Sexually Transmitted Diseases Flashcards by Tyler Yee

What bacteria causes syphilis?

Treponema pallidum

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What type of bacteria is Treponema pallidum?

Gram-negative spirochete

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How is primary syphilis characterized?

Single, Hard, Painless chancre

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How is secondary syphilis characterized?

Systemic so Fever, Rash, Condyloma Latum

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How is tertiary syphilis characterized?

15-20 years later so Chronic meningitis, Ataxia, Aortic valve insufficiency, Gummas

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What occurs in congenital syphilis?

Rhinitis
Skin and mucus lesions
Hepatosplenomegaly
Hutchinson's teeth
Saddle-shaped nose

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How is syphilis diagnosed?

Dark field microscopy
Fluorescent antibodies
Nonspecific serology
Specific serology

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What are the nonspecific serology tests for syphilis?

Venereal disease research laboratory test (VDRL)

Rapid plasma reagin test (RPR)

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What is used as the antigen in nonspecific tests and why?

Cardiolipin from beef hearts

Spirochetes cannot be cultured for use as an antigen

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What are nonspecific serology used for and why only that?

Only for screening

Can be a false positive from damaged normal cells

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What are the specific serology tests for syphilis?

Fluorescent treponemal antibody absorption test (FTA-ABS)
Microhemagglutination test (MHA-TP)

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How is FTA-ABS test done?

Patient serum first absorbed with nonpathogenic treponemes to remove any anti-treponema antibodies that are not specific for only the bacteria

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How is MHA-TP test done?

Treponemal antigens on RBC to see if they agglutinate

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What occurs nonspecific and specific tests after effective treatment?

Nonspecific: are negative
Specific: are positive

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Easy way to remember is a syphilis test is specific?

It has “T” in the abbreviation

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What antibody is looked for in congenital syphilis?

IgM not IgG because IgG can cross the placenta but IgM cannot

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What do you treat syphilis with?

Penicillin

Doxycycline if they are allergic to penicillin

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What causes gonorrhea?

Neisseria gonorrhoeae

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What is Neisseria gonorrhoeae?

Gram-negative diploccus

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Where is Neisseria gonorrhoeae seen?

Inside neutrophils

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What does Neisseria gonorrhoeae have to help stay attached in urethra?

Pilus

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Which patients present with gonorrhea symptoms?

Men

Females are asymptomatic until it is very advanced

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What occurs in women once gonorrhea advances?

Pelvic inflammatory disease
Infertility
Tubal pregnancy

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Why does infertility and tubal pregnancy occur in women in advanced stages of gonorrhea and chlamydia?

Scar tissue in fallopian tubes occurs not allowing fertilized egg down

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What can occur in blood with gonorrhea?

Disseminated gonorrheal infections that manifest in skin and joints

How is gonorrhea treated?

Cefixime and Ceftriaxone (1 dose) and Doxycycline (7 days)

Why is doxycycline given in gonorrhea?

To treat the chlamydia that often is accompanied by it

What causes genital chlamydia infections?

Chlamydia trachomatis serotypes D-K

What is Chlamydia trachomatis?

Gram-negative intracellular

What is gonorrhea discharge like?

Yellow and purulent

What is chlamydia discharge like?

Clear or white

Chlamydia symptoms in males and females?

Males: dysuria Females: asymptomatic

What agar is Chlamydia trachomatis grown on?

McCoy agar

What does Chlamydia trachomatis form when cultured?

``` Inclusion bodies (intracellular) Elementary bodies (extracellular/infectious form) ```

What do you treat Chlamydia with?

Doxycycline or azithromycin

What is lymphogranuloma venereum (LGV)?

A systemic Chlamydia trachomatis infection

What causes LGV?

Chlamydia trachomatis serotypes L1, L2, L3

LGV symptoms:

Transient ulcer Enlarged lymph nodes Proctitis (rectum inflammation) (what most come to doctor for)

What is chancroid?

A soft chancre

What is a soft chancre?

Soft multiple painful ulcers

What causes chancroid?

Haemophilus ducreyi

What are Haemophilus ducreyi?

Gram-negative bacilli

What is bacterial vaginosis?

Overgrowth of bacterial in the vagina

What is the most common cause of bacterial vaginosis?

Gardnerella vaginosis

What is Gardnerella vaginosis?

Gram variable pleomorphic bacillus

What characterizes bacterial vaginosis?

Fishy smelling vagina | pH greater than 4.5

What causes overgrowth of bacteria in the vagina?

Decreased estrogen which decreases the amount of glycogen created in epithelial cells not allowing lactobacilli to thrive

Treatment of bacterial vaginosis?

Metronidazole

What does Metronidazole kill?

Anaerobes Flagellates Amoeba

What is seen in a vaginal swab of bacterial vaginosis?

Clue cells: epithelial cells with fuzzy borders due to excessive amounts of bacteria attached to them

What is the cause of the fishy smell in vaginosis?

Trimethylamine

What causes vulvovaginitis?

Overgrowth of endogenous Candida albicans

Treatment of vulvovaginitis/thrush?

