Y2B3 Micro- Genital Infections Stds

Front 1

what are the five etiologic microorganisms that cause STDS?

Back 1

Neisseria Gonorrhoeae
Chlamydia trachomatis
HSV
Treponema pallidum
HIV

Front 2

how does Neisseria G attach to host cells? what cells can Neisseria G be found on and w/n?

Back 2

attach via their pilli

found on and w/n leukocytes (neutrophils)

Front 3

how is Neisseria G transmitted? how is it gaining resistance to antibiotics?

Back 3

Transmitted by direct contact (since it does not survive well outside of the host)
- resistance: increasing number of strains containing R plasmids.

Front 4

what allows for N. Gonorrhoeae to attach to many different types of cells?

Back 4

antigenic variation brought on by chromosomal rearrangements of pili genes--- allows the creation of differ types of pilli

Front 5

how does N. Gonorrhoeae escape the immune system?

Back 5

antigenic variation which causes the immune system to be incapable of forming antibodies. It also produces an enzyme that breaks down IgA antibody.

Front 6

what is the function of OPA proteins? how do the OPA proteins prevent activation and proliferation of lymphocytes?

Back 6

fxn: increase adherence between gonococci and to eukaryotic cells.

OPA attaches to receptors on CD4 lymphocytes which impairs response to this infection

Front 7

what sxs are caused by gonorrhea in men? in women? What might be some end results for both sexes?

Back 7

men: uretheritis, thick pus containing discharge. Can lead to infection causing scar tissue. End results: sterility and prostatic abscesses
women: painful urination, vaginal discharge. Spread in the cervix and fallopian tubes
end result: PID--> sterility or ectopic pregnancy.

Front 8

How do you tx Gonorrhea?

Back 8

Ceftriaxone

penicillin cannot be used d/t increasing concentration of drug needed to kill susceptible strains.

Front 9

what other infection mimics gonorrhea? What does this infection attach to and cause in men? what can it cause in women?

Back 9

C. Trachomatis (sxs: uretheritis, testicle and fallopian tube damage)

Able to attach to sperm and cause sterility in men and PID in women--> sterility or ectopic pregnancy.

Front 10

what is lymphogranuloma venerem?

Back 10

Rare STD caused by 3 types of C. Trachomatis. LN in the groin swell and drain pus leading to gross swelling of the genitalia.

Front 11

4 types of what pathogen can cause a chronic eye dz trachoma leading to blindness?

Back 11

C. Trachomatis

Front 12

what are the different phases of C. trachomatis?

Back 12

-intracellular bacterium-

1) elementary body-> non replicating, infectious elementary
2) reticulate body--> non infectious, replicating body.

Front 13

what is the infectious form of C. trachomatis? what releases this form of C. Trachomatis?

Back 13

elementary body: dispersal form: induces its own endocytosis w/ host cell. Once inside it germinates into a vegetative reticulate form.

It is released from the reticulate body.

Front 14

how do you diagnose C. trachomatis? how do you tx it?

Back 14

Immunofluorescence

tx: for ocular and genital infections in adults--> azithromycine and doxycycline
for newborn conjunctivitis and pneumonia--> erythromycin

Front 15

what characterizes primary syphilis?

Back 15

painless, red ulcer w/ a hard rim called a hard chancre (heals after 3-6 wks). 10-90 days from exposure to appearance of 1st sxs.

Front 16

Pt presents to your office with a runny nose, watery eyes, a sore throat and a distinctive rash on palms and soles. Dx and tx

Back 16

dx: secondary syphilis (2-10 wk incubation)--> d/t immune cocmplexes
tx: penicillin

Front 17

pt presents to your office complaining of difficulty coordinating muscle movements, paralysis, gradual blindness and a propensity for forgetting things. Pt also presented with a gumma on the roof of their mouth. Dx and tx

Back 17

dx: tertiary syphilis (Gumma- granulomatous necrotizing mass)
resulting from HSN reactions to T. pallidum

tx: penicillin

Front 18

how is secondary syphilis transmitted?

Back 18

thru broken skin or mucus membranes (the sores in the rash contain active bacteria)

Front 19

what causes syphilis? how do you identify this pathogen?

Back 19

Treponema pallidum- motile spirochete

identification: dark field microscopy or fluorescent staining

Front 20

what are the 2 serologic tests for syphilis? what three conditions will give you a false positive

Back 20

RPR (rapid plasma reagin)
VDRL (Venereal disease research laboratory)
--> can detect ab to cardiolipin and other lipoidal.

FP: febrile infections, pregnancy, autoimmune disorders

Front 21

what is the purpose of quantitative, nonspecific tests for syphilis?

Back 21

1) monitor efficacy of tx... ab titers decreased w/ successive txs

Front 22

what are the 2 specific treponemal antibody confirmatory tests? why can't u use these tests to follow therapy?

Back 22

FTA-ABS (fluorescent treponemal antibody absorption)
MHA-TP (microhemagglutination)

-cannot be used to follow therapy because these antibodies do not disappear, pts remain seropositive throughout their lives.

Front 23

what pathogen causes chancroid?

Back 23

Haemophilus ducreyi--> cytolethal, distending toxin--> sexually transmitted genital ulcer disease.

