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82 Cards in this Set
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- Back
- 3rd side (hint)
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What STDs cause mucosal infections?
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Gonorrhea
Chlamydia Trichomoniasis |
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What STDs cause genital ulcers?
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Syphilis
Herpes simplex Chancroid |
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What STDs cause a proliferative infection?
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Papillomavirus
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What viral STDs cause a systemic infection?
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HIV
Hepatitis B |
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What STD is the most common?
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Chlamydia
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What is the reservoir for an STD infection?
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Humans
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What factors influence STD morbidity?
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Transmission rate
Sexual behavior - how many different people is the person having sex with? Duration of infectivity |
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What are the factors that affect the rate of STD transmission?
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Role in sex: if you "receive", you're more likely to contract disease
Genetic susceptibility: ex: CCR5 mutants in HIV Contraceptive/hygenic practices: vaginal washing, spermacidial creams increase risk Circumcision: if circumcised, less likely to contrat |
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What condition in younger women makes them more vulnerable to STDs?
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Cervical ectopy; cuboidal cells (rather than squamous) on the surface of the cervix
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What is a requirement for Gonorrhea to propagate within a population?
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A core of people that have sex with more than one different person every week
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What type of membrane is the target of mucosal STD infections?
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Non-stratified
Mucous |
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What are infections from gonococci and chlamydia in men?
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Urethritis
Epididymitis Proctitis (in gay men) Eye infection |
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What are the infections from gonocci and chlamydia in women?
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Cervicitis
Proctitis |
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What is a secondary complication to urethritis?
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Scarring of the urethra
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Are the majority of women with gynecoccal cervicitis symtpomatic?
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No.
50-80% don't show symptoms |
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What are manifestations of a disseminated gonococal infection?
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Pustular skin lesions
Septic arthritis Tenosynovitis (infection of the tendon sheath) |
3.
2 to do with joints 1 to do with skin |
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What is the morphology and staining of N. gonorrhoeae?
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Gram negative
Diplococci |
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What are the growth conditions and agar gype for N. gonorrhoeae?
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Aerobic
Modified Thayer-Martin media |
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What are the virulence determinants of N. gonorrhoeae?
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Type 4 pilus: adherence, shows antigenic variation
Opa proteins: adherence, express 3 variants at a time LOS: antigenic variation; sialytaed IgA1 protease: cleaves IgA Rmp: induces blocking antibotdies |
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What is a mechanism that humans have developed against N. gonorrhoeae
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An IgA that can't be cleaved by the N. gonorrhoeae IgA protease
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What is a consequence of antigenic variation within N. gonorrheae?
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You can be reinfected with the bug.
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Where does Chlamydia trachomatis live inside the muman cell?
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Intracellularly; obligate
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What is the source of energy for Chlamydia trachomatis?
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Parasitic: obtains ATP, NTs, AAs from host
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What is the life-cycle of Chlamydia trachomatis?
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Elementary body: transmissive
Reticulate body: intracellular, dividing Persistent form |
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What are mechanisms by which the Chlamydia trachomatis survive outside the cells?
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Disulfide bond crosslinked outer membrane; rigidity
TIII secretion system mediates intracellular survival |
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What is the stimulus and mechanism by which Chlamydia trachomatis transitions from an RB to an EB?
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Lack of nutrients, gamma interferon
Crosslinks the outer membrane to form disulfide bonds. |
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What is the effect of interferon gamma and penicillins on Chlamydia trachomatis RBs?
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Adoption of a persistent form
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What cells does Chlamydia trachomatis target?
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Columnar epithelium
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What is the effect of chlamydia heat shock protein-60 on host tissue?
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Induction of a destructive CD4 Th2 response
People with antibodies to this show worse disease |
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What are the different kinds of chlamydial infections?
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Urethritis
Epididymitis Proctitis Mucupurlent cervicitis Pelvic inflammatory disease Trachoma LGV Lymph pathology |
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What is the most effective test for the detection of Chlamydia?
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PCR from the cervix of female; male urine
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What is the best way to diagnose gonorrhea?
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Gram staining from male urethritis
GU tract PCR |
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What is a histological sign of clamydia?
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Sheaths of polys
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What is a histological sign of gonorrhea?
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Polys with cocci inside of them
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What is the treatment of an uncomplicated chlamydial infection?
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Azithromycin 1 g
or Doxycycline 100 mg/7 days |
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What is the treatment for a gonoccaal infection?
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1 treatment of ceftriaxone 260 mg IM
PLUS Treatment for clamydia: Azithromycin |
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What drugs shouldn't you use to treat gonorrhea?
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Ciprofloxacin
Penicillin Tetracyclines |
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What are mechanisms of preventing STDs?
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Abstinence! If you're not having sex, you won't get an STD!
