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165 Cards in this Set

  • Front
  • Back
What are the primary routes of entry for STDs?
mucosa (squamous epithelial cell of vagina, cervix, urethra.
rectum
oral pharynx
Who are the most frequent reservoir of STDs?
asymptomatic human carriers
What is condom protective for? not protective for?
1. gonorrhea, chlamydia, HIV
2. skin-skin organism: syphilis, herpes.
Why is condom not protective against syphilis or herpes?
These are skin-skin transmission.
What are some acute manifestations of STDs?
urethritis
cervicitis
genital ulcers
vesicular lesions
vaginis
What are some chronic manifestations of STDs?
recurrent herpes
genital warts
perlvic inflammatory disease
immunodeficiency
terciary syphilis
What are some sequele of STDs?
infertility
ectopic pregnancy
cervical cancer
opportunistic infection
vertical transmission
What is the most common STD seen in the US?
A. HPV
B. Trichnomas
C. Chlamydia
D. Herpes
D.
The rate of transmission of STD is dependent on which 3 factors?
1. mean efficiency of transfer (B)
2. number of sexual partners/day (C)
3. duration of infectivity (D)
R0=BxCxD
Treponema pallidum is a member of ______.
spirochaetacceae
Treponema pallidum is in the same family as _____.(2)
1. Borrelia recurrentis (relapsing fever)
2. Borrelia burgdorferi/garinii/afzelli (Lyme disease)
What organism's structure is made up of an axial filament composed of three periplasmic flagella, an inner and an outer lipid membrane?
treponema palluidum
Why can't you see trponema paliidum under microscope?
very thin and tiny.
Describe the pathogenesis of treponema pallidum(syphilis).
1. penetrate mucus and adhere to fibronectin through microabrasion during intercourse.
2. coat itself with fibronectin (antiphagocytic) and multiply. May survive intracellularly.
3. produce hyaluronidase facilitating spread
4. spread to lymph/blood.
Compare the content of inner and outer membrane of treponemal pallidum.
Inner membrane contains peptidoglycan.
Outer membrane has high lipid content to avoid phagocytosis, adhesins to bind to fibronectin, and there is no LPS.
What is the function of treponemal pallidum's axial filament?
locomotion in high vicosity (mucus)
What organisms are not culturable? (3)
Mycobacterium leprae
Treponemal pallidum
Molluscum contagiosum virus
Hemophilus ducrevi(difficult)
Is treponemal pallidum susceptible to penicillin?
Yes, because the inner membrane contain peptidoglycan.
_____ is also known as "the great pox", veneral disease, French, Italian, Spanish, German, Polish disease.
Syphilus
How does syphilus transmit?
1. mucus membrane contact: sexual intercourse, kissing, toughing active part.
2. congenital: after 4 month of pregnancy during primary or secondary stage.
3. blood transfusion
4. needle prick
What stage of syphilus is most likely passed on to the infant from the mom?
What stage has the highest viral load?
primary and secondary.
Secondary
What are some risk factors for syphilus?
1. drug use
2. HIV coinfection
CDC's goal for combating syphilus is to _____.
reduce the number of primary and secondary stage infections.
The damage seen with syphilus is caused by ____.
Th1 response (although critial for control of disease).
Antibodies: immune complex formation which cause local inflammation.
What are the clinical stages of syphilus?
1. primary: chancre
2. secondary: more controlled
3. latent: asymptomatic
4. tertiaty: neurosyphilus, Cardiovascular disease, Gamma.
Where do treponemal pallidum exist in the body during primary and secondary syphilus?
Primary: in the lesion (chancre)
Secondary:blood, lymph, skin, CNS.
During what stage of syphilus would you be able to see infiltraion of plasma cells, CD4,8 cells, macrophages, and treponemes?
Primary syphilus.
T/F: Relapse is common in late latent stage of syphilus.
F. Common in early latent stage which is 1-2 years after primary infection.
A patient has a single chancre(smooth base, raised fir border, clean, no excudate) on external genitalia, and histologic stain shows infiltration of plasma cells, T cells, and macrophages.
