STDs Flashcards
(107 cards)
1
Q
The old or classical STDs (group 1), which constitute the true or so-called venereal diseases” include
A
gonorrhoea,
syphilis
chancroid
lymphogranulomavenereum granuloma
2
Q
Group 2 STDs include?
A
All other STDs except HIV/AIDS
3
Q
Group 3 STDs include?
A
HIV/AIDS
4
Q
STDs usually affect sexually active males and females with the age group of ?
A
15-40 years
5
Q
STDs usually affect older children by?
A
Sexual abuse
6
Q
STDs usually affect younger children by?
A
Vertical infection (i.e. from infected
mother to child in utero).
7
Q
What age group in Nigeria are most affected by all STDs?
A
ages 15-29 years
8
Q
Does The presence of any one of these diseases is an indicate exclusion of others?
A
True
9
Q
The golden rule of venereology is?
A
“DIAGNOSIS BEFORE TREATMENT”. This rule must always be
obeyed.
10
Q
Syphilis is an infectious disease, caused by a spiral bacterium (Spirochaete) called ?
A
Treponema pallidum.
11
Q
Can Treponema pallidum be cultured on artificial media in the laboratory.
A
No
12
Q
The mainstay of syphilis laboratory diagnosis is by?
A
Microscopy and serology
13
Q
Venereal syphilis belongs to a group of infections called?
A
treponematoses
14
Q
Other treponematoses include?
A
Yaws
Pinta
Bejel
15
Q
List the Endemic or non-venereal syphilis?
A
Yaws
Pinta
Bejel.
16
Q
Congenital infectious syphilis include?
A
Early congenital stage (i.e. in the first 2 years of life)
17
Q
Acquired infectious syphilis include?
A
Primary syphilis (Chancre)
18
Q
Congenital non-infectious syphilis include?
A
Late congenital stage (from 3ed year of life onward)
Stigmata (sequellae of early & late lesions)
19
Q
Non-infectious acquired syphilis include?
A
Tertiary syphilis
20
Q
The incubation period of syphilis is ?
A
9-90 days, average 30 days.
21
Q
The primary lesion of syphilis is called?
A
chancre (the sore) which is usually one, although it may be two or three-but often not more
22
Q
Describe the stages of syphilitic chancre ?
A
It starts as a macule which develops into a maculopapule, then a papule which erodes to form an ulcer.
23
Q
The traditional picture of clean, indurated and painless ulcer in syphilis depends among others, on the ?
A
personal hygiene of the patient
24
Q
All genital ulcers must be presumed to be due to syphilis unless proved otherwise by what, and done for how long without the patient taking any treponemacidal antibiotics.
A
dark field microscopy done daily for three days
syphilis serology done weekly for four weeks
25
Syphilitic primary ulcer is usually accompanied by regional lymphadenopathy, describe it?
which is discrete, rubbery and painless.
26
Primary syphilitic ulcer heals within ……….. with or without treatment?
3-8 weeks
27
Explain why surface inguinal adenitis in females is present in only about 25% cases.
The appearance of the chancre on the cervix and upper vaginal wall,
both of which drain into the internal pelvic nodes.
28
In secondary syphilis, headache which is present at all times is best at?
Night
29
By far the commonest and the most easily recognizable lesions of secondary syphilis are?
skin rash
mucous
membrane lesions
lymphadenopathy
30
The rash in secondary syphilis usually assumes several forms, which are ?macular/roseolar, papular,
annular, pustular or squamous varieties.
macular/roseolar
papular,
annular
pustular or
squamous varieties.
31
Describe the secondary syphilitic rash?
The syphilitic rash is normally generalized, symmetrical and non-itchy (except if it is secondarily infected)
32
Secondary syphilitic rash occurs more on which parts of the body?
They are more noticeable at the back, on the flanks, shoulders and upper arms.
33
What is Corona Veneris?
Other sites of secondary syphilitic rash include the chin and the forehead where the papules often form a ring below the hairline, giving
the appearance of the crown of venus'.
34
Whether treated or not, secondary stage symptoms disappear within?
1-2 months
35
What comes after the secondary stage?
Latent phase
36
What is Kassowitz's Law?
The effects of untreated maternal syphilis on the fetus depend on the stage of the maternal disease and the stage pregnancy when the infection was acquired.
37
Non-specific (or reaginic tests) for syphilis include?
1.venereal diseases research laboratory (VDRL) test
2. rapid plasma reagin (RPR) test
38
Specific (or treponemal tests) for syphilis include?
1. treponemahaemagglutination (TPHA) test
2. fluorescent treponema antibody-absorbed (FTA-Abs) test
3. treponema immobilization (TPI) test.
39
Positive Reagin and treponemal test indicate?
Active syphilis. If untreated, treat; If treated, surveillance
40
A positive reagin and negative treponemal test indicates?
1. Either a biological false positive reaction, in which case patient should be followed up with repeat serology every month (x3) and also observed clinically.
2. In active (untreated) syphilis, Reagin antibody titre rises, and later the treponema antibodies also appear. If however serology results are negative and no clinical signs appear, discharge the patient.
