Micro 50 - 52

Front 1

Compare STIs & UTIs (4)

Back 1

Front 2

Name the THREE most common STIs world wide

Back 2

Front 3

Name the THREE most common STI's in the USA

Back 3

Front 4

For the following Syndromes, describe the Symptoms, Signs & Most Common causes for
1. Vaginal Discharge (4, 1 & 4)
2. Urethral discharge (3, 1 & 2)
3. Genital Ulcer (1, 1 & 3)
4. Lower Abdominal Pain (2, 1 & 3)
5. Scrotal swelling (2, 1 & 2)
6. Inguinal bubo (1, 3, & 2)
7. Neonatal conjunctivitis (3, 2 & 2)

Back 4

Front 5

Definition of SEX

Back 5

1. MUST BE EXPLICIT

Front 6

More than 340 million news cases of what STI's in Men & Women between (15-49rs old) (4)

Back 6

1.Spyhillus, Gonorrhea, Chlamydia & Trichomoniasis
2. Blacks

Front 7

STIs Disproportionately effect
1. Gender (2)
2. Age group (2)
3. Race
4. 15-24yr olds are ___Sexual Active Population & _____All new STDs

Back 7

1. Women, Infants of Infected mothers
2. Adolescents & Young Adults
3. Communities of Color
4. 1/4 & 1/2

Front 8

Names the Organisms that have gone from GIT to STD (3)

Back 8

1. Giardia labilia
2. Amoeba
3. Shigella

Front 9

Name the Clinical Features & Organism for the following:
0. Gonorrhea (7 & 2)
1. 1⁰ Syphilis (1 & 1)
2. 2⁰ Syphilis (4 & 1)
3. 3⁰ Syphilis (5 & 1)
4. Chancroid (2 & 1)
5. Genital Herpes (6 & 1)
6. Lymphogranuloma venereum (4 & 3)
7. Trichomoniasis (4 & 1)
8. AIDS (3 & 1)
9. Condylomota acuminata (2 & 2)
10. Hepatitis B (1 & 1
11. Bacterial vaginosis (5 & 1)

Back 9

Front 10

Pelvic Inflammatory Disease
1. TWO bugs & difference
2. Symptoms (2)
3. Symptoms may also include (4)

Back 10

1. Chlamydia trachomatis (subacute, often undiagnosed) & Neisseria gonorrhea (acute)
2. Chandelier sign (cervical motion tenderness), Purulent cervical discharge
3. Salpingitis, Endometeritis, Hydrosalpnix & Tubo-Ovarian abscess

Front 11

Name anaerobic gram -ve bacteria that can lead to female genital tract infections (2) Found in abcsesses

Back 11

1. Prevotella bivia & Bacteriodes fragilis (common in abscesses)

Front 12

Nicnames for Gonorrhea

Back 12

Clap
The Drip
Piss of Fire
Bacterial Urethritis

Front 13

Compare the following Bacterial Infections across Pathogen & Signs & Symptoms
1. Gonorrhoea (1 & 5)
2. Chlamydia (1 & 5)
3. Syphillus (1 & 3)
4. Chancroid (1 & 2)
5. Granuloma inguinate or Donovanosis (2 & 3)

Back 13

Front 14

N. gonorrhea
1. Resevoir
2. Tramsmitted by
3. RARE transmission
4. Infection ↑

Back 14

1. Asymptomatically Infected Individual
2. Sexual contact
3. Formite
4. likeley hood of AIDS infection

Front 15

Gonorrhea
1. Peaked in
2. Currently
3. More common in

Back 15

1. 70S
2. Descreasing
3. Men

Front 16

Gonorrhea
1. Male symptoms (2) Restricted to
Women
2. Site of Infection
3. Symptoms (3)
4. Disseminated infection often occur
5. 40% patients w/ Gonorrhea have

Back 16

1. Purulent Urethral discharge & dysuria (urethra)
2. Cervix
3. Vaginal dischrage, Dysuria & Abdominal Pain
4. Females
5. Chlamydia