1. What does the patient has(be specific)?
2. What test can you order to confirm?
3. How to treat this patient?
4. What other organism may cause chanre?
1. primary syphilus.
2. Darkfield demonstration of organism or DFA since he is in early stages.]
3. extended therapy of Benzathine(slow releasing).
4. Afrivan trapanasome.
How to differentiate chancre from Chanroid and Herpes?
Chancroid: pustular, painful.
Herpes: painful, vesicles.
Chancre: not painful, no excudate.
Why is differential diagnosis of second stage syphilus so difficult?
"Great imitator", protean manifestation. Serology is better.
How is skin lesion in secondary syphilus different from primary syphilus?
What other symptoms may accompany skin lesion during secondary syphilus?
Smaller, more controlled, rash on body surface including palms and soles.
Fever, malaise, pharyngitis, arthralgia, lymphadenopathy due to immune complex formation.
What clinical forms of tertiary syphilis are there?
1. neurosyphilus: affect meinges, eyes, ears, cerebral cortex.
2. cardiovascular: aorta, destruction of elastic tissue.
3. gumma: nonspecific granulomatous lesion in skeletal system, skin, any organ.
Tertiary syphilis is due to ____, and occurs ____ years later.
host inflammatory reaction.
2-10 years later.
If a 2 wk pregnant women has syphilis, will she pass the disease to the fetus?
Not likely. Usually after 4month gestation.
Which group of congenital syphilis will have a live birth but may suffer rhinitis, desquamash rash,osteochondritis, or herpatc failure.
Group II. (Group I is usually aborted or stillbirth.
An 2 month old infant who has a saddle nose and a saber chin developed rhinitis, diffuse desquamative rash, and pneumonia.
1. What is likely the cause?
2. What test should you order to confirm?
1. congenital syphilis
2. serology test for mom and the infant.
What are the two types of serologic test for syphilis? Differentiate the two.
1. nontreponemal: RPR, VDRL tests. Dectect antilipid antibodies( IgM, fall during latent and late )stage.May have false positives.
2. treponemal: antibody against treponemal antigens, remain high level. More specific.
Dark field test may be used in early stages of syphilis. Where should you take the sample from?
Not from the oral cavity: normal organisms exist there.
Which of the following are defined as nontreponemal tests?
A. Wassermann complement fixatoin
B. RPR
C. VDRL
D. All the above
D.
Which of the following are defined as treponemal tests?
A. immobilization test
B. FTA-abs
C. MHA-TP
D. All the above
D.
How to diagnose primary or secondary syphilis?
1. nontreponemal test: if postive, do treponemal test. if negative: maybe early in disease.
2. treponemal test: if positive, most likely infected. if negative, false positive.
What test should you used to evaluate therapy of syphilis?
nontreponemal test (ie RPR).
How to diagnose neurosyphilis?
1. serum test, if postive, do CSF testing.
What does it mean when you see nontrponemal antibodies in CSF?
Indicative neurosyphilis since these antibodies usually don't cross CSF.
What does it mean when you find treponemal antibodies in CSF?
May indicate neurosyphilis,but might also be false positive because antibodies might come from passive transfer.
How to diagnose congenital syphilis?
nontreponemal test for the mom first and then the infant to confirm.
What is Jarisch-Herxheimer reaction?
Large quantities of toxins are released into the body as bacteria (typically Spirochetal bacteria) die, due to antibiotic treatment.
A patient came in with chills, fever, arthralgia. History showed that he is taking Benzathine penicillin G.
1. What caused his symptoms?
2. What should you use to treat him?
1. Jarisch-Herxheimer reaction:large quantities of toxins are released into the body due to the antibiotic treatment.
2. Aspirin or ibuprofen.
If a person has syphilis and is allergic to penicillin, what should you use alternatively? What if this person is pregnant?
tetracyclin, ceftriaxone, or azithromycin.
Still penicillin.
List some members of Herpesviridae.
Varicella zoster virus
HSV
Epstein Barr
CMV
HHV 6,7,8
Describe Herpes simplex virus:
1. genomic content
2. enveloped or not?