``` Nystatin (topical) Amphotericin B (IV) ```

What is seen with a vulvovaginitis swab?

Pseudohyphae

How can vaginal thrush occur?

Too much glycogen (increase in estrogen)

How does trichomoniasis present in men and women?

Men: asymptomatic Women: smelly discharge

How is trichomoniasis characterized compared to vaginosis in women?

Trichomoniasis: Large amount of discharge Vaginosis: smelly discharge not alot

What causes trichomoniasis?

Trichomonis vaginalis

Treatment of trichomoniasis?

Metronidazole (its a flagellate)

General rule for herpes virus?

HSV-1: above belt | HSV-2: below belt

Where does dormant HSV reside?

Dorsal root ganglia

What does HSV cause in babies?

Diffuse neonatal encephalitis

Treatment of HSV?

Acyclovir (IV) | Valacyclovir (oral)

What causes condyloma acuminatum?

HPV genotypes 6 and 11

What causes cervical cancer and lesions?

HPV 16 and 18

Condyloma acuminata versus lata?

Acuminata: raised multiple from HPV Lata: flat top, secondary syphillis

Why is prevalence of HIV high despite incidence being down?

Prevalence: amount of people with it (still alive) Incidence: new cases

What two HIVs are found and where?

HIV-1: pandemic globally and US more infectious | HIV-2: West Africa not as infectious

HIV-1 groups?

M N O

Most common HIV-1 group and subtypes of the group?

M most common | Subtypes: A-J

HIV-2 subtypes?

A-F

Three functional genes of HIV?

gag pol env

What does gag encode?

Capsid protein p24 Matrix protein p17 (core proteins)

What does pol encode?

Protease Reverse transcriptase Integrase

What does env encode?

Viral glycoproteins: gp41 and gp120

What glycoproteins are found on HIV?

GP120 (head) | GP41 (stem)

What is looked for in the diagnosis of HIV?

p24

What cells does HIV infect?

Cells with CD-4 receptors (helper cells)

What are the co-receptors found on cells with CD-4 receptors?

CCR5 | CXCR4

What binds the receptors then the co-receptors?

gp120

What is the preference of HIV to co-receptors?

Initially wants CCR5 (needed to start infection) then evolves more so to CXCR4

What from HIV fuses with the cells membrane?

gp41

How does HIV infection begin?

HIV picks helper cells (dendritic or macrophages) to become a pro-virus host and allows it to replicate (for its own DNA to be replicated also); Virus makes its way to the GALT

What is CTL/CD-8 cells role in HIV infection and why is it important?

They attack and kill infected CD-4 cells; however, CTL cells kill the CD-4 cells that are needed for their own activation

Why does HIV switch from CCR5 to CXCR4 co-receptor?

CCR5 is on mature CD-4 cells when they kill are the mature ones they switch to CXCR4 which is found on naive CD-4 cells

What is acute HIV syndrome or acute retroviral syndrome?

Fever and lymphadenopathy in the initial infection

Why is HIV easier to transmit rectally than vaginally?

Rectum has simple columnar epithelium and the vagina has stratified squamous epithelium; the more layers the harder to penetrate

Is HIV transmitted intrauterine?

No, only when going through vaginal canal like HSV

How long does acute retroviral syndrome last, what does it mimic and why does it subside?

Lasts 2-4 weeks Looks like mononucleosis Immune system responds to suppress

What characterizes AIDS?

CD-4 T cells less than 200 cells/mm cubed

What are three common infections reactivated in AIDS?

HSV Toxoplasma JVC

What is JVC?

Demyelinating disease called progressive multifocal leukoencephalopathy (oligodendrocytes targeted)

What are six common opportunistic infections and tumors associated with AIDS and their symptoms?

EBV: hairy leukoplakia along lateral side of tongue Candida: oral thrush Kaposi sarcoma-associated herpesvirus (HHV-8): sarcomas in the immunosupressed Pneumocystis jerovecii: pneumonia CMV: retinitis and blindness Cryptosporidium: diarrhea

Where does HIV naturally like to go?

It is neurotropic so microglial cells in CNS

What is HAART (highly active antiretroviral therapy)?

2 NRTI + 1 PI/NNRTI/INSTI | targets pol genes effects

Ways drugs stop HIV?

``` CCR5 blocker gp41 blocker (fusion inhibitor) ```

What is a more specific test for HIV than ELISA?

Western blot

Vertically transmitted infections mnemonic?

ToRCHeS

What is in ToRCHeS?

``` Toxoplasma gondii Rubella Cytomegalovirus Herpes, HIV, HBV (hepatitis B) Syphilis ```

Sexually Transmitted Diseases Flashcards

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