STIs

Question 1

What is gonoccocal urtheritis/cervicitis/proctitis caused by?

Answer 1

N. gonorrhea

Question 2

What is non-gonoccocal urtheritis/cervicitis/proctitis caused by? (3)

Answer 2

Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum

Question 3

What is the morphology and Gram-staining of N. gonorrheae

Answer 3

Diplocci, G-ve

Question 4

What causes the second most common STI in the UK?

Answer 4

N. gonorrhoeae

Question 5

Is N. gonorheaea intracellular or extracellular?

Answer 5

Intracellular

Question 6

Symptoms of gonorrhoea

Answer 6

• Pus from urethra/vagina/rectum
• Burning sensation
• Testicle/scrotum pain
• Anal itching and bleeding
• Sore throat (oral inoculation)

Question 7

Symptoms of genital gonorrhoea compared to non-gonococcal urethritis?

Answer 7

Indistinguishable

Question 8

Complications of a disseminated gonococcal infection

Answer 8

• Arthritis-dermatitis syndrome.
• Meningitis/osteomyelitis/sepsis (rare).

Question 9

Gonorrhea caused PID, what are the symptoms?

Answer 9

• Infection of fallopian tubes
• Tubo-ovarian abscesses
• Ectopic pregnancy
• Sterility.

Question 10

What complications can gonorrhea cause in men

Answer 10

• Orchitis (inflammation of testes)
• Epididymitis (inflammation of epididymis which stores and carries sperm)
• Sterility (rare)

Question 11

What is Ophthalmia neonatorum?

Answer 11

Eye infection passed from mother who has gonorrhoea or chlamydia during birth.

Question 12

How does N. gonorrhoeae adhere?

Answer 12

Type IV pili for initial adherence and Opa protein for tight adherence

Question 13

How is N. gonorrhoeae uptaken into the cell?

Answer 13

Transcytosis/ receptor-mediated uptake

Question 14

N. gonorrhoeae leads to a large induction of what into the cell?

Answer 14

PMNLs (polymorphonuclear lymphocytes), peptidoglycan fragments, lipooligosaccarides, outer-membrane vesicles

Question 15

Main virulence factors of N. gonorrhoeae?

Answer 15

Adherence, toxin secretion and sequestration of iron

Question 16

N. gonorrhoeae can resist activity of what host factors?

Answer 16

PMNLs, can resist activity of complement pathway and produces an IgA protease.

Question 17

What are the specimin types of N. gonorrhoea?

Answer 17

Swab and urine (low sens in women)

Question 18

What are the test types for N. gonorrhoea ?

Answer 18

Microscopy and culture, NAAT

Question 19

What is NAAT

Answer 19

Nucleic acid amplification technology

Question 20

What agar with what is used to select for N. gonorrhoea

Answer 20

GC agar with VCAT/VPAT

Question 21

What does VCAT/VPAT contain

Answer 21

Vancomycin
Colisitin/polymixin
Amphotericin B
Trimethoprim

Question 22

Can NAAT take urine samples?

Answer 22

Yes

Question 23

How sensitive is NAAT to a female urine sample

Answer 23

Less than for a male

Question 24

How is gonorrhoea treated? Give also alternative

Answer 24

High dose of ceftriaxone,
Alt: Cefixime or azithromycin

Question 25

Overtime can N. gonorrhoea become resistant

Answer 25

To nearly everything

Question 26

What usually causes non-specific urethritis/cervicitis/proctitis?

Answer 26

Chlamydia trachomatis

Question 27

What can Chlamydia trachomatis cause other than an STI

Answer 27

Eye infection called a trachoma

Question 28

Is Chlamydia trachomatis intracellular?

Answer 28

Yes

Question 29

What bacteria causes the most common STI?

Answer 29

Chlamydia trachomatis

Question 30

Incubation time of Chlamydia trachomatis

Answer 30

1-3wk

Question 31

Chlamydia trachomatis can cause co-infection with what?

Answer 31

N. gonorhhoeae

Question 32

Chlamydia trachomatis uses what type of secretion system to inject proteins into host cell

Answer 32

Type 3 secretion system

Question 33

Chlamydia trachomatis: T3SS injects what into the cell

Answer 33

Invasion effectors: internalisation and anti-apoptopic factors

Question 34

What type of body of Chlamydia trachomatis binds cell surface

Answer 34

Elememtary body

Question 35

Before replication there is a transition to what type of body of Chlamydia trachomatis

Answer 35

Reticulate body

Question 36

How is chlamydia treated

Answer 36

Doxycycline, azithromycin. Doxycycline is associated with greater clinical cure rates but there are fewer compliance problems with azithromycin.

Question 37

What is the prevelance of resistance in chlamydia?

Answer 37

Rare

Question 38

Apart from chalmydia what else can cause non-gonococcal urethritis>

Answer 38

Mycoplasma genitalium

Question 39

How is Mycoplasma genitalium treated

Answer 39

Moxifloxacin

Question 40

What bacteria can cause genital ulcerations?

Answer 40

Syphilis, C. trachomatis, Haemophilus ducreyi, Klebsiella inguinale

Question 41

What bacterium causes syphilis

Answer 41

T. pallidum pallidum

Question 42

Symptom of primary syphilis

Answer 42

Chancre

Question 43

Symptoms of secondary syphilis

Answer 43

Generalised malaise/rash Condylomata lata (warts)

Question 44

Symotoms of tertairy syphilis

Answer 44

Gumma Cardio/meningovascular lesions General paresis of the insane

Question 45

How is syphilis diagnosed?

Answer 45

Serology methods

Question 46

How long to treponemal antibodies last

Answer 46

For life

Question 47

How long do non-terponemal antibodies last

Answer 47

Decline after treatment

Question 48

NTT (non-typhi treponemal) tests

Answer 48

RPR, VDLR

Question 49

TT (typhi treponemal) tests

Answer 49

EIA or CIA

Question 50

Do TT or NTT tests have higher sensitivity?

Answer 50

TT

Question 51

How is syphilis treated

Answer 51

Bezathine/procaine penicillin (IM injection)

Question 52

Topical genital ulcerations are most commonly presenting in what patients

Answer 52

From LIC and those with AIDS

Question 53

What is Lymphogranuloma venereum caused by

Answer 53

Caused by L1, L2, L3 of C. trachomatis

Question 54

Lymphogranuloma venereum is an infection of what

Answer 54

Lymph nodes

Question 55

Chancroid is caused by what bacterium

Answer 55

Haemophilus ducreyi

Question 56

Granuloma inguilane (donovanosis) is caused by what bacterium

Answer 56

Klebsiella inguinale

Question 57

Bacterial vaginosis is caused by the decrease of what bacteria and increase in what organisms

Answer 57

Reduction in vaginal dominant lactobacilli and increase in other organisms like Gardnerella vaginalis and Bacteroides spp.

Question 58

Diagnosis of BV

Answer 58

Clue cells (g-ve cells adhering to epithelial cells) and whiff test