Front 24

Pt presents to your office with a soft chancre that is tender, but not indurated. Dx and name what it could be confused with? what is this dx associated with?

Back 24

dx: chancroid (assoc w/ unilateral, inguinal, lymphadenitis--> untxed buboes can form)

confused w/ Syphilis who has a hard chancre that is indurated, but painless.

Front 25

how do males in comparison to females present w/ chancroids?

Back 25

males- usually symptomatic w/ painful lesions and inguinal tenderness
females- usually asymptomatic, but can present w/ sxs such as dysuria, vaginal discharge, painful defecation, rectal bleeding.

Front 26

what are the 3 probably diagnosis for chancroid's based on?

Back 26

1 or more painful, genital ulcers; no evidence of T. pallidum and test results for HSV are negative

Front 27

T/F

Chanchroids tend to affect uncircumcised men more than circumcised men and it is closely associated w/ prostitution. It is also more common in homosexuals.

Back 27

FALSE

everything is true EXCEPT:

Chancroid is more common in HETEROSEXUALS!

Front 28

what genital ulcer disease is the major co-factor in transmission of HIV?

Back 28

Chancroid

Front 29

who common gets granuloma inguinale? what pathogen causes it?

Back 29

commonly found in the tropics and subtropics (poor-- blacks 6x more than caucasians)

pathogen: calymmatobacterium granulomatis

Front 30

what is calymmatobacterium granulomatis? where is it normally found? what does it cause?

Back 30

gram neg, non motile rod (capsule sim to klebsiella)

normally present in the guit flora found primarily intracellular in macrophages

causes: inflammatory reaction after penetrating the skin

Front 31

what is the key diagnostic feature of calymmatobacterium granulomatis?

Back 31

intracellular inclusions called donovan bodies

Front 32

What type of lesions are characteristic of calymmatobacterium granulomatis?

Back 32

lesions on the genital and perianal lesions- start as raised nodules which erode into beefy-red ulcers

Front 33

what does the herpes virus encode that is an excellent target for antiviral drugs?

Back 33

DNA polymerase (promotes viral DNA replication)

Front 34

what are the three immune escape proteins of the HSV genome? What portion of the complement system and antibody are they bound to?

Back 34

gC, gE, gI

C3 is bound to gC--> inhibits complement activation

gE/gI is bound to Fc portion of the antibody--> camouflages virus and virally infected cells

Front 35

pt presents to your office complaining of genital itching, burning and severe pain. On PE you notice small, red bumps on genitalia (some of which that have already turned into blisters). Dx and tx

Back 35

HSV

particaularly- HSV2

Tx: acyclovir and penciclovir (resistance to these drugs results from mutations that inactivate thymidine kinase)

Front 36

T/F

Both HSV-1 and HSV-2 are capable of infecting the genitalia and mouth.

Back 36

true

Front 37

what happens to the epithelial cells that are infected w/ HSV-2?

Back 37

they lyse creating painful ulcerations

Front 38

what is the most common of the sexually transmitted diseases? what is it responsible for?

Back 38

HPV

responsible for papillomas (warty growths on internal and external genitalia) as well as non-warty lesions of mucosal surfaces (uterine cervix)

Front 39

what is the pathogenesis of papillomavirus STDS?

Back 39

believed to enter and infect the deep layers of epithelial cells through abrasions. (result--> latent infections)

Front 40

what can happen to newborn infants that are infected w/ HPV at birth?

Back 40

warts can obstruct respiratory tract

Front 41

what virus is associated w/ cervical cancer?

Back 41

HPV

Front 42

Pt presents to your office complaining of an itching vulva and vagina w/ yellowish-green, frothy vaginal discharge. dx and what else might you see on PE? tx too

Back 42

trichomonas vaginalis- trichomaniasis

PE: strawberry cervix

tx: metronidazole

Front 43

T/F

Trichomonas vaginals remove COOH groups from pyruvate and transfer electrons to hydrogen ions forming hydrogen gas.

Back 43

true

they have no mitochondria, but they do have hydrogenosomes and this is what they do.

Front 44

What should you be concerned w/ if you find trichomonas vaginalis in a child?

Back 44

suspect for child abuse

Front 45

what are the three etiologic microorganisms that cause vaginitis?

Back 45

trichomonas vaginalis
candida albicans
gardnerella vaginalis

Front 46

how can you cause bacterial vaginosis? what accounts for 60% of vulvovaginal infections?

Back 46

- use of broad-spectrum antibiotics---60% (affects lactobacillus- normal flora)
- douching
- overused, retained tampons
- Intrauterine contraceptive devices
- multiple sex partners
- hx of STDS

Front 47

what 4 signs characterize bacterial vaginosis?

Back 47

- decrease in vaginal lactobacilli
- clue cells- sloughed off epithelial cells covered w/ bacteria
- strong fishy odor
- sticky, white or gray discharge

Front 48

how do you diagnose bacterial vaginosis?

Back 48

observation and smell
-addition of 10% KOH to vaginal fluid increases intensity of the odor
- vaginal smear examined microscopically.

Front 49

what are the complications of bacterial vaginosis?

Back 49

PID
infertility
ectopic pregnancy
premature birth
low birth weight