3. it could be an early active syphilis, in which case follow-up serology and clinical signs will emerge, then treat the patient.
41
A negative Reagin test and positive treponemal test indicates ?
Possibly treated syphilis with reaginic seroconversion. Ignore.
42
Negative Reagin and treponemal test indicates?
1. Could be a window period; in that case follow-up serology and clinical observation as in option II.
2. If follow-up serology becomes positive, treat, if not, patient is uninfected, discharge him/her.
3. It could also be early treated syphilis; again if unsure follow-up as under option II.
43
The drug of choice in the treatment of all forms of syphilis is?
Acqueous Procaine Penicillin-G (APPG).
44
Benzathine Penicillin G may be used to treat syphilis when?
Acqueous Procaine Penicillin-G (APPG) is not available, or the patient's compliance cannot be
guaranteed,
45
In cases of penicillin allergy, what drugs are used as substitutes?
ceftriaxone
erythromycin
46
Spell the causative agent of GONORRHOEA?
Neisseria gonorrhoeae
47
What is the shape of Neisseria gonorrhoeae?
Kidney shaped
48
What is the gram reaction of Neisseria gonorrhoeae?
Negative
49
Gonorrhoea is most commonly seen in the what age group?
15-35 years age group
50
Gonorrhoea is most commonly seen in the which sex?
Makes more than females
51
The incubation period of gonorrhoea in males is?
1-5 days, average 2 days, and maximum 30 days.
52
The incubation period of gonorrhoea in female is?
uncertain
53
Is conjunctivitis in gonorrhoea unilateral or bilateral ?
Unilateral
54
The commonest and most dreaded complications of gonorrhoea is?
Subfertility or sterility, resulting from partial or complete occlusion of the vas or fallopian tubes,
55
The purulent discharges from the eyes of such babies, as a rule, manifest within the first …………….. hence the term "Ophthalmianeonatorum?
21 days of its birth
56
Chlamydia may also cause clinically similar lesions to Ophthalmianeonatorum which may
be diagnosed by?
the incubation period and exclusion of gonococci and other bacterial agents from the Gram Stained smear.
57
What other bacteria cause purulent conjunctivitis in babies?
Haemophilus and Staphylococcus species
58
When diagnosing gonorrhoea, Physical examination reveals what kind of discharge?
typical cream-coloured, purulent or muco-purulent discharge
59
How is swab for diagnosis of gonorrhoea done?
The discharge is usually obtained either with a sterile wire-loop or sterile cotton wool. swab from the endo-urethra, rectum, cervix, pharynx, eyes or a combination of these sites; and rarely from the skin, blood or joint fluid.
60
Other diagnostic tests for Neisseria gonorrhoeae include?
1. Sugar fermentation test (the gonococci ferment glucose only)
2. fluorescent antibody technique
3. co-agglutination test
4. Congo red
5. manganous chloride disc test
61
The genus Chlamydia is divided into 2 subgroups, which are?
1. Chlamydia psittaci which is primarily a pathogen of psittacine birds but causes zoonotic infections in man
2. Chlamydia trachomatis which causes infections in man
62
Chlamydia trachomatis is subdivided into several serotypes, which are?
A, B, Ba, C, E, F, G, H, I, J, K, L1, L2 and L3
63
What serotype of chlamydia trachomatis causes trachoma?
A, B, Ba & C
64
Chlamydia trachomatis serotype A, B, Ba & C cause?
Trachoma
65
What serotype of chlamydia trachomatis causes inclusion conjunctivitis & genital infections?
Serotype D to K
66
Serotype D to K of chlamydia trachomatis causes?
inclusion conjunctivitis & genital infections
67
What serotype of chlamydia trachomatis causes lymphogranulomavenereum (LGV)?
Serotypes L1, L2, L3
68
Serotypes L1, L2 and L3 of chlamydia trachomatis causes ?
lymphogranulomavenereum (LGV)
69
In USA, the most common cause of pneumonia during the first 3 months of life has been found to be?
Chlamydia trachomatis
70
The incubation period for Chlamydia is?
1 - 4 weeks, average 2 weeks
71
Concerning symptoms of chlamydia; viscid or mucoid discharge may be observed if?
micturition is withheld for at least 4 hours!
72
Gold standard of chlamydia diagnosis is?
Tissue culture
73
What differentiates ofloxacin and ciprofloxacin?
While ofloxacin is effective against chlamydia and gonorrhoea, ciprofloxacin is effective only against gonorrhoea.
74
Chanchroid is caused by?
Haemophilus ducreyi
75
Gram reaction and shape of Haemophilus ducreyi is?
Gram negative
Bacillus
76
The incubation period of chancroid is?
1-30 days, average 2-5 days.
77
What are the several forms of chancre ulcer?
Several forms of the ulcer exist, elevated (hence the name 'ulcusmolle")
gangrenous,
phagedenic
serpiginous
miliary
ring of roses
giant/dwarf
follicular and transient
78
Describe The Ito-reeinsterna (or Dmelcos) test for chancre?
