Flashcards in Tricky SOB's Deck (53):
How does purulent arthritis from N. Ghonorrhea present?
Purulent arthritis in only one of the knees bilaterally.
Fitz-Hugh-Curtis syndrome is caused by what and appears how?
Caused by N. Gon appearing as violin string inclusions on the liver.
What is the treatment for Gonnorhea?
Doxycycline or azithromycin (Want to treat for chlamydia as well)
What are newborns with N. Gonorhrea treated with?
Prohylaxis with erythromycin and ceftriaxone/ opthalmic ointment.
Soft, flat, moist, pink-tan papules and nodueles called condyloma lata are a sign of what disease?
Syphilis in the secondary stage.
Granulomatous lesions known as Gummas are associated with what disease?
Associated with Syphillis as seen under tertiary infections.
Typically will present with neurosyphilis or cardiosyphilis.
What are the three signs of Congenital Syphilis?
Saddle nose, maculopapular rash
Hutchinsons teeth, blindness, defness, bone malformation.
What is the most common diagnostic tool that we have to detect Syphillis?
Antibody detection/serology via VDRL.
What are considered non treponemal syphillis tests?
MEasures antibody that binds to cardiolipin.
Ex: RPR and VDRL.
These are typically better at detecting primary and secondary syphillis.
If a pt comes in with non-gonococal urethritis (peeing blood) what is your differential?
Chlamydia causes most cases.
Mycoplasma genitalium and Ureaplasma urealyticum are two bacteria that contribute to NGU (think fried egg appearance)
What is used to treat M genitlium?
M. genitalium is seen in many recurring non-gonnococal urethritis. It is immune to doxycycline and thus must be treated with azithromycin.
(It's brother: Ureaplasma will be whiped out with doxycycline)
Which STI is due to recent travel and is related to crack cocaine consumption?
This microbe causes soft painful chancres to form, grows on chocolate agar with factor V and factor X.
The pt is T. pallidium negative and HSV negative.
What microbe is it and what is it treated with?
Haemophylis ducreyi and is treated with marolides azithromycin and erythromycin.
This STI is characterized by an accumulation of Donovan bodies, wart-like lesions that bleed easily and accumulate as granuloma inguinale and is most often native to papau new guinea
When a women receives a historectomy, what family of bacteria subsequently colonize the vaginal canal?
Bacteroides fragilis (anaerobe)
Aerobic escherichia coli and enterococcus species.
The ansel criteria is a grading scale used to diagnose Bacterial vaginosis. What makes the criteria and what is considered a positive ansel sign?
White or grey Discharge.
Whiff test production of fish odor with KOH.
Vaginal pH >4.5
If 3/4 are positive the pt has a positive ansel criteria.
The nugent score is another grading scale used to diagnose bacterial vaginosis. What is the criteria within this scale?
This is a numerical scale based on the presence of:
Large gram + rods
Small gram - variable rods
Curved gram variable rods.
7-10 is BV criteria
4-6 is intermediate
0-3 is considered normal with lactobacillus being dominant.
What is the treatment for bacterial vaginalis?
The term, Strawberry cervix is most attributed to what pathogen?
Trichmonas causes petechial hemorrhages that appear as a "Strawberry cervix"
What is the treatment for Trichomatis?
Metronidazole for both partners as reinfection is normal and men are typicall the resevoirs.
TSST-1 the toxin that causes TSS is classified as what sort of toxin?
As a supertoxin that tightly binds MHCII to TCR stimulating T cell release of cytokines.
What chemokines drectly cause hypotension and shock in result of TSST?
TNFalpha and TNFbeta are directly known to cause the hypotension and shock.
HIV must undergo maturation via potease cleaving. What exactly does Protease cleave to cause maturation?
The protease cleaves the gag and gag-pol vral polyproteins in a process called virion maturation.
What is the risk of HIV transmission from mother to child?
Overall 1/4 with the highest chance being during birth (50-65% at birth)
When does the HIV acute syndrome occur and what is it marked by?
Occurs typically 3-6 weeks following infection with symptoms similar to mononucleosus. At this time HIV antibodies might not be detectable.
What is the innitial immune resposne to HIV?
Seen in the graph, the birst of viremia initially causes the immune response to increase antibody levels thus decreasing viral levels.
What is the chronic phase of HIV infection marked by?
MArked by very low levels of viremia with pt often asymptomatic. This can last up to 10 years if left untreated.
What markers does HIV testing look for?
HIV1 and HIV2 antibodies as well as p24 antigen.
For a neonate, which test should be give to determine infection of HIV?
HIV nucleic acid test as it actually looks for the HIV RNA genomes.
What test can be used to detect provirus in infected HIV cells?
What does the drug Maraviroc do?
Binds to the co receptor of CCR5 and prevents gp120 binding.
What does the drug Enfuvirtide do?
This is a Fusion inhibitor that binds to gp41
What does Azidothymidine AZT do?
This is an anti HIV drug that acts as a nucleoside inhibitor NRTI and actually gets incorporated into the provirus synthesis.
What does Nevirapine do?
This is a nonnucleoside inhibitor that binds directl to the reverse transcriptase and inhibits its activity.
What does Raltegravir do?
This is an anti HIV drug that inhibits integrase function
What does the drug Saquinavir do?
This is a drug that acts against HIV proteases.
What is the probablility and mortality rate of HSV encephalitis?
Chances are 1/3 that the neonate will develop encephalitis. There is a 50% mortality rate in infants that do not receive treatment with encephalitis.
What is the mortality rate of disseminated HSV before and after treatment?
Before treatment mortality reaches 80%.
Following treatment mortality drops to 23%.
What virological tests and smears can be used to detect HSV?
Tzank smear (Fried blue eggs)
PCR to detect the genome
Immunocytochemistry to detect antigens.
What does Acylovir do?
Acyclovir is a nucleoside analogue that when phosphorylated will inhibit viral DNA polymerase.
Used to treat HSV
What does Foscarnet do?
An HSV nonnucleoside inhibitor that does not require phosphorylation to inhibit the HSV polymerase.
Which HPV serotypes cause laryngeal papilomas?
HPV 6 and HPV 11.
Which HPV serotypes cause high risk angiogenital warts?
HPV 16, 18, 31, 33
Which serotypes of HPV are low risk for anogenital warts?
HPV 16, and 18
Which serotypes are known to cause common cutaneous warts?
Which serotypes are known to cause pantar warts?
Hpv 1 and 4
HPV E7 and HPV E8 work directly on what causing what?
HPV E7 works on RB
HPV E8 works on P53
Both of these proteins are produced by low and high risk HPV strains and cause the cell to continually go from G1 to S phase.
Hyperkeratosis and koilocytes are histogenic markers for what pathology?
HPV can be seen under scope as Fried blue eggs.
Guardisil is what sort of HPV vaccination?
Guardicil is a quadrivalent vaccine made in yeast given to men and women via three doses
(Men only receive the quadrivalent)
What type of HPV vaccination is ceravix?
Ceravix is a bivalent vaccine composed in yeast and given to women only in a series of three dosages.
Which strains does guardisil protect against?
Strains 6, 11, 16, 18
What strains does ceravix protect against?
Strains 16, 18