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Sexually Transmitted Infections Flashcards

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1
Q

What is the bacteria responsible for causing syphilis?

A

treponema pallidum pallidum

- there is 11 m new cases a year worldwide

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2
Q

What is the most common age group to have syphilis in canada and what is the gender?

A
  • makes aged 30-39
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3
Q

What is the incubation period if treponema palladium pallidum

A

1-90 days

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4
Q

What makes up the primary phase of syphilis?

A
  • chancres/skin lesions at the site of inoculation
  • usually painless and heals spontaneously
  • highly infectious
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5
Q

What is the secondary phase of syphilis?

A
  • signs of the disseminated disease
  • occurs 2-12 weeks after th infection
  • skin lesions are on the trunk, palms and soles of the feet
  • lesion fluid is highly infectious
  • signs of other organ involvement
  • 3-12 weeks, disappearance of symptoms
  • latent phase follows (asymptomatic, antibodies present, untreated patients have 3 outcomes - relapse, no relapse or the tertiary phase)
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6
Q

What is considered tertiary syphilis?

A
  • can occur after initial infection
  • neurologic and cardiovascular symptoms
  • may have gummas (nonspecific, granulomatous lesions)
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7
Q

Congenital syphilis passed on to the child will give the baby signs of _____ at birth

A

secondary syphilis

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8
Q

Congenital syphilis can be prevented is woman are treated with ____ early in pregnancy

A

penicillin

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9
Q

Lab diagnosis depends solely on microscopy and serology for what reasons?

A
  • because treponema cannot be grown in vitro
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10
Q

What two types of microscopy are used to see treponema bacteria?

A
  • dark field or fluorescent microscopy
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11
Q

What are the nonspecific serodiagnostic tests for treponema using nontreponemal antibodies?

A
  • venereal disease research laboratory test

- rapid plasma reagin test

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12
Q

What are the specific tests for syphilis using treponemal antibodies?

A
  • FTA-ABS: florescent treponemal antibody absorption

- agglutination tests ( microhemagglutination test and Treponema palladium particle agglutination test)

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13
Q

What aret eh 2 antibiotics that are used to treat syphilis?

A
  • penicillin and doxycycline
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14
Q

What bacteria causes gonorrhoea? Describe it

A

Neisseria gonorrhoeae

- gram negative diplococci

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15
Q

Where does gonorrhoea typically infect in the female reproductive tract?

A
  • typically the cervix, the uterus and the fallopian tubes

- also the urethra (in both males and females)

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16
Q

Females have a __ % chance of infection post single encounter, while males have a __ % chance of infection post single encounter

A

50%

20%

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17
Q

How is gonorrhoea vertically transferred?

A
  • can cause opthalmia neonatorum when passed on to children
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18
Q

N. gonorrhoeae is a ____ that thrives in a humid atmosphere

A

capnophile

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19
Q

What are the different virulence factors that N. gonorrhoeae possesses?

A
  1. Pilus: aids in attachment to human mucosal epithelium - contains constant and hyper variable regions- analagous to immunoglobulins
  2. Por proteins: forms pores through the outer membrane - antigenic
  3. Opa proteins: assist binding to the epithelial cells
  4. LOS: lipooligosaccharide (endotoxin activity)
  5. RMP proteins: inhibit ‘cidal’ activity of serum
  6. IgA protease: core contains enzyme- released by cell to destroy IgA
  7. Capsule: resists phagocytosis- unless antibody is present
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20
Q

Gonorrhoea in females is often asymptomatic, but if symptoms are present they develop in 2-7 days and the main symptom is often _______

A

vaginal discharge

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21
Q

What are the main untreated complications of untreated gonorrhoea in females?

A
  • PID
  • chronic pelvic pain
  • infertility
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22
Q

In makes, what is the main symptoms of gonorrhoea?

A
  • urethral discharge

- painful urination

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23
Q

What are the other conditions that are also known to be signs and symptoms of gonorrhoea?

A
  • anorectal (purulent discharge), pharyngeal (sore throat), and ophthalmic infections
  • ophthalmia neonatorum in newborns
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24
Q

What is the most useful method of determining a gonorrhoea infection?