Screening Condoms |
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What is a problem with Non-oxynol-9, a spermicidal compound in condoms?
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Increased risk of HIV
Increased risk of Candida, UTIs |
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Who shows symptoms of disease from Trichomonas vaginalis?
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Women
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What disease does Trichomonas vaginalis cause?
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Vaginitis in women
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What are the symptoms of vaginitis in women?
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Itching
Vulvar irritation/erythema Thin, frothy discharge pH > 4.5 (high!) |
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Do men show symptoms of Trichomonas vaginalis infection?
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NO!
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What is the most effective way to diagnose an infection byTrichomonas vaginalis?
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Vaginal pH
Cuture |
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What is the treatment for Trichomonas vaginalis?
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1 large dose of Metronidazole
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It's a protozoa
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What are the treatment principles for Trichomonas vaginalis?
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Treat both partners simultaneously
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What are the bacteria that cause PID?
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Primary pathogens:
N. gonorrhoeae C. trachomatis Secondary pathogens: E. coi Strep. H. influenzae |
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What are the short-term consequences of ascending PID?
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Salpingitis
Tuboovarian abscesses Peritonitis, perihepatitis |
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What are the long-term sequelae of PID?
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Chronic pain
Infertility Tubal Pregnancy |
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What are symptoms of PID?
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Lower abdominal pain
+/- Vaginal discharge +/- Vaginal bleeding |
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What are signs of PID?
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Abdominal/adnexal tenderness
Cervical tenderness |
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What are the principles of antimicrobial therapy for PID?
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Activity against:
Gonococcus Streptococci Gram-negatives Obligate aerobes Chlamidya |
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What are some examples of drug combinations for PID?
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2nd gen cephs + doxy
Clindamycin + gentamicin Zosyn + doxy |
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What is the most common sore-causing STD?
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HSV
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What is the typical presentation of syphilis ulcers?
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One ulcer
Not painful Bulging, indurated ulcer |
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What is the typical presentation of a chancroid ulcer?
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Multiple
Painful Soft, flat |
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What is the typical presentation of herpes ulcers?
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Multiple, coalescing ulcers
Painful Soft, flat |
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What is the bacteria that causes chancroid?
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Haemophilus ducreyi
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What disease does Haemophilus ducryei cause?
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Chancroid
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What is the morphology and staining of chancroid?
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Gram negative
Coccobacilli |
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What is the difference on a gram stain between H. ducrase and H. influenzae
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Ducae forms chains
Influenzae does not. |
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What population has chancroid?
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Female commercial sex workers
Sex-for-drugs trade |
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What is the treatment for chancroid?
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Ceftriaxone or Azithromycin (1 dose)
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What is the bacteria that causes sypilis?
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Treponema pallidum
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What disease does treponema pallidum cause?
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Syphilus
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What is the the morphology of the bacteria that causes syphilis?
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Treponema pallidum, a spirochete
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What is unique about the virulence factors of T. pallidum?
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It really doesn't have any!
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What is the replication rate of T. pallidum?
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Slow!
Replicates ever 30-33 hrs. |
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What is the pathology of the lesions in T. pallidum infections?
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Obliterative endarteris:
blocking arteries, causing downstream ischemia |
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What are the symptoms of primary syphilis?
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Chancre
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How long does it take for the symptoms of primary to manifest after contact?
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3 weeks
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Are chancres in primary syphilis?
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YES!
WEAR YOUR GLOVES! |
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What are the manifestations of secondary syphilis?
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Rash (on the feet and palms)
Lesions Fever Lymphadenopathy Aseptic meningitis Eye lesions |
6 symptoms
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What are some structural abnormalities with secondary syphilis?
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Saber shins
Saddle deformity of the nose Hutchinson's teeth |
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Do most people with secondary syphilis progress to tertiary?
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No.
Only 30% do. |
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What are the manifestations of tertiary syphilis?
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P: personality change
A: affective disorder R: reflexia E: eye findings - Argyll-rogberteson's/Prostitute's pupil; doesn't constrict with light, gun barrel pupil S: sensorium changes I: Intellectual loss S: speech disturbance |
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What is the gait of a person severely affected by tertiary syphilis like?
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"Slapping gait"
Have lost sensory information from feet, so have to slap feet hard against ground to be able to feel |
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What is the location of joint damage in a tertiary syphilis patient?
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The knee, bilaterally
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What are manifestations of tertiary syphilis on the skin?
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Gumma
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What is the most effective way to diagnose syphilis?
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Darkfield microscopy
Serology: screen with VRDL, convirm with FTS |
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What is the treatment of syphilis?
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Penicillin!
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Where is syphilis most common?
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Urban areas
Rural south: STAY AWAY FROM THOSE SOUTHERN BELLES! |
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