Rpdwk1- 3-15 Micro Virus

Front 1

What is the most common protozoan parasite in industrialized countries?

Back 1

tichomonas vaginalis

Front 2

What are the HPV diagnostic techniques?
On histo what do you look for?

Back 2

DNA detection is very sensitive detects 13 high risk types

- look for koilocytes

Front 3

Which types of HPV represent 90% of genital warts?

Which two mc cause cancer?

Back 3

6 and 11

16 and 18 MCC cancer

Front 4

What kind of pathogenesis does HPV have?

Back 4

non-lytic replication causes cell proliferation via E6 and E7

Front 5

Where do the high risk types of HPV usually infect?

What are the two vaccines?

Back 5

cervical transformation zone

Gardasil (HPV6,11,16,18) and Cervarix (16 and 18)

Front 6

Vesicular labial lesions that are painful and cervical ulcerations associated with?

Back 6

HSV- dsDNA replicates in nucleus (enveloped virus)

Front 7

HSV transmitted how?

MC result of infection?

Back 7

direct skin to skin contact and has latency and then reactivation in ganglia

- asymptomatic infection if symptomatic usually bilateral erythematous papules/ vesicles on genitalia

Front 8

Why are HSV carriers at greater risk of HIV?

Back 8

CD4+ T cells recruited to sites of HSV and allow direct access to mucosal tissues which allow portal entry for HIV

Front 9

Tests for dx of HSV?

Back 9

1. PCR- most sensitive/ rapid
2. Antibody test- a-HSV glycoprotein G, HSV Ag detection
3.

Front 10

A 23 year old female presents with fever, right upper quadrant abdominal pain and vomiting of 3 days duration. She hasn’t felt well for several weeks, with general malaise, anorexia and nausea. She denies recent IV drug use. A urine specimen is brownish in color, and a physical exam revealed hepatomegaly and slight yellowing of the skin. What should you order and why?

Back 10

Hep screenings
1. a-HAV--> possible vaccine against Hep A
2. a-HAV IgM- recent infection
3. HBsAg- Hep B is present
4. a- HBs-
5. a-HBc IgM- accute and infectious
6. a-HCV- hep c

Front 11

Type of genome for hepatitis B virus?

What is unique about it?

Back 11

circular DNA makes nucleocapsid (HBeAg)

- partially dsDNA peplicates an RNA intermediate... it is a retrovirus

Front 12

Main areas of Hepatitis B virus?

Back 12

High- blood, serum, wound exudates
Moderate- semen, vaginal fluid, saliva
low- urine, sweat, tears, breast milk

Front 13

Types of diagnosis stuff for HBV...
HBsAg, HBs GO BACK

Back 13

 HBsAg: General marker of infection -HBs: Recovery and/or immunity to HBV infection
 i.e. Vaccination OR natural infection
 -HBc IgM: Marker of acute infection
 -HBc (Total): Past or chronic infection
 HBeAg: Active replication of virus and infectiveness
 -HBe: Virus no longer replicating
 HBV-DNA: Active replication of virus- (More accurate than HBeAg Used to monitor response to therapy)

Front 14

testing for karposi?

Back 14

Also detecting presence of KSHV in the lesion itself
 PCR testing to pick up KSHV DNA

Front 15

type of HIV virus?

Back 15

enveloped ssRNA infects CD4 + Tcells and kills them

Front 16

What does HIV need to infect someone?
What are the strain types

Back 16

CD4 and (CCR5 (R5) or CXCR4 (X4))

Front 17

What are the envelope proteins targeted in drugs of HIV?

Back 17

gp120, CCR5

Front 18

Name the 4 main stages of HIV infection

Where does it replicate during the 8-10 yr latent phase?

Back 18

1. Flulike (acute)
2. Feeling fine (latent)
3. Falling count
4. Final crisis
- latent phase it replicates in lymph nodes

Front 19

What type of virus is HCV?

Major rx factor of HCV?

What causes the liver damage in HCV infections?

Back 19

enveloped ssRNA from flavivirus

- drug use IV use

-- Liver injury due to inflammatory cells and cytokines

Front 20

How do you diagnose HCV?

Back 20

One of the three
1. Antibodies to hepatitis C virus (a-HCV) via EIA
2. HCV Recombinant Immunoblot Assay (HCV RIBA)
3. Nucleic Acid Test (NAT) for HCV RNA (incl. genotype) (most sensitive)
AND
--> is negative for IgM against HAV and HBV

Front 21

What are the 8 bacterias that cause discharge STI's? Which is the MC?

Back 21

CC- GH- MN- TU
– Candida albicans
– **Chlamydia trachomatis–
- Gardnerella vaginalis
– Herpes simplex virus
– Mycoplasma hominis–
-Neisseria gonorrhoeae–
-Trichomonas vaginalis
– Ureaplasma urealyticum

Front 22

What are the types of ulcerative both painless and painful bacterial causes of STI's?

