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STD's Flashcards

1
Q

Nisseria Gonorrhea- resovoir

A

humans

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2
Q

N. Gon- trasmission

A

sexual

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3
Q

N. Gon- morphology

A

Gram negative diplococci

kidney bean shaped

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4
Q

N. Gon- metabolism

A

Facultative anaerobe that grows best in high CO2 environment.
Glucose only fermenter

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5
Q

N. Gon- virulence factors

A

Pilli- adherence to epithelial cells. undergo extensive antigenic variation. Antiphagocytic
IgA proteases
Outermembrane proteins- protein I and protein II- Opacity protein
chealators

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6
Q

N. Gon- toxins

A

endotoxin- LPS

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7
Q

N. Gon- clinical presentation in men

A

Asymptomatic

Urethritis

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8
Q

N. Gon- clinical presentation in female

A

cervical gonorrhea –> PID

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9
Q

complications of PID

A 
sterility
ectopic pregnancy
abscess
periotonitis
perihepatitis
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10
Q

N. Gon clinical complications n in both sexes

A

gonococcal bacteremmia

Septic arthritis- MCC of septic arthritis in sexually active individuals

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11
Q

N. Gon- clinical presentation in neonates

A

Acquired while passing through the birth cananl

Conjuctivits in the 1st 5 days- Opthalmia neonatorum

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12
Q

N. Gon tx- adult- 1st line

A

3rd gen Cephalosporin- Ceftriaxone

may add doxycycline to cover chlamydia and syphillis

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13
Q

N. Gon tx- adult- 2nd line

A

Fluroquinolones and Spectinomycin

neither is effective against syphillis

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14
Q

N. Gon tx- opthalmia neonatorum- prophylaxis

A

Erythromycin eye drops should be given as prophylaxis at birth to protect from N. Gon and chamydia.