Front 17

Neisseria gonorrhoeae Characteristics
1. Gram
2. Motile
3. Spore
4. Other (3)
5. Name Virulence factors (5)

Back 17

Gram-ve diplococci, non motile & non spore forming
4. Oxidase +ve, fstiduos & outer surfeace has multiple antigens
5. Pili, Opa, Por protein, LOS & Iron binding proteins

Front 18

Neisseria gonorrhoeae
Pathogenesis
1. Attaches to via Pili (3)
2. MoA Pili
3. Role of Opa
4. Role of LOS (1)
5 .Other VFs

Back 18

1. Columnar epithelium, Distral Urethra & Cervix
2. Antigenic variation by DNA rearangement
3. Opaque colony attachement
4. Induces TNFα
5. Por protein & Iron Binding Protein

Front 19

Neisseria gonorrhoeae
1. Organisms multiply where
2. Thus, large #s
3. Spread in females to cervix via
4. Seeding my a occur (common in what patients)
5. Chronic infections can causes (3)

Back 19

1. In Situ in huge numbers
2. Secreted by both men & women
3. Urethral or Uterine Contractions
4. Blood (complement defecient)
5. Scarring/Strciture of fallopian tube or Urethra

Front 20

Neisseria gonorrhoeae DIAGNOSIS
1. Men
2. Women (3)

Back 20

1. Gram-ve diplococci in SYMPTOMATIC men
2. Isolation on media for 24hrs. Thayer Martin, Chocolate II Agar & Oxidase -ve + colonies

Front 21

Describe the THREE pathways for N. gonorrhoeae Infections

Back 21

Front 22

Neisseria gonorrhoeae
1. Treatment limited to
2. What is the Gonococcal Isolate Surveillance Project

Back 22

1 .cephalosporins
2. Monitors durgs used to treat Neisseria gonorrhoeae

Front 23

Chlamydia trachomatis epi
1. Most common
2. Most cases still go
3. Sever impact on (2)
4. Infection

Back 23

1. Reported notifiable disease
2. Undiagnosed
3. Youg & Minority WOMEN
4. ↑ Risk of HIV infection

Front 24

Chlamydia trachomatis
1. Transmission to Newborn baby during
2. 50% risk for
3. 20% risk

Back 24

1. Labor
2. Conjuctivitis
3. Infection of lung

Front 25

Chlamydia. The biovar is associated with
1. A, B, Ba & C
2. D-k
3. LGV1-3

Back 25

1. Agent of Trachoma
2. Conjuncitivitis, Infant Pneumonaie & Urogenital disease
3. Lymphogranuloma venereum

Front 26

Chlamydia trachomatis. CLinical Presentation
1. Ussualy
2. If present, symptoms (2) d.t (2)
3. 40% of Untreated women develop
4. Leading to (3)
5. Male complications

Back 26

1. Asymptomatic
2.Nonspecific:Vaginal dscharge & burning on urination (diredt distruction of cells, host inflammatory response)
3. PID
4. Infertility, Ectopic Pregnancy & Chronic Pelvic Pain
5.Epididymitis & Urethritis (both rare)

Front 27

Chlamydia trachomatis. Characterestics
1. Infectious form
2. Noninfectious form
3. Type of bacteria
4. Entry via (2)

Back 27

1. Elementary bodies
2. Reticulate Bodies
3. Obligate intracelullar parasite
4. Abrasions/Laceration

Front 28

Chlamydia trachomatis
Key difference vs. Gonorrhea in males (2)

Back 28

1. Enlarged scrotum & mucus discharge( large volume)

Front 29

Chlamydia trachomatis Pathogenesis
1. Receptos for EB (6)
2. Immunity

Back 29

1. Mucus membrane of Urethra, Endocervix, Endometrium, Fallopian Tubes, Ano-REctum, Respiratory Tract & Conjunctivae
2. NOT long lasting

Front 30

Chlamydia trachomatis
1. Two types of tests (2)
2. Screening recommended for

Back 30

1. Swab or Nuclear probe (if available)
2. Sexually active women under 26 yrs old or Women with new sexual partners

Front 31

Chlamydia trachomatis
1. Screening & Treatment reduce what by 50%
2. Reducing impact Chlamydia trachomatis also requires

