Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
Gonorrhea
|
Neisseria gonorrheae Gram(-) diplococcus Gonococci penetrate columnar epithelial cells -inflammatory response |
|
|
Syphillis
|
Treponema pallidum (anaerobic spirochete) Penetrates mucous mb or abraded skin -systemic infection of vascular system |
|
|
Trichomoniasis
|
Trichomonas vainalis (flagellated protozoan) Infect squamous epithelium in urogenital tract -women can acquire from women -men to men is uncommon |
|
|
Bacterial vaginosis
|
Gardnerella vaginalis Change in vaginal flora d/t decrease in dominant H2O2 producing lactobacilli -leads to overgrowth of vaginal anaerobes ~anaerobes produce proteolytic enzymes Usually transmitted from female to male |
|
|
Chlamydia
|
Chlamydia trachomatis Acts on columnar epithelium in a manner similar to gonococcus |
|
|
Herpes
|
Genital Herpes Simplex HSV Type 1: associated with oral infection -transmitted sexually; present in saliva, stool, urine -often impacts children younger than 5 yo HSV Type 2: implicated in most genital, anal, and perianal herpes |
|
|
Gonorrhea Clinical Manifestations in Men
|
Incubation: usually 3-6 days Symptoms: asymptomatic, urethritis, inflammation at site of infection Complications: epididymitis, infertility Diagnosis: First catch urine specimen or urethral swab |
|
|
Gonorrhea Clinical Manifestations in Women
|
Incubation: unclear; Sx usually w/in 10 days Sn/Sx: Majority asymptomatic; purulent vaginal discharge, dysuria, abnormal vaginal bleeding Complications: Infection of oviducts and fallopian tubes, infertility Dx: Vaginal, endocervical swabs or urine specimen |
|
|
Primary Syphilis Incubation |
10 to 90 days (average 3 weeks) Chancre: -highly infectious, painless ulcerative lesion at portal of entry -Early: macule/papule erodes -Late: clean based, painless, undurated ulcer with smooth, firm borders -unnoticed in 15-30% of patients resolves in 4 to 6 weeks |
|
|
Secondary Syphilis
|
Represents hematogenous dissemination of spirochetes Usually 2 to 8 weeks after chancre appears Sn/Sx: -Low grade fever, malaise, sore throat, HA -Rash on whole body -Resolve in 2 to 10 weeks |
|
|
Latent Syphilis
|
positive for syphilis by serologic assays Stage must last more than 40 years Mucocutaneous lesions during early latent stage- Contageous 2/3 of patients remains asymptomatic If untreated, tertiary(late) syphilis can develop -aortic necrosis, degeneration of neurons |
|
|
Chlamydia trachomatis in Men (Urethritis)
|
Incubation: Sx usually w/in 5-10 days Sn/Sx: majority are asymptomatic; may have mucoid or watery urethral discharge Complications: epididymitis, prostatis, proctitis, lymphogranuloma venereum, conjunctivitis, infertility Dx: First catch urine specimen or urethral swab |
|
|
Chlamydia trachomatis in Women (Cervicits)
|
Incubation: Sx usually within 7 to 14 days Sn/Sx: majority asymptomatic, may have purulent vaginal discharge, abnormal vaginal bleeding Potential to transmit to newborn during delivery -conjunctivitis, pneumonia Complications: PID, proctitis, conjunctivitis, infertility Dx: Vaginal, endocervical swabs or urine specimen |
|
|
Genetial Herpes Simplex Pathogenesis
|
HSV Type 1: associated with oral infection -transmitted sexually, present in saliva, stool, urine HSV Type 2: Implicated in most genital, anal, and perianal herpes |
|
|
Genital Herpes Simplex Transmission, Sn/Sx and Dx
|
Transmission: Spread by shedding of virus Sn/Sx: Primary infection commonly asymptomatic; symptomatic cases sometimes severe, prolonged, systemic manifestations -Vesicles>painful ulcerations>crusting -potential reoccurance Dx: Culture, serology, PCR |
|
|
Trichomonas vaginalis in Men (Urethritis)
|
Asymptomatic in over 75% of cases and transient Sn/Sx: Clear, mucopurulent urethral discharge, dysuria Complications: Prostatitis, epididymitis, infertility, prostate cancer |
|
|
Trichomonas vaginalis in Women (Vaginitis)
|
Asymptomatic carriers Sn/Sx: Purulent, malodorous, thin discharge, with burning, pruritus, dysuria, abdominal pain, dyspareunia Physical Exam: Green-yellow, frothy, malodorous discharge, 10-30%, strawberry cervix- 2% of cases Complications: Urethritis or cystitis, cervical neoplasia, PID, infertility |
