertiary Treponema pallidum response?
Lesions of tissues through body caused by immune response
17
Why can't you culture a tertiary Treponema pallidum response?
Treponema pallidum hasn't been able to be cultured so far
Even if it could, its only immune response at this point, not the actual bacteria
18
Important causes of vertically transmitted disease
Toxoplasma
Other -- HIV, Coxsackie, Chicken Pox, etc.
Rubella
Cytamegalovieus
HErpes
Syphilis
19
Clinical presentation of tertiary Treponema pallidum response?
Gummas
Bones: porous, bendable, fragile
Heart: aorta swells, ruptures
liver
CNS
20
Two manifectstions of Treponema pallidum in the CNS
Brain -- General paresis
Spine -- tabes dorsalis
21
Significance of Treponema pallidum in pregnant women?
20% abortion or stillbirth
80% have congenital defects
22
Primary defects associated with Treponema pallidum transmission in utero? (Name the group name)
Hutchison's triad
23
What does Hutchison's Triad entail?
Blindness
VIII Nerve Deafness
Hutchison's Teeth
24
What are Hutchison's Teeth?
Double pointed incisors
25
What organisms can carry Treponema pallidum?
Only humans
26
How is Treponema pallidum transmitted?
Exclusively STD
27
How long are infected individuals contagious with Treponema pallidum?
3-5 years
28
What population is seeing the most rapid increases in Treponema pallidum diagnosis?
Over 50
29
Two groups that should always be tested for Treponema pallidum
High-Risk Populations
After any stillbirth
30
Describe the infectivity and molecular mechanism of Treponema pallidum infection.
Highly infectious
Hyaluronidase facilitates spread/invasion of tissues + Rapid Motility
31
How is Treponema pallidum controlled (in a public health-y kind of way)?
Finding, Testing Sexual Contacts
32
How is Treponema pallidum diagnosed?
Look for spirochetes in chancres
Serologic Tests for Treponema pallidum
33
What do indirect tests look for? Direct tests?
Antibodies
the Organism
34
Descrive the Treponema pallidum indirect test.
Add Cardiolipin to patient's serum
If + Reagin will cause it to clump
Many false positives
35
What is Reagin
IgM+IgA
36
What occurs in a direct Fluorescent Treponema Antibody test?
Sandwich assay for Treponema pallidum epitopes
37
How is early Treponema pallidum typically treated?
How is latent Treponema pallidum typically treated?
1 dose Penicillin G
3 doses Peni. for latent
38
Why does tertiary Treponema pallidum require much greater levels of penicillin?
You have to get through the Blood Brain Barrier
39
Describe the structure Neisseria gonorrhea.
G-
Coffee Bean Shape
Diplococcus
40
How is Neisseria gonorrhea cultured?
Best with selective media (vanco, colistin)
Also gros on MTM or chocolate blood
41
What oxygen metabolism does Neisseria gonorrhea use?
Aerobic, but likes 5% CO2
42
Describe the genetic setup on Neisseria gonorrhea
2 identical diploid chromosomes
NEVER heterozygous
43
Neisseria gonorrhea invades _______
Mucus membranes of UGT, Rectum, Eye, Throat
44
In either gender, Neisseria gonorrhea tends to present with... (4)
Urethritis
Proctitis
Pharyngitis
Arthritis
45
Unique Neisseria gonorrhea manifestations in women (5)
Vaginitis
Salphingitis
Pelvis Inflammatory Disease
Peritonitis
Major cause of infertility in women
46
How does Neisseria gonorrhea manifest in neonates?
Conjunctivitis
47
How is Neisseria gonorrhea spread?
Human STD
48
Neisseria gonorrhea is commonly associated with ______ co-infection. So What?
Chlamydia
Treat for both (presumed coinfection)
49
Why is Neisseria gonorrhea so widely spread?
Asymptomatic Carriers
50
How is Neisseria gonorrhea diagnosed?
Males -- Gram stain of urethral drip
Females -- Culture of cervical/vaginal swab
51
Unique components of Neisseria gonorrhea attachment?
- Pilus cassette switching avoids immune response
- Opa protein has a great deal of antigenic variation caused by slippage of DNA repeats
52
In females, Opas change during...
Menstrual Cycle
53
Three proteins involved in Neisseria gonorrhea evasion
Por
Rmp
IgA Protease
54
What is Por protein in Neisseria gonorrhea?