Back 31

1. PID
2. Reducing incidence in males

Front 32

Chlamydia trachomatis
8 step life cycle of Chlamydia

Back 32

Front 33

Treponema pallidum (aka Syphillus)
1. 1⁰ & 2⁰ epi?
2. Transmission via
3. Curable at what stage
4. Genital Ulcers

Back 33

1. ↓ in the 90s, then ↑2000-07
2. Direct contact w/ 1⁰ & 2⁰ lesions
3. 1⁰ & 2⁰
4. ↑ likelihood of HIV transmission

Front 34

Treponema pallidum 1⁰ Stage
1. Develops post infection (4)
2. Incubation period
3. Disappears w/ treatment after
4. W/O treatment
5. % of cases that resolve
6. Diagnosis

Back 34

1. Hard, painless but Sensitive CANCRE (ulcer), w/ Thin Greyish crust
2. 9-90 days
3 1 week
4. 4-12 weeks
5. 75%
6. DARKFIELD microscopy

Front 35

Treponema pallidum 2⁰ Stage
1. Develops post infection (4)
2. Incubation period
3. Disappears w/ treatment after

Back 35

1. Maculopapular Rash (palms & soles), CONDOLYLOMA LATA, & Flue like symptoms
2. 2-8 weeks after Ulcer
3.

Front 36

Treponema pallidum 3⁰ Stage
1. Inucbation
2. key Symptoms
3. CNS (3)
4. Cadiovascular
5. Hypersensitive granulomatous reaction (2)

Back 36

1. 15-20 yrs
2. Stromal Haze, Hutchinson's Teeth & Diffuse CHRONIC inflammation
3. Dementia, Meningitis & Hallucination
4. Thoracic Aortic Aneurysm (Obliterative endarteritis of Vaso Vasorum)
5. Destructive to Visera or Mucocutaneous AReas

Front 37

Congenital Infection of Treponema pallidum
1. Transmission
2. Most cases (2)
3. Effects seesn

Back 37

1. Uterine & Placental Membrane
2. Spontaneous or Septic Abortions
3. SADDLE NOSE, stromal haze & Hutchinson's Teeth

Front 38

Treponema pallidum Characteristics
1. Type of bacteria
2. Motility
3. Replication
4. Pathogen
5. Other (3)
6. VFs (2)

Back 38

1. Tightly coiled spirochetes, w/pointed straight ends.
2. 3 flagella @ each end
3. Slow & NOT in cell free cultures
4. Obligate Human pathogen
5. Fastitduous & Outermembrane w/ NO LPS or PORINS
6. Hyalurinadase & Fibronectin

Front 39

Treponema pallidum PATHOGENESIS
1. Host's response to pathogen
2. Promotes adherence
3. Spreading factor? via?
4. Protects vs. Phagocytosis

Back 39

1. Tissue destructin & Lesion (2)
2. Outer membrane
3. Hyaluronidase via. Perivascular Infiltration
4. Fibronectin

Front 40

Treponema pallidum 1⁰ Stage Pathogenesis
1. Enters tissue? Via?
2. Multiplication
3. Symptoms (2)
4. Disseminate via

Back 40

1. Subepithelial via Skin Breach
2. Slow
3. Endarteritis & Granulomas
4. Lymph & Bloos

Front 41

Treponema pallidum PATHOGENESIS
2⁰ Stage
3⁰ Stage (2)

Back 41

2⁰- Evasion of the immune system
3⁰ - Chronic inflammation, damage to CNS

Front 42

Treponema pallidum diagnosis
1. Issue
2. Testing (2)

Back 42

1. Fastiduous: HIGHLY SENSITIVE organism
2. DARKFIELD microscopy & serology

Front 43

Treponema pallidum
1. Screened (2)
2. Treatment

Back 43

1. MSM w/ anually & Pregnant Women prenatal screenign
2. Penicillin vs. neurosyphillus

Front 44

Haemophilis ducreyi
1. Causes
2. Enhances transmission of
3. Geographic spread (4)
4. Accounts for what % of Genital Ulcer diseases in these regions