3. genetic content encode for what products?
1. ds DNA virus
2. enveloped
3. DNA-dependent DNA polymerase, scavaging enzymes, total of 80 proteins.
What's the function of scavenger enzymes? Give an example of this enzyme.
To provide substrates for genomic replication of HSV.
Example: Thymidine kinase.
Describe the lytic infection of HSV.
1. Virus bind to heparin sulfate, envelope fuse with cell membrane.
2. nucleocapsid docks with neclear membrane and gemone enter the nucleus.
3. early gene products: replication proteins
4. late gene products: structural
5. viral assemly in nucleus
6. buds through nucleat membrane
7. final processing in Golgi.
8. viral release: exocytosis, cell lysis, cell-cell fusion, intracellular bridges.
What are inclusion bodies?
packaged virus inside the nucleus.
Varicella zoster virus becomes latent in ____ whereas Herpes simplex virus becomes latent in ____.
DRG.
sensory nerve ganglions:trigeminal, sacral.
What are some triggers of recurrent herpes?
sunlight
fever
local trauma
trigeminal nerve manipulation
menstruation
emotional stress
How does herpes spread?
oral or genital secretions
How does host responde to herpes and how does HSV combat against them?
1. IFN and NK response: HSV produce protein that block action of IFN.
2. CMI(crucial): HSV interfere with ER processing of its antigens and MHCI presentation to CD8 cells.
3. Humoral: HSV produce receptors for Fc and complement.
What is the characteristic lesion seen in herpes?
thin walled vesicle, local lymphadenopathy.
T/F: You may see giant cells with herpes infection.
T.
When does the production of herpes virus not result in cell lysis?
When it becomes latent in neurons.
What happens when latent herpes simplex virus is triggered to reactivate?
1. latent stage: RNA transcript but no protein made.
2. when activated: virus travel back down to neuron to original site of inoculation.
Why do you see skin lesions repeadly on the same area?
When latent virus reactivated, it travels back to the original site and trigger inflammation there.
What are the primary infection sites for herpes?
oral: HSV1
genital: HSV2
What are some symptoms of primary HSV1 infection?
Gingivostomatitis, phatyngitis, followed by fever, sore throat, erythema.
Small vesicles on mucosa, rapidly ulcerate. Severe mouth pain.
A child comes in complaining of fever, sore throat, painful mouth. When you examine the oral mucosa, you see several small vesicular lesions, some are ulcers.
1. What does the kid have? be specific.
2. What complications should you worry about?
3. what test can be used to diagnose the complication in question 2?
1. primary HSV1 infection
2. encephalitis, focal seizures.
3. PCR CSF for viral genes
A women presents with vesicular lesions on the cervix. She also has bilateral inguinal lymphadenopathy.
1. What is the causative agent? be specific
2. What complication/disease should you worry about?
1. Primary HSV2
2. aseptic meningitis
What is blepharitis? What might cause this?
Blepharitis: inflammed eyelids.
HSV1
A guy presents with painful vescible lesions on his hand. He mentioned that a week ago he had a fight and got a cut on the hand by the other guy the teeth.
1. What is the causative agent?
2. What is the technical name for this lesion?
1. HSV1
2. herpetic gladiatorum.
Which of the following has more occurance?
A. HSV1
B. HSV2
B.
What drug reduces recurrance rate in herpes?
Acyclovir.
If a pregnant women has promary herpes, what should be considered for the delivery?
C-section because neonatal infection is aquired by passing through birth canal.
What are some effective tests to diagnose herpes?
1. culture: look for cytopathic effects (turn blue)
2. PCR viral genes (method of choice for encephalitis)

*direct demonstration(DFA, Tzank smear for inclusions) of organism has poor sensitivity.
What causes chancroid?
Haemophilus ducreyi
Describe haemophilus ducreyi on gram stain.
GNB
A patient presents with a painful pustular lesion on external genitalia. You can also see sinus tract forming.
1. What do you suspect the patient has?
2. How to rule out syphilis?
1. chancroid
2. darkfield or serology test. Plus syphilis is not painful, no pus.