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15
Q

N. Gon tx- opthalmia Neonatorum

A

systemic tx with ceftriaxone

concurrent Erythromycin to cover chlamydia

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16
Q

N. Gon- dx

A

Gram stain of pus
Culture
PCR

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17
Q

N. Gon- what do you see on gram stain

A

urethral pus shows diplococci within WBC

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18
Q

N. Gon- culture media

A

Choclate agar
Thayer Martin VCN
cytochrome oxidase-= pink colonies

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19
Q

N. Gon- immunity

A

can be reinfected numerous times

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20
Q

Gardinella Vaginallis- transmission

A

STD

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21
Q

G. Vaginallis- virulence

A

no capsule

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22
Q

G. vaginallis- toxins

A

none

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23
Q

G. vaginallis- disease

A

bacterial vaginitis

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24
Q

Ssx bacterial vaginitis

A

foul smelling (fishy) vaginal discharge
vaginal pruritis
dysuria

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25
G. Vaginalis- tx
Metronidazole
26
G. Vaginallis- dx
clue cells | no lacto bacilli
27
What are clue cells
vaginal epithelial cells with tiny pleomorphic gram negative bacilli in the cytoplasm
28
G. Vaginallis- growth requirements
DOES NOT required factor X or factor V for growth
29
Chlamydia trachomatis- reservoir
humans
30
Chlamydia- morphology
Gram negative BUT lacks peptidoglycan and muramic acid
31
Chlamydia transmission
contact
32
Chlamydia- primarily effects what organs
Eyes Genitals Lungs
33
Chlamydia- global distribution
trachoma is mostly found in the under developed word, and transmission is via poor hygiene.
34
Chlamydia- Life cycle
Elementary body- dense spherule that infects cells --> trans forms to initial body --> when it is ready to leave the cell transforms back to EB to infect other cells
35
Chlamydia- characteristics of the IB
larger and more osmotically fragile reproduces via binary fission requires ATP from host
36
Chlamydia- metabolism
obligate intracellular parasites b/c it steels ATP from from host via- ATP/ADP translocator
37
Chlamydia-virulence factors
resistant to lysozymes | prevents phagosome- lysosome fusion
38
Chlamydia- clinical presentation- types A,B, and C
Trachoma- leading causing of blindness worldwide. causes scarring of the inside of the eyelid --> redirection of eyelashes onto the corneal surface --> secondary infections cause blindness
39
Chlamydia- clinical presentation- types D-K- infants
``` inclusion conjuctivitis (opthalmia neonatorum) infant pneumonia ```
40
Chlamydia- clinical presentation- types D-K women
urethritis cervicitis PID
41
Chlamydia- clinical presentation- types D-K men
NGU epididymitis Prostatitis
42
Complications of Chlamydia infxn
women- sterility, ectopic pregnancy, chronic pain- after PID Reiters syndrome FItz- Hugh- Curtis syndrome Lymphogranuloma
43
Reiters syndrome
Arthritis Conjuctivitis Urethritis
44
Fitz- Hugh- Curtiz syndrome
perihepatitis
45
Chlamydia- serotypes L1,2, and 3 have what complication
lymphogranuloma verenum
46
Chlamydia-tx- genital and eye infections
Doxycycline for adults Erythromycin for kids and preggers Azithromycin Systemic tx is required for eye infection especially in infants
47
Chlamydia- growth
Cannot be growth on traditional media
48
Chlamydia -dx- inclusion conjunctivitis
Conjunctival scrapings will show intracytoplasmic inclusions in the epithelial cells Stain with Iodine and Giemsa
49
Chlamydia-dx- urethritis
urethral swab Gram stain will not show gram negative intracellular diplococci PCR Immunofluorescence Serologic for anti chlamydia antibodies and immune fluorescence
50
Lymphogranulomatous venereum dx
Urologic test | Frei test
51
Spirochete reproduction
Transverse fusion
52
Spirochete motility
Six axial filaments | Filaments are between cytoplasmic and outer membrane
53
Spirochete - culture
Cannot be cultured on an artificial media except for leptosporia
54
Treponema pallium- reservoir
Humans
55
T. Pallidum- transmission
Sexual
56
T. Pallium- air preferences
Microaerophillic
57
T. Pallidum- morphology
Thick rigid spirals
58
T. Pallidum- temp sensitivity
Sensitive to high temperatures
59
T. Pallidum- virulence
Motile
60
T. Pallidum-dz
Syphillis
61
T. Pallidum- how many clinical stages are there ?
4
62
T. Pallidum- primary stage
Painless chancre at site of infiltration
63
Syphillis- secondary stage
Disseminated- CNS, eyes, bones, kidneys, and joints all may be involved Rash on soles and palms Condylomata latum
64
Condyloma latum
Painless wart like lesions in warm moist areas- scrotum and vulva
65
T. Pallidum- latent stage
25% may relapse to secondary stage, this stage has a wide amount of vairability for how long it can last
66
T. Pallidum tertiary syphillis
Gummas of skin and bone Cardiovascular syphillis Neurosyphillis-
67
Gumma
Granulomatous lesions that eventually fibrose and necrose. Non infectious Skin- painless with sharp borders and solitary Bone- deep knawing pain Resolve with tx
68
Cardiovascular syphillis
Chronic inflammatory destruction of the vaso vasorum --> medial necrosis of the aorta--> aneurysm of the ascending aorta or aortic arch Aortic valve insufficiency or Coronary artery occlusion- if dissection travels back that far Cannot be fixed with anti microbial therapy
69
Types of neurosyphillis
``` Asymptomatic neurosyphillis Subacute meningitis Meningoaascular syphillis Tabes dorsalis General paresis Argyll Robertson pupil ```
70
Asymptomatic neurosyhphillis
clinically normal but CSF is positive for syphilis
71
Subacute meningitis
fever, stiff neck, HA | CSF- high lymphocyte, high protein, low glucose and positive syphilis
72
Meningovascular syphilis
bac attacked BV of brain and meninges leading to CV occlusion and infraction (brain, spinal, cord meninges).
73
Tabes dorsalis
Posterior column- vibratory and propioceptive sense --> ataxia Dorsal root and ganglia- loss of reflexes, pain, and temperature sensations
74
General Paresis
progressive degeneration of nerve cells in the brain --> mental deterioration, psychiatric symptoms
75
Argyll Roberson pupil
prostitute pupil- constricts but doesn't accomodate present in tabes dorsalis and general paresis midbrain lesion- pupil constricts during accomodation but doesn't react to light
76
T. Pallidum- rule of 6's
``` Sexual transmission 6 axial fillaments 6week incubation 6 weeks for chancre to heal 6 weeks from chance heal to secondary syphilis 6 weeks for secondary syphilis to resolve 66% of secondary pts have resolution 6 yr min until dev tertiatry syphilis ```
77
Types of congenital syphilis
early congenital syphilis | late congenital syphilis
78
Congenital Syphilis
T. Pallidum can cross plancenta high mortality rate develop early or late congenital syphilis
79
early congenital syphilis
``` occurs within 2 yrs wide rash, condyloma latum snuffles- mucus membrane and runny nose LN, liver, spleen, enlargement bone infection ```
80
Late congenital syphilis
neurosyphilis + 8th CN deafness saddle nose, saber shins, hutchitsons teeth, mulberry molars eye disease
81
When does T. Pallidum damage the fetus
not until the 4th month of gestation- so damage can be prevented by treating before then
82
T. Palldum- tx
Pen G Erythromysin Doxycyline
83
Jarish Herxheimer rxn
T. Pallidum releases a pyrogen when it is dying so right after tx is started pts feel worse.
84
T. Pallidum- Dx- cutaneous lesions
cutaneous lesions- Dark field microscopy, immunofluorescensce, ELISA, silver stain
85
T. Pallidum- Non specific treponemal test
VDRL and RPR- look for non specific markers of syphillis infection- anti cardiolipin and lecithin Ab. but 1% of people w/o syphilis have these all pregnant women should be screen with this bfr 4 months of gestation
86
T. Palldium- Specific treponemal test
FTA-ABS- Anti Treponemal Ab
87
Can PCR be used to diagnose T. Pallidum
Yes
88
Candida Albincans- where is this normally found
Normal flora of skin, mouth and GI tract | NOT NORMALLY FOUND IN BLOOD
89
Candida- morphology
Pseudohyphae and yeast
90
Candida- clinical presentation in a normal host
Oral thrush (if u see this do HIV test) vulvovaginal candidiasis cutaneous infxns- diaper rash, in skins of obese people
91
Candida- clinical presentation in an immunocompromised host
Thrush- invades esophogous disseminated candidiasis chronic mucocutaneous candidiasis vagintis, and cutaneous infxns
92
Symptoms of esophogeal candidiasis
retrosternal chest pain dysphagia fever
93
Candida tx- considerations
depends on location of infxn and severity
94
Candida- thrush - tx
oral fluconazole nystatin swish and spit clotrimazole candies
95
Candida- Cutaneous infxn- tx
topical imidazole | oral fluconazole
96
Candida- Esophogeal tx
(most common in HIV)- fluconoazole, capsofugin
97
Candida- systemic candidiasis- tx
IV amphoteracin B fluconazole Capsofugin
98
Candida- chronic mucocutaneous candidiasis- tx
ketonazole | fluconazole
99
candida dz
KOH and silver stain blood culture blood assay for D glucan

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