Back 44

1. Chancroid (painful ulcer of genital region
2. ↑HIV
3. Predominant in Tropics (also Africa, Asia & Latin America
4. 20-60%

Front 45

Haemophilis ducreyi:
1. Clinical Presentation (3)
2. Incubation
3. Also have in 25% of cases
4. Difference vs. Syphillus

Back 45

1. Soft chancre, chancroid & PAINFUL Genital ulcer
2. 5-10days
3. Spontaneous rupturing buboes
4. Chancre: No greyish crust & Faint Red rimd

Front 46

Haemophilis ducreyi
1. Characterestics (2)
2. Pathogen
3. other

Back 46

1. Gram -ve rod (coccobacilli)
2. ExtracellularObligate Human anerobe
3. Fastiduous

Front 47

Haemophilis ducreyi
Pathogenesis
1. VF responsibe for resisting phagocytosis
2. VF responisble for tissue destruction

Back 47

1. Outer Membrane Serum Resistance Protein
2. CYTOLETHAL DISTENDING TOXIN (CDT) & Hemolysin

Front 48

Haemophilis ducreyi
0. Stain
1. Diagnosis (3)
2. Culture
3. Accuracy of clinical diangosis

Back 48

0. Gioneten Violet Simple Stain
1.Antigen detection, Serology & Genetic Amplifcation
2. not easily accesible
3. 30-80%

Front 49

Haemophilis ducreyi
1. AB used for treatmen

Back 49

1. erythrmycin

Front 50

Compare Chancroid & Syphillus across
1. Chacnre (2)
2. Pain
3. Diagnosis

Back 50

Front 51

Bacteria Vaginosis/Vaginitis
1. Describe
2. Discharge (4)
3. Other symptoms
4. MOST COMMON
5. Having BV can

Back 51

1. Normal BALANCE of bacteria DISRUPTED & replaced by overgrowth
2. Fishy odor, thin, white or gray
3. Often ASYMPTOMATIC
4. In Women of CHILD BEARING age
5 ↑ HIV Infection risk.

Front 52

Bacteria Vaginosis/Vaginitis
1. Under Microscope
2. Differentiates vs.
3. What bacteria is ↓ed
4. pH

Back 52

1. CLUE cell
2. Candidasis & Trichomanis
3. Lactobacilli
4.pH >4.5

Front 53

Describe Thrichomoniases & Candidiasis across
1. Bug
2. Symptoms

Back 53

Front 54

Candida Albcians
0. Layman name
1. 75% of who have @ least 1 occurrence
2. Characterestics (3)
3. Normal flora of
4. Commensuals (3)

Back 54

0. Yeast Infection
1. ADULT WOMEN
2. Oval, yeast form w/ PSEUDOHYPHAE
3. GIT
4. Vagina, Urethra & Skin under

Front 55

Candida Albcians
1. Discharge
2. At risk conditions (3)
3. Pathogenic path way
4. In other parts of the body

Back 55

1. Thick cottage cheese like discharge which is odorless.
2. Pregnancy (hormonal disturbance) Diabetes & Use of Broad spectrum Antibiotics
3. pH sensing pathway
4. Oral thrush in Mouth & affects finger nail

Front 56

Trichomoniasis
1. Common
2. Site of Infection in Women
3. In Men
4. Transmission (2)
5. Region
6. Inflammation ↑

Back 56

1. In young sexually active Women
2. Vagina
3. Urethra
4. Sexual & Formite
5. Tropical & Worldwide
6. Risk of Infectionr

Front 57

Trichomoniasis
0. Trichomonas vaginalis is a
1. Most women are
2. Incubation
3. Vaginal discharge
4. Clinical presentation (4)
5. pH

Back 57

0. Protozoan
1. Commonly asymptomatic
2. 5-28 days
3. Frorthy
4. Cervix has "STRAWBERRY" appearance", Itching, Burning & Painful urination
5. pH>4.5