In this test, 0.1 ml of Dmelcos antigen is injected intradermally into the forearm, and the result is read in 24-48 hours.
Induration of 0.4 cm or more constitutes a positive result.
This test is obsolete now because of too many false positives.
79
90 - 100% of Haemophilus ducreyi isolates from Africa are producers of ?
beta-lactamase
80
In chancre Treatment m, it should be prolonged for ……….. whenever bubo is present.
2-3 weeks
81
What should be done to buboes when present in chancre and why?
Buboes, when present, should be aspirated and NEVER incised.
This is to avoid the formation of serpiginous ulceration following the incision.
82
83
The incubation period of LGV is?
1-5 weeks, average 3 weeks, and maximum 3 months.
84
Describe the different stages of LGV ulcer?
The initial lesion is usually an erosion, then a papule, then vesicle (herpetiform type), which breaks down to form a small ulcer with clean edge and white base.
The ulcer is small, painless, usually, single and non-indurated transient (often described a s "hair-cut"), and
usually heals within 1 week, leaving no scar behind.
85
In LGV, Occasionally, symptoms are
severe with meningism, or high fever, causing a?
typhoid state
86
Describe the sign of the groove?
There is inguinal "bubo" from the inguinal drainage area. Multiple nodes are usually affected e.g. above and below the inguinal ligament along its length, leaving a characteristic groove overlying the ligament
87
In diagnosis of LGV, The antigen for this test (Frei test) is from infected
yolk sac, and it is available commercially as?
LYGRANUM
88
Describe the microscopic diagnosis of LGV?
A thin film o f bubo pus could be stained with Giemsa or dilute lugol's iodine to demonstrate the elementary bodies.
With Lugol's iodine, they appear brown because of glycogen
matrix around the particles.
With Giemsa' stain, they fluoresce
bright yellow when viewed under dark field microcopy.
89
What is the causative agent of GRANULOMA INGUINALE (DONOVANOSIS)?
The causative agent of this disease is Calymatobacteriumgranulomatis, a Gram negative bacillus,
90
What is the incubation period for donovanosis?
The incubation period of this disease is unknown for sure, but it varies between one week to six months, average 2 month
91
Describe the changes in lesion in donovanosis?
First, a papule, then a vesicle, followed by a nodule (raised button), tissue is followed with nodules, and finally velvety granulation tissue
(beefy-red granuloma).
92
Describe Donovan bodies?
The Donovan's bodies which stain
blue or black are recognized by their safety-pin appearance within the cytoplasm of mononuclear cells.
93
What is the incubation period of Trichomoniasis?
The incubation period varies between 2-28 days, average 10 days.
94
Describe the clinical picture of acute Trichomoniasis infection?
There is copious leucorrhoea, accompanied b y cervicitis, vaginitis
and vulvitis.
Small punctuate haemorrhagic spots may be found on the vaginal and cervical mucosa giving the so-called "strawberry appearance".
95
Describe trichomoniasis discharge?
it is greenish, watery and foamy (it contains air bubbles);
It smells very badly and itches intensely, the itching being characteristically worse at night.
96
Regarding trichomoniasis, Severe vaginitis gives rise to dyspareunia and uncomfortable posture during
walking or sitting, resulting in the thighs being rubbed against each other - this phenomenon is called?
Scissors action
97
Signs and symptoms of trichomoniasis are cyclic and worsen in times of ?
Menses
98
Describe the size and shape of trichomonas vaginalis?
Trichomonas vaginalis is a pear-shaped, highly motile organism about twice the size of a white
blood cell, with four anterior flagella and an antero-posterior crossbar, the axostyle
99
What is the commonest fungus causing genital yeast infection?
The commonest fungus causing this disease is Candida albicans.
100
What is the incubation period for genital yeast infection?
The incubation period is not known
for sure, but varies from a few days to 4 weeks, maximum 3 months.
101
How do we sufficiently exclude yeast infection from any patient?
It is noteworthy that negative microscopy is insufficient, culture is mandatory to exclude yeast infection in any patient.
102
What causes bacterial vaginosis?
It I s caused by a Gram negative, microaerophilic bacillus called Gardnerella vaginalis.
103
What is the incubation period for bacterial vaginosis
The incubation period is not known
for sure but lies between 1-4 weeks.
104
What happens to the population of vaginal lactobacilli, gardenella and other anaerobes in bacterial vaginosis?
In bacterial vaginosis, the population of vaginal Lactobacilli is greatly diminished, while Gardnerella in synergy with Mycoplasma hominis, mobilincus
species and other anaerobes, proliferate.
105
Describe the vaginal discharge in bacterial vaginosis?
The disease is characterized by profuse malodorous, milky white, grayish-granular vaginal discharge with no vaginal inflammation and no
itching or irritation.
106
In bacterial vaginosis, which does the patient experience discomfort in, vulva or vagina?
Vulva
107
What vaginal pH is considered diagnostic for bacterial vaginosis?
Vaginal pH > 4.5
