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MDSC 3312 MB > ST2 -Gonorrhea and Syphillis > Flashcards

ST2 -Gonorrhea and Syphillis Flashcards

(73 cards)

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1
Q

How are STD spread?

A

Skin to Skin contact with infected areas , including thighs , scrotum , vulva , penis , anus.
Touching below the waist (infected areas).
Oral sex – Infected genitals to mouth or infected mouth to genitals.
Kissing infected mouth area.
Anal sex.

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2
Q

What diseases are associated with eye infections?

A

gonorrhea, chlamydia, herpes

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3
Q

What diseases affect the oral region?

A

herpes, syphilis, gonorrhoea

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4
Q

Genital regions

A

herpes, syphilis, gonorrhoea

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5
Q

What is the major reservoir for gonorrhea carriage?

A

asymptomatic

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6
Q

There is high incidence of gonorrhea in?

A

High Incidence in some groups defined by geography , age , sexual risk behavior - sex worker

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7
Q

How is gonorrhoea transmitted?

A 
Male to female via semen 
Female to male urethra
Rectal intercourse ( Anal sex )
Pharyngeal infection ( Oral sex )
Perinatal transmission ( Mother to Infant )
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8
Q

Gonorrhoea is a pyogenic infection of the?

A

urethra and uterine cervix

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9
Q

With gonorrhea, there is an increase risk of?

A

Gonorrhea associated with increased transmission of And susceptibility to HIV infection

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10
Q

What are the virulence factors of gonorrhea?

A

pilli, fimbria, capsule,por, opa, rmp protein

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11
Q

What do the fimbriae involve?

A
  • Initial attachment to the cell surface with Fimbriae / Pili: ( Adherence ) to the Urethral mucosa
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12
Q

What prevents phagocytosis?

A

capsule

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13
Q

Por protein function

A

Por protein ( protein I ) : Protects the phagocytosed bacteria from intracellular killing .

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14
Q

Opa protein function

A

Opa protein ( Protein II ): Allows tight attachment to host cells & bacteria migrates into epithelial cells & multiplies

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15
Q

Rmp protein function

A

Rmp protein ( Reduction – modifiable protein ) = ( Protein III ) : Stimulates production of antibodies that block serum bactericidal activity against gonococci

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16
Q

What is the incubation period of gonorrhea?

A

2-8 days

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17
Q

Who are carriers of this infection?

A

women

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18
Q

What are the clinical findings of females?

A 
Cervicitis - Mucopurulent
Vulvovaginitis ( Prepubertal girls )
Endometritis - Uterus
Salphingitis and 
PID ( Pelvic inflammatory disease ) –May lead to sterility
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19
Q

Clinical findings of gonorrhea in women

A

Acute Urethritis –Purulent urethral discharge –( word ‘gonorrhea’ is derived from flow of seed resembling semen ).
Chronic urethritis – Stricture formation.
Multiple discharging sinuses ( Water can perineum ).

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20
Q

What is epididymitis? What is associated with it?

A

Symptoms : Unilateral. Testicular pain & swelling.

Infrequent but commonest local complication in males.

Usually associated with subclinical urethritis.

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21
Q

What are the non-specific signs of cervicitis in women with gonorrhoea infections?

A

Abnormal vaginal discharge , Inter menstrual bleeding , Dysuria , Lower abdominal pain.

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22
Q

What are the clinical findings with cervicitis?

A

Mucopurulent or purulent cervical discharge , easily induced Cervical bleeding.

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23
Q

When do the symptoms of cervicitis appears?

A

50% of women with clinical cervicitis have no symptoms.
Symptoms may occur within
8 - 10 days of infection

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24
Q

In 1-3% of persons affected by Gonorrhea, what occurs?

A

Disseminated Gonococcal Infection ( DGI ) in 1-3%
Fever, Septic rthritis ( Polyarthritis ).
Pustular-hemorrhagic skin rash

