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1

A woman presents with 

  • genital: itchin, burnin and whitish vaginal discharge

2

4th most common cause of nosocomial infections

vaginal candidiasis

exceeds gram-negative infections

3

explain the two types of transmission with candidiasis

  1. endogenous
    1. most types of infections
    2. self innoculating
  2. exogenous
    1. health care worker-> patient, patient-> patient

4

a microscopic sample for oral and vaginal tissue collection of cutaneous and mucosal lesions, oberserves the following

  1. budding yeast-like forms and pseudohyphae can be seen with a fluorescence microscope
  2. disease
  3. casues
  4. treatment

candidiasis/vulvovaginal candidiasis

  1. opportunistic infection
    1. exogenous/endogenous
  2. treatment
    1. azoles
      1. inhibits the fungal cyt-P450
    2. antimetabolites
      1. flucytosine
        1. interferes with teh synthesis of DNA, RNA and proteins

5

a patient is put on azoles and antimetabolites, what is the infection?

candidasis/ fungal infection

6

patient is brought into the ER. She has low SES, reports of poor maintinence of mentrual hygiene. 

  • sudden fever, chills, vomiting, muscle aches, rashes
  • blood pressure drops and kidneys are failing
  • what could cause this?

staphylococcal toxic shock- S. aureus

  1. associated with use of tampons abrade the vaginal wall

7

patient presents with desquamation of the palms and soles. She was very ill and still sufferes from: chills, fever, vomiting, diarreah.

what could it be

staphylococcal toxic shock

8

what are the following at risk for?

  1. menstruating women
  2. women using barrier contraceptives
  3. Those who have undergone nasal surgery
  4. postoperative wound infections

staphylococcal toxic shock

9

  1. this bacteria is an obligate human parasite.
    1. do not survive well ouside the host
    2. transmission must be direct
  2. what is it? describe
    1. gram
    2. shape
    3. location
  3. method of resistance?

  1. neisseria gonorrhoeae
    1. gram neg
    2. diplococcus
    3. foundi nurethral pus
    4. attach to host cells by use of pili
      1. can express many types
  2. increase number of strains contain R plasmids
    1. resistance to antibiotics such as penicillin tetracycline

10

Describe the antigenic variation of N. gonorrhoeae

  1. different type of
  2. enzyme
  3. special protein

  1. antigenic variation via differnt pili types
    1. allow for evasion of the immune system
    2. adherance to many cell types
  2. produce protease breaking down IgA
  3. Opa proteins
    1. increase adherance between
      1. gonococci
      2. eukaryotic cells
        1. phagocytes
      3. epithelial cells
    2. outermembrane 
      1. attach to CD4 lymphocytes, preventing activationa nd proliferation 

 

 

11

untreated N gonorrhoeae can lead to what

  1. men
  2. women
    1. how does the bacteria tranverse, with being immotile?

  1. men
    1. urethitis
    2. sterilty along with prostatic disease
  2. women
    1. pelvic inflammatory disease
    2. the N gonorrhoeae attaches to the sperm and ttransits to the fallopian tubes

12

diffirentiate chlamydia trachmoatis from neisseria gonorrhoeae

symptoms are very similar.

  1. sample will show the difference
    1. CT
      1. gram -
      2. spherical
      3. obligate intracellular bacterium
      4. men-grey white discharge,painful testes
      5. women - increased vaginal discharge, painful menses and urination
    2. Ng
      1. gram -
      2. diplococcus
      3. men-urethritis, thick pus discharge
      4. women-painful urination, vaginal discharge

13

has subtypes that may cause blindness

chlamydia trachomatis

14

treatment for the following

  1. gonnorrhea
  2. trachomatis
  3. syphilis

  1. fluoroquinolones, cephalosporins
    1. pregnant-1% silver nitrate or eryhtromycin
  2. azithromycin, tetracylcin, erythromicin
  3. penicillin

15

what are the stages of syphilis

  1. primary
    1. single chancre
    2. 10-90 post exposure
  2. secondary
    1. if no treatment  in primary stage
    2. skin rash mucus membrane lesions
  3. tertiary
    1. damage to internal organs: NCS, heart, blood vessels
    2. gumma
    3. hypersensitive to treponema pallidum- causes blindness

16

trponema pallidum 

  1. causes
  2. shape
  3. motility
  4. identified by
  5. congenital exposure

  1. syphilis
  2. spirochete
  3. motile
  4. dark field microscopy, not gram stain
  5. congenital
    1. damage apears ~4th month of pregnancy
    2. hutchinsosns teeth
    3. facial deformities

17

small red bumbs on genitalia appear ->blisters

  1. genital burning/itching
  2. severe pain
  • type
  • initial infection vs latent

HSV-2

  1. double stranded DNA, enveloped virus
    1. apears similar to HSV1
  2. inital
    1. fluid filled blisters (Vesicles) contain large number of infecious virons
  3. latent
    1. partial transciption
    2. no blisters

18

risk of newborn to HSV2

treatment?

if mother has primary infection near delivery time, baby has 1/3 risk of acquiring infection->death or disabeled. baby is usually cesrian

  1. treatment-decrease the attacks, NO CURE
    1. acyclovir
    2. famcicblovir

19

GENITAL WARTs and cervica lcancer is associated with

  1. type
  2. incubation

HPV

  1. most common STI
  2. type
    1. non-enveloped
    2. DNA
  3. incubation = 3 months

20

yellowinsh green frothy vaginal discharge

  1. causative agent
  2. incubation
  3. motility

  1. Trichomonas vaginalis
    1. strawberry cervix
    2. burning discomfort upon urination
    3. itching
  2. 4-20 days
  3. 4 flagella viewed, allow for jerky motility
  4. don't have mitochondria
    1. hydrogenosomes
      1. remove the pyruvate and transfer electrons to hydrogen ions forming hydrogen gas

21

Infection of this indicates child abuse.

what should the treatment be?

trichomonas vaginalis

treatment-metronidazole