Front 58

Trichomonas vaginalais
0. Smear for Microscopy (2)
1. Identification on Microscopy (3)
2. Other diagnostic techniques (3)
3. Treatment

Back 58

0. Vaginal or Urethral discharge
1. Parasite w/ 4 flagella, w/ Membrane responsible for motility
2. Serologic tests, Nucleic Acid Probe & Culture
3. Metronidazole

Front 59

Compare the following Viral STIs across PATHOGEN responsible & Symptoms & Signs:
1. AIDS (1 & 5)
2. Herpes Genitalis (1 &2)
3. Genital Warts & Cervical Cancer (1 & 4)
4. Viral Hepatitis (1 & 5)
5. Cytomegalovirus (1 & 3)
6. Molluscum contagiosum (1 & 3)

Back 59

Front 60

HHV-1 & HHV-2 EPIDEMIOLOGY
1. Most genital Herpes caused by
2. Transmission
3. HHV-1 &-2 Can be found in
4. Virus may be also released
5. Genital Herpes is common in
6. Epid history
7. More common in

Back 60

1. HHV-2
2. By close contact & Sexual Contact via Mucosal membranes or Breaks in the skin
3. Ulcers that virus cause
4. Between OUTBREAKS
5. USA in adults & Adolescents
6. ↓ of the past Century
7. Women (1 in 4) than Men (1 in 8)

Front 61

HHV-1 & HHV-2: Clinical PRESENTATION
1. Most individuals
2. 1⁰ Symptom? (4) Where (3) With? (2)
3. What happens when Blisters break
4. Long to heal
5. Subsequent outbreaks when (2)
6. Type
7. Site of Genital hepres in women
8.

Back 61

1. Present NO symptoms
2. 1 or More FEVER Blisters or COLD sores & VESICULOPAPULAR lesions around Genitals/Rectum/Mouth (Itching & Vaginal Discharge
3. Tender Ulcers
4. 2-4 Weeks
5. Weeks, Months
6. Severity ↓es with Age & Time
7. Vulva
8. Penile Shaft

Front 62

HHV-1 & -2
1. Shape, Structure
2. Envelope
3. Nucleic Acid
4. Baltimore Class
5. Characterestic
6. Share (3)
7. Encode enzymes that provide

Back 62

1. Lage Icoasahedral
2. ds DNA
3. Envelope
4. Class I
5. UBIQUITOUS
6. Antigenic determinants, Tissue Tropism & Disease symptoms
7. good ANTIVIRAL targets

Front 63

Baltimroe I virus Review
1. NA
2. Unique Characterestics

Back 63

1. ds DNA
2. Immediate Early, Early & Late Protien

Front 64

HHV-1 & HHV-2: PATHOGENESIS
1. Initially infect & replicate in
Viruses are
2. Lytic in? Causing?
3. Persistent in (2)
4. Latent in

Back 64

1. Mucoepithelial Cells
2. Most cells. COWDRY type A IBs & Synctia
3.Lymphocytes & Macrophages
4. Neurons

Front 65

HHV-1 & HHV-2: PATHOGENESIS
1. Virus blocks effects of?
2. Preventing?
3. Escapes? (2) Via?
4. Recurrence occurs d/t

Back 65

1. IFN
2. CD8 T-cell recognition of Infected cells
3. Antibody Neutralization & Clearance BY Going into hiding

Front 66

HHV-1 & HHV-2. Predilction for
1. HHV-1 only (6)
2. HHV-2 only (2)
3. Both (4)

Back 66

Front 67

HHV-1 & HHV-2: DIAGNOSIS
1. Test
2. Between outbreaks

Back 67

1. Sample of Ulcer
2. Serology

Front 68

HHV-1 & HHV-2
1. Cure
2. Treatment
3. Suppression therapy can

Back 68

1. NO CURE
2. Antiviral medications (enzymes)
3. Reduce Transmission

Front 69

Condyloma
1. LATA
2. ACUMINATUM

Back 69

1. 2⁰ SyphiLLus
2. HPV 6 & 11

Front 70

Ayclovir
1. DOES not work vs. what Herpes (2)
2. Works vs what Herpes (2)
3. Why?

