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87 Cards in this Set
- Front
- Back
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a painless ulcer that developes at the site of entry
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chancre
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elementary body
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infective
metabolically inactive Chlamydia |
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IgA1 protease producted by what?
role? |
gonorrhea
facilitate adherence to mucosal surfaces |
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what is orchitis
what is salpingitis |
inflammation of the testes
inflammation of the fallopian tubes |
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Gram-negative diplococci
kidney/coffee bean shape |
Neisseria meningitidis
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environment for optimal gonococcus growth?
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humid
CO2 |
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Gonococcus
major contributor to virulence ad inflammation |
LOS
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gonococcus
virulence factors |
pili - adhere, prevent phago
porin - acquire substrates Opa/Rmp - adhere, prevent phago LOS - toxic IgA1 protease transferrin-binding proteins - scavenge iron naturally competent - take up DNA |
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unique feature of gonococci that aids in transmission
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can bind to sperm
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sequence of infection
gonococci |
attachment -> local invasion using LOS toxicity to epithelium -> submucosa -> large inflammatory response
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what is the earliest and most effect of inflammatory control against gonococci
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neutrophils
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major Ab formed durng invasive infection of gonorrhea
directed against what? |
gonococci virulence factors
IgG1 |
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how does IgG1 work?
what role does it serve? |
bind complement -> opsonization, killing
chemotaxis prevent dissemination from mucosa |
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recurrent episodes of disseminated neisseria infections?
defect? |
deficiencies of C5-C9
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African American MSM from southeast
urethritis |
gonorrhea
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urethritis/cervicitis
opthalmia neonatorum PID prostatitis |
gonorrhea
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what is dermatitis-arthritis syndrome a sign of?
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disseminated gonococcal infection
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gonorrhea often has concomittant infection with what other pathogens
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Chlamydia
Mycoplasma |
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fibrosis
scarring urethral strictures obstructive uropathy obstructive renal failure |
untreated chronic gonorrhea infection
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vaginal discharge
abdominal pain frequent urination |
gonorrhea in women
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gonorrhea
major danger in females? |
ascending infection -> PID -> infertility, ectopic pregnancy
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acute sore throat/pharyngitis
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gonorrhea
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conjunctivitis
opthalmia neonatorum |
gonorrhea
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infants with copious purulent exudate from their eyes
complications? tx? |
corneal perforation
scarring blindness opthalmia neonatorum (gonorrhea) tx: silver nitrate |
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urethritis
purulent exudates Gram-neg diploccoi w/ neutrophils |
gonorrhea
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culture gonococci
blood, joint fluid, CSF |
chocolate agar
(sterile location) |
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culture gonococci
throat, urethra, cervix, rectum |
Thayer-Martin medium
- Chocolate agar + vancomycin (nonsterile sites) |
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Gram negative diplococci
produce glucose (oxidase positive) colistin-resistant tx? |
ceftriaxone
cefixime N. gonorrhoeae |
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gonorrhea
penicllin-allergic tx? concomittant Chlamydia or Mycoplasma? |
spectinomycin
azithromycin, doxycycline |
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types of antibiotic resistance in gonorrhea
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plasmid-encoded
chromosomally-encoded |
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Chlamydia
2 major biovars |
trachoma
LGV |
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has 2 forms
EB & RN which one is similar to spores? which one induces phagocytosis? which one forms intracellular inclusion bodies? |
Chlamydia
EB EB RB |
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what does Chlamydia do after it attaches?
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EB induces phagocytosis
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what are MOMPs
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serovar specific epitopes in Chlamydia
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gives structural integrity to particle to withstand harsh conditions
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MOMPs
Chlamydia |
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unable to synthesize ATP for energy
- parasitized from host through active transport pumps |
Chlamydia
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obligate intracellular parasites
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Chlamydia
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Associated w/ LGV
what do the other 15 serovars cause? |
L1
L2 L2a L3 oculogenital disease |
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Why does 70 db HL equal 77.5 dB SPL at 1000 Hz?
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If you think back to the conversion we did from SPL to HL. We learned that at 1000 Hz you add 7.5 to convert dB HL to dB SPL. So, at 1000 Hz a 70 dB HL tone is equal to 77.5 dB SPL. This audiometer with this earphone is in perfect calibration. If we change frequencies and go to five hundred or 2000 Hz, we will have to look on our conversion chart from SPL to HL to see the difference there.