Back 22

Painless-
a. HPV
b. K. granulomatis
c. LGV
d. Treponema pallidum
Painful-
a. haemophilus ducreyi (you do cry)
b. HSV

Front 23

Neisseria gonorrhoeae...
a. shape/gramstain
b. test
c. motile or not? (presentation?)
d. virulence factors

Back 23

a. microaerophilic gram (-) diplococci
b. oxidase positive, isolated on thayer martin (chocolate agar + vanc, colistin, nystatin)
c. nonmotile- purulent creamy disharge
d. pili, LOS, IgA1 protease, iron scavenging, surface proteins attach to PMNS

Front 24

What bacterias can cause PID (pelvic inflammatory disease?
What is an emerging cause of it?

Back 24

New emerging cause= mycoplasma genitalum
Anaerobic bacteria (bacteroides)
Falcultative Gram neg rods (ie E. coli)
C. trachomatis
Mycoplasma hominis

Front 25

Describe the symptomatic manifestations of DGI (disseminated gonococcal infection)

Back 25

1. low grade fever
2. migratory polyarthralgias involving large joints (septic arthritis)- pain and swelling, w/ purulent synovial fluids, and joint destruction
3. skin rashes- pustules on the back of hang

Front 26

What strains of n. Gonorrhoeae are resistant to bactericidal effect of serum?
What are the Antigen detection and nucleic acid techniques for n. gonorrhoeae?

Back 26

AHU- (arginine, hypoxanthine and uracil
- GEN- PROBE: rapid DNA probe system

Front 27

What is found on laparoscopic examination in pelvic inflamatory disorder?

Back 27

swollen pus-filled fallopian tubes,
- purulent exudate in the cul-de-sac

Front 28

MC bacterial STD in the US?

Back 28

Chlamydia

Front 29

What are the many things that chlamydia can cause?

Back 29

NGU (non-gonococcal urethritis)
Cervicitis
Salpingitis
Pelvic inflammatory disease (PID)
Infertility
Lymphogranuloma venereum (LGV)
Neonatal- respiratory/ocular

Front 30

Describe the following for chlamydia... General type of organism?
a. gram stain

c. how does it infect?

Back 30

a. gram negative cell wall without peptidoglycan
c. elementary body (infectious unit) enters cell via endocytosis and reticulate body (reproductive unit) replicates by fission

Front 31

1. Which serotypes of chlamydia trachomatis cause blindness/ eye infections? why?

Back 31

A-C due to folliular conjunctivitis in Africa (remember ABC= Africa/Blindness/Conjunctivitis)

Front 32

1. Which serotypes of chlamydia trachomatis cause genital infections?

1. Which serotypes of c. trachomatis cause ulcerative genital infections?

Back 32

D-K

- L1-3 cause LGV lymphogranuloma venereum

Front 33

What are the main virulence factors of chlamydiae? (5)

Back 33

1. MOMP- major outer membrane protein (ompA gene)
2. POMP- polymorphic outer membrane proteins (pmp gene)
3. Chlamydial type III secretion system (TTSS)
4. Putative chlamydial cytotoxin
5. LPS: 'rough' type... lipid A penta-acylated

Front 34

What is the gold standard for diagnosis of C.trachomatis?

Back 34

NAAT- nucleic acid amplification, PCR and other methods
Chlamydia rapid testing: immunoassay based- rapid and less expensive test for monoclonal Ab binding of chlamydial Ag from vaginal swab

Front 35

For tissue cultures of c. trachomatis what type of stains and what would you look for?

Back 35

McCoy cells
look for intracytoplasmic inclusions with (giemsa (iodine and immunofluorescence staining)

Front 36

What do we have here?

Back 36

chlamydia inclusion bodies on giemsa stain

Front 37

what do we have here?

Back 37

chlamydia inclusion surrounding host cells nucleus on acridine orange stain

Front 38

What is the most common women's health problem?

Back 38

bacterial vaginitis

Front 39

What are the main bacterial causes of vaginosis?

Back 39

1. garnerella vaginalis
2. Mycoplasma hominis
3. ureaplasma urealyticum
4. Tons of anaerobes

Front 40

What are the similar clinical manifestations of bacterial vaginosis?

Back 40

1. homogenous and thin abnormal vaginal discharge- normally white or gray with a milk-like consistency
2. vaginal mal odor
3. often vaginal itching or burning, lower abdominal pain, burning on urination

Front 41

For diagnosis of bacterial vaginosis what must there be?

Back 41

3 of the following 4...
1. thin/homogenous discharge
2. pH of discharge greater than 4.5
3. clue cells,
4. fishy amine odor

Front 42

First AID pneumonic for memorizing gardnerella vaginalis and what to look for?

