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Flashcards in STDs Deck (57):
1

What bugs can cause urethritis?

Neisseria gonorrhea
Chlamydia trachomatis
Mycoplasma genitalium

2

Of the three causes of urethritis, which one is a gram- diplococci? What else is a distinguishing factor?

N. Gonorrhea

Also oxidase+

3

How N. gonorrhea be distinguished from N. meningitides?

N. gonorrhea only oxidizes glucose

N. meningitides oxidizes BOTH glucose and maltose

4

When is gonorrhea most common?

With menstruation or with an IUD

5

What is a telltale sign of gonorrhea?

Septic arthritis in sexually active people

6

Gonorrhea produces a discharge. What does it look like?

Gonorrhea → purulent discharge

7

What are some possible consequences of untreated gonorrhea?

PID
Ectopic pregnancy
Sterility
Fitz-Hugh-Curtis syndrome

8

What is Fitz-Hugh-Curtis syndrome?

PID with an inflamed liver capsule

9

What virulence factors does gonorrhea have?

Pili
IgA protease

10

What does having pili do for gonorrhea?

Allows for attachment to mucosal cells (urethra or vagina)

11

What is the result of gonorrhea killing ciliated cells?

Inflammatory response → urethritis (men) or cervicitis (women)

12

Besides seeing a gram- diplococci on a gram stain and evidence of the ability to metabolize glucose, what else can be done to diagnose a N. gonorrheal infection?

N. gonorrhea selectively grows on Thayer-Martin media

13

How is gonorrhea treated?

Ceftriaxone → for N. gonorrhea
Doxycycline → for the probably concurrent Chlamydia

14

Is Chlamydia gram- or gram+?

Neither

15

What kind of bacteria is Chlamydia?

Obligate intracellular parasite

16

Where does Chlamydia replicate in a host cell?

Chlamydia replicates in inclusion bodies

17

What serovars of Chlamydia are spread via sex?

L1-L3 cause Lymphogranuloma Venereum (LGV)

18

Does Chlamydia cause a discharge?

Yes...significant amount of a clear discharge

19

Other than a clear discharge, how else does Chlamydia present?

Painless ulcers that heal...but then there is regional lymphadenopathy that can lead to draining sinuses and proctitis or renal stricture

20

What are some complications of untreated Chlamydia?

Females → Fitz-Hugh-Curtis syndrome
Males → Reiter's syndrome

21

What is Reiter's syndrome? Is there a specific HLA type patient more likely to develop Reiter's syndrome?

Reactive arthritis...also conjunctivitis

HLA-B27 is most likely to develop Reiter's syndrome

22

How is Chlamydia diagnosed?

PCR
Iodine stain+
Giemsa stain+

23

How is Chlamydia treated?

Azithromycin
Tetracyclines
Erythromycin (oral/eye drops...for neonates)

24

What is a non-cyst forming protozoan that can cause vaginitis?

Trichomonas vaginalis

25

How does trichomonas vaginalis present?

Itching
Copious yellowish discharge

26

What can potentially happen if a pregnant woman is infected by trichomonas?

Premature labor

27

What is seen on a wet mount of vaginal/urethral discharge that would be diagnostic of trichomonas?

Tear-drop shaped trophozoites with 5 flagella and 1 nucleus

28

What is the vaginal pH with a trichomonas infection?

Higher than 4.5 (4.5 is normal)

29

How is trichomonas treated? Who all gets it?

Metronidazole

Patient AND partner

30

What bacteria can cause Bacterial Vaginosis (BV)?

Gardnerella spp.
Mobiluncus spp.

31

How is gardnerella BV diagnosed?

Gram stain → clue cell
KOH amine test → presence of amines

32

How does vaginosis present?

Moderate amount of gray/white very SMELLY discharge

33

What causes copious secretion of a cottage cheese like discharge?

Candida albicans

34

When is candida albicans likely to occur?

After an antibiotic regimen or in immunocompromised patients

35

How is candida diagnosed?

Pseudohyphae and budding yeast on tissue scrapings

36

What is Treponema Pallidum?

Spirochete bacteria that causes syphilis

37

How does T. pallidum initially present?

The first sign of syphilis is a painless chancre at the inoculation site that remains up to 6 weeks

38

If left untreated, what can happen with a syphilis infection after the initial chancre heals?

Treponema pallidum disseminate and proliferate → 2° syphilis

39

What are the symptoms of 2° syphilis?

Condyloma lata
Maculopapular rash on palms and soles
Meningitis, hepatitis, arthritis, etc.

40

What is condyloma lata?

Wart-like painless lesions in moist areas

41

How long do symptoms of 2° syphilis remain?

Up to 6 weeks...cycles can repeat many times

42

If still untreated, what can happen if the treponema pallidum infection progresses to 3° syphilis?

Chronic inflammation of:
Bone and soft tissue (Gummas)
CV system (aortitis and AAA)
CNS (tabes dorsalis, general paralysis, Meningitis, Argyll Robertson)

43

What is tabes dorsalis?

Demyelination of the dorsal column (proprioception, vibration, and discriminatory touch)

44

What abnormalities can happen to an infant born to a mother with syphilis?

Stillbirth
CN VIII deafness
Saber shins
Saddle nose
Hutchinson's incisors

45

How is treponema pallidum diagnosed?

Dark-field microscopy (NOT gram stain)
Serological tests
Bunch of tests that can give false positives with SLE or mono
FTA-ABS (detects anti-treponemal antibodies)

46

How is syphilis treated?

Penicillin G

47

Is penicillin G oral or IV?

G is IV...GIVe penicillin G

48

What is a potential complication of treating treponema pallidum?

Jarish-Herxheimer reaction d/t release of endotoxin-like factors (fevers, chills, and myalgias)

49

Which HSV typically infects below the waistline?

HSV-2

(HSV-1 potentially could after oral)

50

What kind of genome does HSV have? Is it enveloped

HSV is a linear dsDNA, enveloped virus

51

How does herpes usually present?

Usually asymptomatic, but can cause vesicular lesions

52

Where does herpes remain latent?

In the lumbosacral ganglia...travels through sensory nerves

53

Can herpes cross placenta?

Yes...causes congenital defects, spontaneous abortion or neonatal encephalitis

54

How is herpes diagnosed?

PCR
Multinucleate giant cells on Tzanck smear of skin lesions
Eosinophilic Cowdry intranuclear inclusion bodies on skin biopsy
Fluorescent antibody test is available

55

How is herpes treated?

Acyclovir

56

What forms the normal vaginal flora of reproductive age women?

Candida
Lactobacillus

57

What forms the normal vaginal flora in young girls/old women?

Non-hemolytic strep
Staph
Corynbacterium
Lactobacillus