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101 Cards in this Set

  • Front
  • Back
org which causes chancroid
haemophilus ducrei
org that causes genital warts
etioloogic agent of syphilus
treponema pallidum
describe trep pallidum
gram -, spiral shaped, hard to visualize under LM b/c cel wall too thin
where are syphilis rates highest
avg rate in US, GA
3/100K, 7.3/100K
which ethnic group are syphilis rates highest, which sex and age
AA, 5.1M, 0.9W
age range where 1 and 2 syphilis is most common
30-44, rates increasing most in MSM
secretion of this enzyme allows organism to migrate into tissuesand into blood stream
what are lesions and other clinical manifestations in syphilis due to
host immune response to bacterial antigens
what does the org coat itself with to avoid phagocytosis by the host
host fibronectin
what are the characteristics of primary syphilis
regional lymph, ulcer chancre at site of infection, painless ulcer, contains abundant T. pallidum, heals s tx in 2-6 wks
this stage of syphilis results from dissemination of T. pallidum
secondary stage
this rash contains knob like or warty papular lesions, which is typically 1-3 cms and assoc c 2 syphilis
condylomata lata
this phase of syphilis occurs in the latent phase which is when 1 or 2 is acq or diag during the preceding yr
early phase
seroreactivity in absence of symptoms, greater than 2 yrs after infection
late phase of syphilis
result of a chronic prog infl process producing clinical man yrs to decades after infection, wide spread tissue destruction secondary to host response to organism
tertiarry syphilis
this causes local destruction of affected organ system, coascelescent granulomatous lesions
bony overgrowth and instabilty of joints which affects the musculoskeletal system
charcot joint
non Treponemal serologic tests
VDRL and RPR, venerial disease reference lab and rapid plasma raegin test
what are the laboratory diagnosis for the serology of syphilis
non trep antibodies and trep Ab
what exudates are you looking for on the laboratory diagnosis of syphilis
darkfield qnd direct fluorescent antibody
what is the problem c non-trep serologic tests
nonspecific but cost effective, can't rule in dx, sensitivity of 80% in symp primary and 100% c secondary shyphilis
what are the specific tests to T Pallidum
confirmatory tests are FTA-ABS(fluorescent trep Ab absorption) and MHA-TP (microhemagglutination assay for T pallidum)
what is the tx for 1, 2 and early latent syphilis
Benzathine penicillin G 2.4 mil units
tx for late latent syphilis or latent syphilis of unknown origin
benzathine penicillin G 7.2 mil units total, 3 doses of 2.4 at 1 wk intervals
how can you check to see if the tx worked
repeat VDRL or RPR at 3, 6, 12 months and if non reactive - worked, but if reactive it could be due to lack of penetration of drug into CNS
DNA virus which replicates in nucleus
occus in 70% of adults, which can also cause oral lesions
what are the results of primary genital infections c HSV
asymp, symp- pain, fever, urethral vag D/C
how are recurrences prev in HSV
strong cellular immune response-CD4, CD8 cells
Does high Ab titer prevent recurrences
how is genital herpes diagnosed
clinical appearance, viral isolation c typing, viral antigen detection and serology c typing
what do antiviral drugs do in the treatment of HSV
decrease recurrences, shorten duration of lesions and may reduce transmission
what 3 antivirals are used in treatment
the cyclovirs, (A, Fami, Vala)
what are the recommended dosages for the 1st clinical episode of genital herpes
A 400 mg 3x's day for 7-10 days, A 200 mg 5x's for 7-10 days, Fam 250 mg 3x/day for 7-10 days, Vala 1g twice/d for 7-10 days
tx for suppressice therapy for recurrent genital herpes
A 400mg 2/d, Fam 250 mg 2/d, Vala 500 mg or 1g once a day
which std causes chancroid
Hamophilus ducreyi
what areas are chancroid found
isolated STD and prostitution populations
how is chancroid diagnosed
ruling out syphilis and genital herpes
how does chancroid present
tender papule c erythematous base
how is chancroid tx
Azithromycin, ceftriaxone, cipro, erythromycin
Ds DNA nonenveloped virus which causes chronic infections
genital warts
very common STD which 20 mil in US have, by age 50 80% of women carry infection, 5.5 mil new infec yearly
clinical manifestations 0f benign lesions
condyloma accuminanta
clinical man of pre malignat and then malignant lesions
flat condyloma and CIN --- cervical carcinoma
how are genital warts diagnosed
clinical appearance and pre-cancerous lesions are initially by abnormal pap smear
this test determines if high risk HPV is present
HPV DNA test but does not detect individuals of low type or individual types
what is the tx for HPV
podophyllin, salicylic acid and trichloroacetic acid
what are the symptoms of cervicitis
abnormal vag D/C and intermenstrual vag bleeding or may be asymp
what are the two infec causes of cervicits urethritis
n. gonorrhea and chlamydia trichomoniasis
discharge of mucopurulent or purulent material, dysuria or urethral pruirits
symptoms of urethritis
obligate intracellular pathogens which can exist as elemantary or reiculate bodies
chlamydia trachomatis
metabolically inactive form of chlamydia that is the infec form
elementary bodies
metabolically active form of chlamydia that is the noninfec form
reticulate bodies
this biovar of chlamydia trach which infects non-ciliated mucosal epi and conjunctival cells, causes urogenital infec, neonatal infec and trachoma
trachoma biovar