Back 42

"I don't have a Clue why I smell Fish in the Vagina Garden"

Front 43

Describe how a vaginitis infection occurs...

Back 43

loss of lactobacilli (which produce hydrogen-peroxide to prevent anaerobic overgrowth) --> pH rises--> overgrowth of vaginal anaerobes

Front 44

For garderella vaginalis what is...
a. gram stain?
b. color and on what agar?
c. viral factors?

Back 44

a. facultative gram-positive bacilli but does not stain consistently
b. grey colonies on chocolate agar
c. adhesins and biofilm production

Front 45

Mycoplasm hominis is unique in a few ways... why?

WHAT is mycoplasms characteristic growth on agar

Back 45

smallest free living and self-replicating organsm in nature
- no CELL WALL, it contains STEROLS

--> center of the colony embedded beneath the surface with a "fried egg" appearance

Front 46

what is the most common protozoal urogenital tract infection?
What is treatment?

Back 46

trichomonas vaginalis

- metronidazole

Front 47

Trichomonas vaginalis...
a. clinical presentation
b. dx?

Back 47

a. foul smelling green or yellow creamy discharge, that itches and burns
b. Trophozoites (mobile w/flagella) on wet mount--- "pear shaped"

Front 48

Vulvovaginal candidiasis features?

Back 48

d/t to overgrowth of dimorphic fungus
mycotic vuvovaginitis, itching and burning pain
- white, thick discharge, "curd like", with white spots on the vagina

Front 49

What does candida albicans look like at 20 degrees?
at 37?

Back 49

20- pseudohyphae and budding yeasts
37- germ tubes
- use KOH prep of vag. secretions, can also culture on Sabouraud's medium

Front 50

1. What is the bug that causes syphilis?
2. What is the shape and description of syphilis?
3. What do you use to visualize?
4. What are the major virulence factors?

Back 50

1. treponema pallidum
2. delicate and highly motile corkscrew-shaped spirochetes
3. darkfield microscopy technically gram-neg but doesnt gram stain
4. motility, the slow growth allows immune evasion

Front 51

Describe the following types of syphilis...
a. primary
b. secondary
c. latent
d. tertiary

Back 51

a. presents with painless chancre regional lymphadenopathy
b. disseminated rash, condylomatas and generalized lymphadenopathy (secondary means systemic)
c. recurrence of secondary in 25%
d. Gumma (chronic granulomas), cardiovascular aortitis, argyll robertson pupil and tabes dorsalis

Front 52

How do you identify t. pallidum non-blood wise?

Back 52

1. Direct exam w/ physcial lesions
a. Darkfield microscopy
b.. direct fluorescent Ab test for T. pallidum (DFA-TP)
2. Preliminary serologic tests-

Front 53

What are the preliminary serologic tests for syphilis?
What is the go-to confirmatory test for syphilis?

Back 53

1. nontreponemal Ag tests (to r/o syphilis)- measure IgG and IgM directed against a lipoidal material released from damaged cells
2. VDRL- confirm with Fluorescent Ab absorption (FTA-ABS)
3. TRUST
4. RPR

Front 54

What could cause a false positive syphilis test? (VDRL)

Back 54

VDRL-
1. Virus (mono, hepatitis)
2. Drugs
3. Rheumatic fever
4. Lupus and leprosy
- also pregnancy, malignant neoplasms

Front 55

1. What causes Chancroid? How does it present?

2. What is slightly unique about its composition?

3. What kind of agar?

Back 55

Haemophilus ducreyi (H. ducreyi is so painful you "do cry")
- presents with a painful genital ulcer and inguinal adenopathy

- oxidase positive

3. Mueller- Hinton agar (cohesive colony morphology, hemin requirement, oxidase positive)

Front 56

Donovanosis (granuloma inguinale)... describe the lesion
a. causative agent?
b. type of gram pic?
c. type of stain?
d. where is it MC seen?

Back 56

rolled border on a large red, cobblestone base
a. klebsiella (Calymmatobacterium) granulomatis
b. encapsulated gram (-) short rod
c. giemsa stain- safety pin appearance (bipolar stained bacilli within mononuclear cells)
d. tropics

Front 57

How does a dumbass make a diagnosis of donovanosis?

Back 57

"donovan bodies" precence of mononuclear cells with intra-cytoplasmic vacuoles of bacteria

Front 58

Lymohogranuloma venereum (LGV)
describe the lesion
a. causative agent?
b. type of gram pic?
c. type of stain/dx?
d. where is it MC seen?

Back 58

Rectal strictures, lymphadenopathy, genital ulcers
a. chlamydia trachomatis L1-3
b.
c. serology for increased Ab titer: tissue culture (McCoy cells)- LGV complement fixation tests (LGV-CFT)
d. Tropical africa and Asia