|
|
Gardnerella vaginalis |
Women: asymptomatic 50-75% Sn/Sx: Vaginal off-white malodorous discharge Bacterial vaginosis alone does not cause dysuria, pain during intercourse, vaginitis Men: Asymptomatic -Usually self-resolves |
|
|
Laboratory test for Bacterial Vaginosis
|
Amsel Criteria: -Characteristic vaginal discharge, fishy odor -Elevated pH, Clue Cells Gram Stain of vaginal discharge (gold standard) Wet Mount - Clue cells |
|
|
Human Papilloma Virus
|
Pathogenesis: HPV DNA present in anogenital (anal, penile, vulvar, vaginal) and oral cancers/precancers -Expression of viral oncogenes is demonstrated in tissues with lesion Infection indicated by the detection of HPV DNA ->99% of cervical cancers have HPV DNA detected within the tumor Pap smears ensures early detection |
|
|
STDs with sores
|
Syphilis Genital herpes |
|
|
STDs with drips
|
Gonorrhea Nongonococcal urethritis -chlamydia -trichomoniasis Bacterial Vaginosis |
|
|
Common modes of HIV transmission
|
unprotected sex, sharing needles, infected mother>fetus, infection from blood products Blood Semen Vaginal Secretions, uterine cervix Breast Milk |
|
|
Process of HIV infection
|
Fusion of HIV to host cell surface HIV RNA, reverse transcriptase, integrase enter Viral DNA is formed by reverse transcriptase Viral DNA integrates into host DNA New viral RNA is used to make viral proteins New viral RNA and proteins form new HIV Virus matures by protease releasing HIV protein |
|
|
Based on the HIV replication cycle, explain possible mechanisms by which antiretrovirals are used to suppress viral replication
|
GP120 binds to CD4 receptor (termed attachment) this promotes co receptor binding which causes a conformational change. This allows GP41 to fold and it folds back on itself and it allows for diffusion of the membranes Viral nucleocapsid enters the host cells and breaks open (releases 2 viral RNA strands and 3 essential replication enzymes protease, integrase, and reverse transcriptase) Polymerase active site: single stranded viral rna is transcribed into an RNA-DNA double helix. RIbonuclease H breaks down the RNA The polymerase then completes the remaining DNA strand to form a DNA double helix. Integrase goes into action and cleaves the dinucleotide from each 3’ end of the DNA creating 2 sticky ends Integrase then transfers the DNA into the cell nucleus and facilitates its integration into the host cell genome Now the genome has genetic information of HIV, activation of cell induces transcription of proviral DNA into messenger RNA The viral messenger RNA migrates into cytoplasm, where building blocks for a new virus are synthesized and some have to be processed by viral protease Viral Protease cleaves longer proteins into smaller core proteins (step crucial to create infectious virus) Two viral RNA strands and the replication enzymes come together and core proteins assemble around them and form the capsid The virus matures and becomes ready to infect other cells Entry into the host cell can be blocked by fusion inhibitors Inhibition of reverse transcriptase by nucleoside inhibitors or by non nucleoside reverse transcriptase inhibitors is part of standard anti retroviral regimens Action of Integrase can be blocked Protease inhibitors are part of standard anti retroviral therapy Each step blocked is a step to better control of HIV disease |
|
|
Based on the results of a rapid HIV test, explain the next appropriate step(s) needed to confirm a diagnosis of HIV.
|
• No effective vaccine • Mainstay of prevention is diagnosis and treatment • Prior to rapid testing, only 62% of persons who tested HIV+ in the US received their results. • Need for immediate information or referral for treatment choices – Perinatal settings – Post‐exposure treatment settings • Screening in high‐volume, high‐prevalence settings |
|
|
Explain the differences between an HIV RNA level and an HIV antibody test and when it is appropriate to measure these levels post‐exposure. HIV Abs
|
– Detects previous exposure to HIV antigen – Detected in most patients w/in 3‐4 weeks of transmission HIV RNA (viral load): – Predictor of disease progression and outcome over timeV RNAV
|
