STI

Question 1

What does Treponema pallidum look like, and how is it cultured?

Answer 1

spirochete
endoflagella
cardiolipin in membrane

cultured in rabbit testes

Question 2

What are the clinical presentation of T. pallidum?

Answer 2

Syphilis
Primary: chancres
Secondary: maculopapular rash
Tertiary: no organisms, gummas, neurosyphilis

Congenital syphilis: Hutchinson’s triad
keratitis, deaf, teeth

Question 3

Virulence factors and treatment for syphilis

Answer 3

hyaluronidase, no LPS, few surface proteins

Pen G injections

Question 4

What does Nisseria gonorrhea look like?

Answer 4

G-
coffee-bean shaped
diplococcus
intracellular in PMNs

Question 5

What are the clinical symptoms of N. gonorrhea?

Answer 5

depending on which mucus membrane: proctitis, pharyngitis, arthritis

male: urethritis + pus from urethra
female: PID, infertility

conjunctivitis from infected birth canal

Question 6

How is N. gonorrhea diagnosed, and how is it treated?

Answer 6

G stain of urethral drip in males, and cervical swab in females

ceftriaxone + azithromycin (for chlamydia co-infection)
tetracycline drops for newborns

Question 7

What are the symptoms of N. meningitidis, and how is it transmitted?

Answer 7

meningococcemia: purpura
headache, stiff neck, vomitting
PMNL in CSF
Waterhouse-Friderichsen Syndrome- meningococcal septicemia

aerosol transmission (NOT STD)

Question 8

What virulance factors allow N. meningitidis to be a douche?

Answer 8

Antiphagocytic PS capsule

special pili attach to BBB and make it porous

Question 9

Treatment/control for N. meningitidis?

Answer 9

vaccine for all types except B

Pen G preferred (BBB is compromised so it can cross)
Ceph. III if pen allergy

Rifampin as prophylaxis

Question 10

Clinical presentation and treatment of Moraxella catarrhalis?

Answer 10

Acute otitis media (#3)
opportunistic sinusitis, bronchitis, pneumonia

3rd gen Ceph or ciprofloxacin

Question 11

Epidemiology and virulence factor of M. catarrhalis?

Answer 11

50% carrier rate in school age children, exacerbates COPD

produces beta-lactamases

Question 12

What do Chlamydia organisms look like?

Answer 12

G-
obligate intracellular
2 form lifecycle (EB and RB)

Question 13

How is Chlamydia trachomatis transmitted?

Answer 13

STD or contact transmission

Question 14

What are the clinical presentations of C. trachomatis?

Answer 14

Trachoma: infected birth canal or flies. Causes keratinized cornea and blindness

Inclusion conjunctivitis: seen in neonates, not as severe as trachoma, but has possible respiratory complications

Neonatal pneumonia: pneumonia without fever, commonly seen with inclusion conjunctivitis

Chlamydia: urethritis, epididymitis, prostatitis in males; PID leading to infertility in females

Latent lymphogranuloma venereum: small abcesses turning to painful inguinal buboes with fever. Can cause elephantiasis or bowel obstruction.

Question 15

Virulance factors of C. trachomatis?

Answer 15

T3SS remodels host cytoskeleton

Lysozyme resistant

Question 16

Treatment of Chlamydia trachomatis?

Answer 16

preferred is oral azithromycin, secondary tetracycline or macrolides

Question 17

Epidemiology, symptoms, and treatment of Chlamydia pneumonia?

Answer 17

carried by Koala bears, respiratory transmission

mild URT, or walking pneumonia

usually untreated, tetracycline if necessary

Question 18

Epidemiology, symptoms, and treatment of Chlamydia psittaci?

Answer 18

transferred from birds by bites or feces inhalation

Parrot fever: acute, severe pneumonia and sepsis

treated with tetracycline