Outer membrane porin
Prevents phagolysosome fusion in host
55
What is Rmp in Neisseria gonorrhea?
Host Abs bind to it, prevents Ab binding to Por and LOS
56
Significance of IgA protease in Neisseria gonorrhea?
Stops IgA's bacteriocidal, complement activating activity
57
What two components of Neisseria gonorrhea mediate toxicity?
LOS
PG released from autolysins at low temp/alk. pH
58
What does Fbp protein in Neisseria gonorrhea do?
Scavenges Fe from human lactoferrin and transferrin
59
Neisseria gonorrhea secretes blebs with ____ inside
PG
60
Why is Neisseria gonorrhea hard to drug?
Resistance is acquired very easily
61
What do you do for patients with Pan-resistant Neisseria gonorrhea.
Say a prayer or something - they're keeping their Neisseria gonorrhea
62
How do you typically treat Neisseria gonorrhea?
Cephtriaxone or cefixime
(plus doxycycline/erythromycin for chlamydia)
63
How is newborn Neisseria gonorrhea treated?
Tetracycline drops
64
You've cured your Neisseria gonorrhea patient! Good job! What do you need to make sure not to forget?
Treat everyone they doinked
65
How is Neisseria meningitidis spread?
Respiratory Droplets
(NOT an STD. Here because Med School is dumb)
66
Describe the structure of Neisseria meningitidis.
G-
Coffee bean shapes
Diplococcus
Polysachharide capsule
67
How many types of Neisseria meningitidis are there?
Name the top 5.
About 12
A, B, C, Y, W-135
68
Blood related presentation of Neisseria meningitidis?
Meningococcemia
Purpura and Petechial Hemorrhages
- Caused by toxic effects of LOS, soluble PG
69
Non-blood clinical presentation of Neisseria meningitidis?
15% involvement of meninges
Acute Headache, Vomiting, Stiff Neck
Sometime neurological symptoms, coma, and death
70
In CNS cases of Neisseria meningitidis, what two findings might you expect?
PMNL in CSF
Purulent exudate of PMNL and Nm surrounding brain
71
What is meningococcal septicemia?
DIC and Circulatory Collapse
72
_____ modification with ______ disrupts microcolony. This is what allows Neisseria meningitidis to spread from the respiratory tract.
Pilin
Phosphatidylglycerol
73
Name a couple placed most prone to have an Neisseria meningitidis outbreak
College dorm, Military barracks
74
Most epidemics of Neisseria meningitidis are due to...
Specific Capsular Antigen Types
75
Pathogenesis of Neisseria meningitidis is most similar to...
Gonococcus
76
Unique pathogenesis of Neisseria meningitidis?
Antiphagocytic Polysaccharide Capsule
Special Pili for BBB endothelial cells
Bonus Adhesins in OM
77
How does the antiphagocytic polysaccharide capsule work?
Antigen B is sialyted
More disguised than others
78
Why do we care that Neisseria meningitidis has BBB attaching pili?
The proteins recruit proteins away from junction complexes, depleting cell jxns, making barrier porous
79
Can Neisseria meningitidis be vaccinated for? How?
Currently there are vaccines for all types
Menvo + BEXSERO or Trumenba
80
How is Neisseria meningitidis treated?
3rd gen. Cephalosporin
81
Why are Rifampin and 3rd gen ceph. used prophylactically?
They can cross the BBB whenever they want
82
Why might you prescribe Vancomycin for Neisseria meningitidis, even though it can't penetrate BBB?
If the BBB is damaged/porous it can cross.
If a different, G+, bacteria causes meningitis, its helpful
83
How does Moraxella catarrhalis tend to present?
Opportunistic sinusitis, bronchitis, pneumonia
Otitis media in children
84
Moraxella catarrhalis tends to exacerbate what other disease in adults?
COPD
85
Top three causes of otitis media?
S. Pneu
H. flu
Moraxella catarrhalis
86
How do you treat Moraxella catarrhalis?
3rd generation Ceph. OR Cipro
OR not at all
87
Physical characteristics of Chlamydia trachomatis
Like G- Envelope
Small genome
Cell wall without MurNAc
88
How must Chlamydia trachomatis grow?