this biovar infects macrophages and causes lymphogranulosa venerium
lymphogranuloma venerium biovar
what dx's are assoc c C. trach
eye infec- trachoma and neonatal conjunctivitis and urogenital infec
7 mil people blind due to this, primarily a dx of people in devp countries, repeated infec which lead vision loss
most freq reported infec dx in US, PID(salphinigits), endometritis, cervicitis and urethritis
what are the most sensitive diag tests in the diagnosis C trach
what must you do to patients c chlamydia
test for other STDs
what are the recommended regimens for the tx of C Trach
Azithromycin ( preferred b/c don't have to worry about compliance issues; and Doxycyline ( cheaper)
what are the alternative tx's of urogenital infec c C. trachomatosis
Erythromycin, Ofloxacin and Levofloxacin(CI in pregnancy)
what is essential to reduce the risk of reinfection
tx of sex partners, refer sexual partners for tx and all partners in past 60 days and refrain from sexual intercourse until they and sex partners have completed tx
gram neg diplococci that causes urethritis, pharyngitis, proctitis in men and women plus cervicitis in W
which sex is more likely to have noticable symptoms(urethritis and cervicitis) and seek tx for gonococcal infec
men b/c infec in women may not produce recognizable symp until complications have occured --- produces 600K new infec/yr eachyr
what are the complications of untx infec in women
PID resulting in tubal scarring which can lead to infertility or ectopic pregnancy, disseminated infec and transmission to newborns
most common cause of septic arthritis in sexually active young adults
disseminated gonococcal infec
these virulence factors help N gonorrhea attach to and penetrate the mucousal cells
pilin-attachment, which promotes survival within neutrophil phagosomes and Opa proteins giving it an opaque appearance
this virulence factor incites inflammatin leading to purulent D/C and other clinical man of infection
Lipoligosaccharide (LOS)
most sensitive test when testing for Neisseria Gonorrhea
Nuc acid amplification tests (NAAT)- PCR based
this probe or test will also test for chlamydia and Gonorrhea
Nucleic acid hybridization test (DNA probe test, molecular probe test)
in which sex can gram stain be diagnostic for N gonorrhea
male (urethral specimen)
what is the culture named for Neisseria G
thayer martin or chocolate agar
DOC for tx of Neiss Gonor
cephalosporins- cephtriaxome or cefixime
alternative tx that has been gaining resistance to
quinolones( westeern us, and msm)
what is the tx for disseminated gonococcal infection
hospitalization-initial therapy, ceftriaxone for 24-48 hrs, then switch to cefixime, oflaxacin or levofloxacin for 1 week
what else should you tx for with this infection unless the appriopate testing has ruled it out
c. trachomatis
what are manifestations of vulvovaginitis
vag D/C, &/or vulvar itching, and vaginal odor-possibly
most common cause of vulvovaginitis
bacterial vaginitis (anaerobic microorg, mycoplasmas, ams gardnerela vaginalis)
what is the most prevalent cause of vag D/C or malodor
bacterial vaginitis, 50% women are asymp
what is the causes which lead to bacterial vaginosis
replacement of normal vaginal lactobacillus in c high conc of anaerobic bacteria or gardnerella
how does BV present
gray, thin and homogenous D/C that is adherent to vaginal mucosa
predisposing factors for BV
recent Ab use, decreased estrogen prod of host, wearing an IUD, douching and sexual activity c new sexual partners
related to haemophilus sp, facultatively anaerobic gram - variable rod, predominantly occurs in women of repro age
gardnerella vaginalis
do men usually get gardenella
how is BV diagnosed
clinical criteria or gram stain
homogenous, thin white D/C that smoothly coats the vaginal walls, prescence of clue cellson micro gram stain, pH of vag fluid> 4.5, fishy odor of vag D/C
clinical criteria of BV- need 3 of the 4
tx of BV
metronidazole- avoid alcohol during tx, clindamycin-cream
what usually causes vulvovaginal candidiasis
C. albicans or other candida
what is the most common symptom of VVC
pruritus, thick odorless white D/C(cottage cheese)
definitive diagnosis of VVC
wet prep- saline, 10% KOH, gram stain of vag d/c both demonstrating yeasts or pseudohyphae
risk factors for overgrowth in VVC
oral contraceptive use, diabetes, HIV or other immunocomprimised states, chronic Ab use, pregnancy, young age at 1st intercourse, increased freq of intercourse, receptive oral sex
2nd most common cause of vaginitis, 75% of women will have at least one episode, 40-45% two or more
the majority of healthy women c this form of VVC have no identifiable precipitating factors
uncomplicated form
10-20% have this form which occurs in women c uncontrolled diabetes, debilitation or immunoseppression or pregnant which is recurrent or severe and is non albicans candidiasis
complicated form of VVC
tx for VVC
flucanazole-oral agent, rest of azoles- butocona, clotrim, micon, ticono
what should one do if symptoms persist or recur c 2 months
be evaluated for underlying conditions
in women this dx is assoc c a foul smelling d/c, frothy vag d/c, vulvar irriation, severe pruritis, PAINFUL sexual intercourse and in men can be asymp or assoc c nongonoccoal urethritis
tx of trichomoniasis
metronidazole-single dose or tinidazole in a single dose or metronidazole 500 mg orally bid for 7 days, sexual partners should also be tx and sex avoided until they are cured(therapy completed or patient and partners are asymp