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serovars associated w/ urethritis, cervicitis, proctitis
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D to K
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types of cells infected by most Chlamydia
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mammalian
non-ciliated columnar cuboidal transitional |
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how is LGV different than most Chlamydia infections
what does this behavior make LGV? |
most Chlamydia infections are restricted to mucosal surfaces
LGV can replicate in mononuclear phagocytes w/in lymphatics and reticuloendothelial system - systemic in nature |
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cell lysis and death
loss of barrier function fluid loss PMN influx fluid leak as discharge result of? |
EP rupture
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granuloma formation
mixed inflammatory w/ PMNs -> suppuration -> fibrosis, scarring |
LGV
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reinfection is common
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Chlamydia
Immunity is transient |
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flies can also be a host
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Chlamydia trachomatis
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urethritis
lymphogranuloma venereum |
Chlamydia
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most common bacterial STD in the US
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Chlamydia
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dysuria
frequent urination water/milk discharge swelling in testes |
Chlamydia in males
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percentage of Chlamydia carriers that are asymptomatic
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Males: 50%
Females: 80% |
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vagina discharge
irregular bleeding lower abdominal pain burning urination nausea fever common sequelae? |
infertility due to PID
Chlamydia in females |
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papule -> ulcerates
fever heache myalgia buboes abscess fistulae type of disease? |
systemic
LGV |
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leading cause of preventable blindness worldwide?
pathogenesis |
infect conjunctivae -> inflammatory follicles -> eyelid fibrosis -> lashes turn inward -> abrade cornea -> heal w/ scars -> blindness
Trachoma Chlamydia |
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pain
mucopurulent discharge blurred vision keratitis assoc w/ what? |
genital chlamydial infection in pt and partner
adult inclusion conjunctivitis |
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chronic keratitis
corneal infiltrates coeanl vascularization fibrosis |
chronic infection Chlamydia
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swollen eyelids
conjunctival hyperemia mucopurulent ocular discharge scarring tx? |
topical erythromycin
neonatal inclusion conjunctivitis |
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what can/can NOT silver nitrate treat successly?
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can: ocular gonorrhea
cannot: ocular Chlamydia (neonatal) |
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infant
pneumonia simultaneous ocular disease rhinitis cough diffuse interstitial pneumonia |
neonatal pneumonia
Chlamydia |
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urethritis
30 yo white male conjunctivitis polyarthritis skin lesions - circinate balanitis - keratoderma blennorrhagica condition? pathogen? |
Reiters syndrome (Reactive Arthritis)
Chlamydia |
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HLA-B27
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Reiters Syndrome
(Chlamydia) |
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non-gonococcal urethritis
presence of PMNs |
Chlamydia
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Diagnostic tests for Chlamydia
what DOESN'T work? |
Culture in yolk sac of chicken embryo
DFA Not useful: serology - doesn't distinguish b/w current and past |
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what is serology most useful for? why?
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LGV
- systemic infection |
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what type of diagnosis is Trachoma usually?
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clinical
- resource-limited settings |
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Chlamydia
tx? |
tetracycline
macrolides |
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C. trachomatis
tx? useful for what types of pt? |
sulfa drugs (sulfisoxazole)
pregnant, children - cannot take tetracycline |
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depressed bone growth
discoloration of teeth what are some alternative drugs that can avoid this? |
adverse effects of treating chlamydia w/ tetracycline
- sulfa drugs - macrolides (azithromycin, clarithromycin, erythromycin) |
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how should you treat pt w/ symptomatic chlamydia?
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quickly to prevent blindness
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other causes of urethritis and vaginitis besides Chlamydia
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mycoplasma
candida trichomonas vaginalis gardnerella vaginalis |
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vaginal irritation
redness itching cottage cheese like vaginal discharge dysuria tx? recently took taking antibiotics |
vaginal imidazole
triazole creams oral fluconazole stop causative antibiotics |
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flagellaed unicellular protozoan
vaginitis copious, maladorus, yellow-green watery discharge itching burning dysuria vaginal pH? |
alkaline
trichomonas vaginalis |
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exists only as a trophozoite (no cyst)
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trichomas vaginalis
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chronic colonization of the prostate as a reservoir
tx? |
trichomonas vaginalis
tx: metronidazole |
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bacterial vaginosis
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gardnerella vaginalis
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polymicrobial infection
excessive maladorus vagina discharge elevated vagina pH above 4.5 fishy amine-like odor clue cells danger? |
garnerella vaginalis
spontaneous abortions |
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epithelial cells coated w/ attached bacteria
how to culture? |
clue cells
gardnerella blood agar high CO2 |
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whiff test
tx? |
metronidazole
gardnerella |
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