A
  • in men- by using a direct gram stain
  • uses urethral discharge from symptomatic males with urethritis - gram negative diplococci inside PMNs, diagnostic
  • this is not as useful in women - normal vaginal and rectal flora have G- coccobacilli so therefore the bacteria has to be confirmed by culturing
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25
What is the highest amount of STIs reported in canada?
- chlamydia
26
Chlamydia is considered an ____ ______ bacterium
obligate intracellular
27
Serotypes A-C of the Chlamydia trachomatis cause what disorder?
trachoma (an infection of the eye)
28
Serotypes D-K are the cause of ________ and associated ocular and respiratory infections
genital infections
29
Serotypes L1, L2, L3 cause the systemic disease of _________
lymphogranuloma venerum
30
What is the life cycle of chlamydia infections?
- elemental body attaches to a specific receptor on the host columnar epithelial cells - enters the epithelial cells - forms reticulate/initial body (adapted for intracellular replication) - replicates by binary fission pf reticulate bodies - differentiation back into epithelial bodies - release of epithelial body progeny spreads to adjacent cells (infectious)
31
Chlamydia is a _______ diagnosis, where they have a clinical suspicion based on symptoms that the patient is experiencing
presumptive | *** however, can also use a positive non culture result, where they use EIA, DFA or nucleic acid detection
32
What is the gold standard definitive diagnosis of chlamydia?
- culture and ID of inclusion bodies | - combination of 2 non culture methods
33
What is the major cause of vaginal candidiasis?
- C. albicans
34
What are the main symptoms of a candidal infection?
- itching - erythema - discharge
35
Trichomoniasis is a protozoan infection caused by what?
- trichomonas vaginalis
36
What are the clinical signs of a trichomoniasis infection?
- profuse, offensive and hello-green discharge | - can also be asymptomatic
37
What is the treatment of a trichomoniasis infection?
- metronidazole
38
HSV-1 infection is primarily where?
- transmitted by the saliva | - oropharyngeal infections in children - cause cold cores after reactivation
39
HSV-2 infections are a result of what?
- emerged as a result of independent TM via the venereal route
40
Genital herpes is characterized by what? How long do these show up post infection?
- characterized by ulcerating vesicles | - primary lesion appear on the penis/vulva 3-7 days post infection
41
What are other symptoms that can be associated with genital herpes?
- swollen lymph nodes, fever, headache, malaise
42
Healing of genital herpes takes _____
2 weeks
43
Describe the process of the viral infection going latent, as well as the process of the virus being reactivated
- Latent: the virus gets in through a lesion, goes into the sensory nerve ending and the latent infection travels in the dorsal root ganglion neurons - Reactivation: travel down the same route- recurrent lesions occur and turn into genital cold cores
44
A mother giving birth to an infant while having genital herpes leads to _____
neonatal disseminated herpes or encephalitis
45
How is genital herpes diagnosed?
- virus DNA in vesicle fluid or ulcer swabs | - immunofluorescence
46
What is the treatment for genital herpes?
- antivirals | - recurrent infections (troublesome - 6-12 months of low dose antiviral to stop/reduce the frequency of recurrences)
47
Can HPV be grown in a culture?
no
48
What is required to determine the presence of HPV?
- cytology secretions (pap smears, koilocytes) | - nucleic acid detection via PCR
49
HPV is a ____ vaccine, with types 6, 11, 16 ad 18
quadrivalent
50
Why is HIV considered a retrovirus?
because it is a single stranded RNA virus that contains a pol gene that codes for reverse transcriptase
51
HIV is also a slow, or ____, virus
lentivirus
52
HIV-1 is separated into 3 groups. What are they?
- M (main) -> A to J B most common in NA and Europe, while A and C are most common in Africa - N (new) - O (outlier) both of these are most common in west central africa
53
HIV infected cells with a ___ surface marker
CD4 | Th cells, for example
54
What allows the entry of the HIV virus into the cell?
- binding of the viral p120 envelope glycoprotein to a CD4 receptor
55
The chemokine co-receptor ____ establishes infection, individuals with this gene have deletions that are resistant
CCR5
56
Disease progression in HIV variants are using the ____ receptor
CXCR4
57
Viral replication of HIV halts after the integration of the _____, leaving it lying latent in the cell
provirus
58
HIV transmission is associated with breastfeeding for up to ____
24 months
59
What is the mainstay of treating an HIV infection?
HAART (highly active antiretroviral therapy) | - combines 2 NRTIs, as well as an NNRTI and a PI drug - seen to have a dramatic effect on the progression of AIDS
60
What are the drawbacks of HAART?
- mitochondrial toxicity and altered fat distribution - HIV inhabits CSF and GU tract- unfortunately the drug cannot reach in here- there is a high load in the semen - can lead to resistance

Microbiology (16 decks)

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