Obligate intracellular parasite
89
How is Chlamydia trachomatis often grown in the lab?
embryonated chicken eggs
McCoy cells in monolayer tissue cultures
Mouse Brains
90
Two forms of Chlamydia trachomatis?
Elementary Bodies
Reticulate Bodies
91
Describe Elementary Bodies in Chlamydia trachomatis.
Infective Form
0.3uM diameter
Tough S-S membrane
92
Describe Reticulate bodies in Chlamydia trachomatis.
Replicative Form
1.0uM diameter
Fragile SH HS
93
Does Chlamydia trachomatis tend to manifest as chronic or acute?
Chronic
94
Five ways that Chlamydia trachomatis infection may present in the clinic
Trachoma
Inclusion Conjunctivitis
Neonatal Pneumonia
Chlamydia
Latent Infection
95
How does a person get a Trachoma (Chlamydia trachomatis)?
Infection from birth from infected birth canal
Infection in early childhood by contact/mechanical vector
96
How does Trachoma (Chlamydia trachomatis) present clinically?
- Mucopurulent discharge, Pannus formation, cornea obstruction
- Irritation from pannus+eyelashes+other bac --> blindness
97
How do people get inclusion conjunctivitis from Chlamydia trachomatis? How does it present clinically?
Mostly neonates (infected birth) and adults (self-inoculation)
Less severe trachoma, maybe respiratory complications
98
Presentation of Neonatal pneumonia via Chlamydia trachomatis? When should you suspect?
Shortness of breath, no Fever
If symptoms occur with inclusion conjunctivities
99
Chlamydia trachomatis patients tend to also be infected with ________
Gonorrhea
100
Symptoms of Chlamydia (Chlamydia trachomatis) in males
Non-gonococcal urethritis
Epididymitis
Prostatis
101
Symptoms of Chlamydia (Chlamydia trachomatis) in females
Urethritis
Cervicitis
Salphingitis
PID
102
Long term significance of salphingitis in Chlamydia and Gonorrhea?
Common cause of infertility from fallopian rupture
103
Symptoms of a latent infection with Chlamydia trachomatis.
Small abscess
Inguinal Buboes form sometime thereafter
If chronic, can cause fibrous lymphatic restrictions or bowel obs.
104
How are the buboes seen in latent Chlamydia trachomatis differentiated from plague?
Chlamydia trachomatis buboes are never in cervical lymph nodes
105
The STD form of Chlamydia trachomatis is most common in...
NA, SA, Eur
106
Trachoma Chlamydia trachomatis is most common where?
Asia/Africa
Hot, Dry places with poor access to clean water
107
_________ is a leading cause of infectious blindness in the world.
Trachoma Chlamydia trachomatis
108
Why would you treat both localizations of Chlamydia trachomatis infection at the same time in a patient?
They can cross-infect
109
Pathogenesis of Chlamydia trachomatis?
- Elementary bodies bind host receptor, induce endocytosis
- Chlamydia prevent phagolysosome fusion
- Induce cytokines (IL-1) and cause inflammation
- Remain for long periods without killing host
110
Why are vaccines against Chlamydia trachomatis ineffective?
Intracellular location of pathogen
111
_____ is the key to control. This is accomplished by ___.
Screening.
PCR
112
How is Chlamydia trachomatis treated?
Azithromycin
Tetracycline and macrolides may also work
113
Drastic measures to prevent Trichiasis Chlamydia trachomatis corneal keratinization include....
Surgery
Epilation (pulling out lashes)
114
You're awesome! You just cured your patients Chlamydia trachomatis! Now, just don't forget to...
Identify and treat all of their sexual conacts
Expedited partner therapy if necessary
115
How does Chlamydia pneumoniae tend to present clinically?
Mild URT disease
Possibly progressing to mycoplasma-like pneumonia
116
Chlamydia pneumoniae may be associated with what other major diseases?
Atherosclerosis
Asthma
Stroke
Late-Onset Alzheimers
117
How to treat Chlamydia pneumoniae?
Usually Untreated
Tetracycline might help
118
Chlamydia psittaci is also known as..
Parrot Fever
119
How does Chlamydia psittaci tend to present in the clinic?
Acute, Severe Pneumonia and Sepsis
Patchy, well-defined lung involvement
120
How is Chlamydia psittaci transmitted?
Contact with psittacine birds (esp. bites or feces)
121