Back 70

1. HHV-4 & HHV-5
2. HHV 1-3
3. Presence of viral THYMIDINE KINASE

Front 71

Human Papillomavirus (HPV)
1. Most common
2. Lifetime Culmative risk of Acquring a form of HPV
3. Low risk realated to
4. High risk related to (2)
5. What other cancers has it been related to
6. Very rarely transmitted? Reults in (2)
7. 16 & 18 Responsible for what % of Cervical cancer
8. 6 or 11 Genital warts

Back 71

1. #1 VIRAL STI
2. 80%
3. Condyloma ACUMINATA
4. Dysplasia & Cervical Cancer
5. 305 of Head/Neck cancers
6. Vaginal delviery leadin to Warts & Voice box on child
7. 70%
8. 90%

Front 72

HPV
1. name the Other high risk types

Back 72

1. 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 & 82

Front 73

HPV General Symptoms
1. Infections
2. Incubation

Back 73

1. Often asymptomatic
2. Weeks/Months/Years
3

Front 74

HPV 6 & 11
1, Condylomata ___
2. Warts appear where? As (7)
3. in women (4)
4. In Men (4)
5. Femal age group
6. Male Age group

Back 74

1. ACUMINATA
2. Bumpsin genital area, raised or flat, single or multiple, small or large, sometimes
CAULIFLOWER
3. Vulva, Vagina, Anus, Cervix
4. Penis, Scrotum, Groin or Thigh
5. 20-24yrs old
6. 25-29 years old

Front 75

HPV 16 & 18
1. Main Cancer in females
2. Other cancers (4)
3. HPV is more like to turn to cancer in the mouth, then

Back 75

1. Cervix
2. Vulva, Vagina, Anus & Penis
3. Smoking & Alcohol

Front 76

HPV -16 & 18 PATHOGENESIS
1. Enters skin via
2. Targets
3. Oncoproteins & Target GEnes

Back 76

1. Mircoabrasions
2. Basal Layer Eptithelium
3. E6 → p53 & E7 →pRb

Front 77

HPV Diagnosis
Geneital Warts
1. Diagnosed by
2. What is used to identify Flat warts
3. Cervical changes identified by
4. What is better

Back 77

1. Visual inspection
2. Acetic Acid
3. Pap Smear
4. HR-HPV detection tests (PCR or NA hybrdiization)

Front 78

HPV
1. L1 →
2. L2 →
3. E6 → (2)
4. E7 →

Back 78

1 & 2 Site of Vaccination (Both are Cpasid proteins)
3. →p53 & Telomerase
4. pRb

Front 79

HPV Screeningn
1. Before 30
2. After 30

Back 79

1. Everyone has it: UNECESSARY
2. High risk subtype

Front 80

HPV Screening Guidlines
1. Start @ what age?
2. Screen every 2 years when?
3. At 30 screen every 3 years if
4. Negative if (3)
5. Annual screening if (4)
6. Stop screening at 60 or 70 if (3)
7. Stop screenig also if (2)

Back 80

1. 21 yrs of Age
2. 21-29
3. Negative
4. Negative CYTOLOGY 3 prev. paps, NIELM & Negative HR & HPV tests in 1 year & no history of High Grade lesions
5. Immunocompromised, History of CIN II, III or Cancer or Exposure to DES in utero
6. 3 prior normal smeasrs or no hsitroy of ABNORMAL screening in last 10 years
7. Hysterectomy for benign diseae w/ no hist history of Abnormal pap smeasr

Front 81

HPV Vaccinate
GARDASIL
1. Vs.types
2. Vs. protein
3. For girls & boys
4. why boys
Cervavix
5. Only
6. Both are what type of vaccine
7. # of DOSES

Back 81

1. 6, 11, 16 & 18
2.L1 & L2
3. 9-26
4. prevent transmission
5. 16 & 18
6. Prophylactic
7. 3

Front 82

Name the Top Three causes of Children born with long term congenital defects

Back 82