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25
What are the consequences of gonorrhoea?
Pharyngitis –Orogenital sex | Conjunctivitis -Autoinoculation
26
What are the pathological manifestations in children/neonates?
i) Gonococcal - Ophthalmia | Neonatorum - if untreated – Blindness
27
How gonorrhoea is transmitted in newborns?
Neonates may become infected through passage of the birth canal.
28
How to prevent ophthalmia neonatorum?
: by Instillation of Tetracycline / Erythromycin / Silver nitrate in conjunctival sac of New Born
29
What are the complications of gonorrhoea in women?
Pelvic Inflammatory Disease (P I D) : – 10 - 20 % ( Women with Endocervical gonorrhea ) .
30
Acute infection complication in women
Salpingitis , Tubo-ovarian abscess , | ndometritis , Bartholin abscess .
31
Chronic infection complication in women
Ectopic pregnancy , Infertility .
32
What are the symptoms/ how does chronic infection in women present?
May be Asymptomatic OR | May present with - Lower abdominal pain , Discharge , Irregular menstrual bleeding & Fever
33
What is the transport media for gonorrhea?
stuart transport media
34
What samples are taken?
pus, swabs, synovial fluid,swab
35
Swabs are taken from
rectum, conjuctiva, throatSecretions / discharge from : Urethra – Urethral swab - Male , Cervix – Endocervical swab - Female
36
For dgi . what samples are taken?
synovial fluid from joints
37
What is the morphology,motile and location of gonorrhea?
Nonmotile – Gram – ve Diplococci - Kidney shaped (pairs of cocci) Or - Bean shaped adjacent sides concave. intracellular organisms - In purulent material - Organisms mainly Intracellular ( within Polymorphs - some may be loaded with as many as 100 Cocci.)
38
What is the role of the fimbriae?
on the surface.-Responsible -for- Adherence to -Urethral mucosa .(virulence factor)
39
Capsule
Outer surface of cocci covered with loosely associated Micro - Capsule ( Slime ) Prevents Phagocytosis (virulence factor).
40
Which sele ctive media is used and why?
Modified Thayer Martin – Enriched Medium with lysed blood and antibiotic- Selective for Neisseria gonorrhoeae especially when specimen is from vagina & rectum having other bacteria too – which are inhibited.
41
What does colistin prevent?
: Inhibits Gram - ve flora ( N. gonorrhoeae & N. meningitidis resistant to colistin , most saprophytic species of Neisseria susceptible
42
Vancomycin inhibits
: Inhibits Gram+ve.
43
Nystatin inbhibits
Inhibits yeast flora.
44
Trimetoprim inhibits
Inhibits swarming Proteus spp.
45
What are the conditions and agar used?
5-10% CO2
46
Colonies on blood agar
Small , Convex , Glistening , Soft , Mucoid Colonies.
47
Oxidase, catalase test gonorrhea
oxidase and catalase +ve
48
Oxidase test
Tetra-methyl- para phenylene -diamine hydrochloride. | Filter paper soaked with fresh oxidase reagent.
49
Gonorrhea ferments
Gonococci ferments only Glucose with Acid production. | Does not ferment other sugars
50
When is NAAT used and why? Which specimen ?
Essays for direct detection of Neisseria gonorrhoeae in Genito -urinary specimen. The specificity & sensitivity of the Test is very High. Advantage : Better detection & rapid result ( 2 - 4 hours ).
51
When are serological tests useful?
Useful in chronic cases & in metastatic lesions ( arthritis ) DGI . Includes : R.I.A.( Radio Immuno Assay ) & ELISA .
52
Resistance in gonorrhea in seen against
- Chromosomally mediated & Plasmid mediated to penicillin ( β Lactamase producing ).
53
What is the treatment for gonorrhea?
Recommends the Treatment For - Uncomplicated Genital & Rectal Infection of N.gonorrhoeae : Ceftriaxon 125 mg single IM OR Cefrofloxacin 500 mg OR Ofloxacin 400 mg single oral dose + Doxycycline 100 mg twice daily orally for 7 days. Alternative to Doxycycline include Erythromycin 1 gm or Azithromycin 1 gm single oral dose for 7 days.
54
What are prevention techniques?
Early detection of cases & Tracing of contact . Health education & Other general measures . Barrier method with Condom can greatly reduce the Transmission of Infection . Avoid Multiple Sexual Partners . Promotion of safe sex & individual counselling .
55
Treponema subspecies
T. Pallidum considered to include three subspecies pallidum causing venereal syphilis, endemicum causing endemic syph. & pertenue causing yaws –
56
Treponema shape
Relatively short , slender with fine spirals & | pointed or rounded ends.
57
Treponema pallidum
syphilis
58
Treponema Pertenue
yaws
59
Treponema pinta
pinta
60
How is syphilis transmitted?
By Direct Sexual contact And Trans- placentally ( Congenital Syphilis ). Hospital personnel , Laboratory staff & Blood transfusion recipient may contract disease Accidentally. Sharing of needles by I.V. Drug users. Syphilis is one of ancient sexually transmitted disease .
61
Syphilitic Lesions are a portal for?
HIV transmission
62
Which stages of syphilis are contagious?
primary, secondary - contagious
63
Late Syphills contagious?
No
64
What is the pathogenesis of syphilis?
Treponema pallidum penetrates mucous surface or abraded skin & travel to draining Lymph node in about 30 min , where they Multiply during incubation period . The Treponema invades the lymphatics & disseminates in the blood stream ; adheres to endothelial cells.
65
What is the incubation period?
3wks to 10-90 dyas
66
What is a primary lesion?
Primary lesion end - arteritis → Endothelial scarring → Intense Inflammatory reaction & tissue necrosis
67
What occurs with replacement fibrosis?
→ Replacement fibrosis → Iry Chancre Ulcers heals but spirochetes disseminate .
68
What are the virulence factors for syphilis?
outer membrane protin, hylauronidase, fibrone
69
Outer membrane protein
– Promote adherence of Treponema pallidum to surface of host cell - facilitating the infection
70
What is the role of hyaluronidase and fibronectin?
Enzyme hyaluronidase – Facilitates perivascular infiltration . Fibronectin– Prevents phagocytosis of T.Pallidum by macrophages.
71
Primary - symptoms, signs, infectiousness
Chancre (a small, usually painless skin sore ) , regional lymphadenopathy Contagious
72
Secondary syphillis
Rashes , sores on mucous membranes , hair loss , fever , condolamata lata. Contagious Occurs weeks to months after the primary stage
73
Is latent and late/tertiary syphilis contagious? Which is symptomatic?

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