How to treat chancroid?
Macrolide: azithromycin, ceftriazone, ciprofloxacin, or erythromycin.
A patient presents with a umbilicated papule(nodular to wardlike). What is the causative agent?
Molluscum contagiosum.
Describe molluscum contagiosum:
1. genome content
2. what family?
3. enveloped or not?
1. ds DNA virus
2. poxviridae: replicate in cytoplasm
3. enveloped
With what infection you might see inclusions?
1. HSV
2. chancroid
What organisms can not be cultured?
1. treponemal pallidum
2. mycobacterium leprae
3. molluscum contagiosum
How to treat molluscum contagiosum?
physical removal
What do you suspect when you see warts?What types?
HPV, type 6, or 11.
Describe HPV:
1. genome content
2. family
3. enveloped or not
1. dsDNA, small genome
2. papillomaviridae
3. no envelope
There are more than 100 HPV types. It is due to ____, not ____.
DNA sequences.
serology.
Describe the genomic makeup of HPV.
Small genome: 8kbp.
Circular.
Early genes: E5-7 used in transformation.
Late genes: L1,L2. L1 is the target for vaccine.
What part of the HPV genome is the target of HPV vaccine?
L1: late genome.
Describe the pathogenesis of HPV.
1. virus enter stratum germinativum.
2. replicate in epidermis, replicate in sync with host.
3. thickening of epidermis, some cells become koilocytes.
4. benign lesions formed (warts).
What are koilocytes? What infection is this associated with?
Keratinocytes with shrunken nucleus, halo around the nucleus.
HPV.
What are the function of E1 and E2 elements of early genes of HPV?
Down regulate E6,7 expression. E6 binds to p53 and degrades it. E7 binds retinoblastoma gene product. E1,2 disrupted when DNA integrated into host genome. MAy cause cancer.
What is wart a good sign?
Wart means viral DNA is still extrachromosomal.
Don't see warts if DNA is linearized, which makes the cell susceptible to mutation and later become cancerous.
A women with cervical cancer comes in and told you she has HPV. What types of HPV do you suspect she is infected with?
type 16, or 18, or 31.
What are some risk factors associated with cervical cancer?
1. sexual partners
2. smoking, contraceptive methods, dietary factors, other infections.
What are some cutaneous manifestations of HPV?
common warts, planter warts, juvenile warts.
Usually asymptomatic and spontaneousely recover.
What are some genital manifestations of HPV?
anogenital warts (condyloma acuminatum): gray colored papules, itchy, burning, pain, tenderness.
A women compaines about a painful lesion around her perianal area. When you examine her, you see a gray colored papule.
1. What do you suspect she has?
2. Do you think there are lesions in her cervical areas too?
Genital HPV.
Yes.
Single oral papillomas may be caused by _____.
HPV6,11
Oral cancer may be caused by HPV___.
16.
What is the best strategy to diagnose HPV? Why?
PAP smear combined with DNA hybridization: this might expalin confusing colposcope resport and it may reduce screening frequency.
How to treat HPV?
Physical removal of warts.
Intralesional IFN in some non-HIV infected people.
Gardasil is preventative of HPV of what types?
6,11,16,18.
If a lady is vaccinated with gardisil, will she still need to do PAP smear?
Yes. VAccine is not protective to all types of HPV.
Is C section recommended for women with HPV?
No.
C section is recommended in ____ infection, but not in_____ infection.
HSV
HPV
Describe Nisseria gonorrhea:
1. gram stain
2. oxidase
3. aerobic or anaerobic
1. GNC, in pairs, flattened sides together.
2. oxidase positive
3. aerobic
What is the growth condition for Nisseria gonorrhea?
chocolate agar
Thayer Martin agar: chocolate agar + antibiotics
temperature below 35 degree
Describe the pathogenesis of Nisseria gonorrhea.
1.pilin attach to nonciliated epithelial cell.
2. cytoskeleton rearrange, internalize organism. Sloughing of ciliated cells.
3. Opa protein makes tight binding and induce mucosal cell phagocytosis.
4. Por protein inhibit intracellular killing
5. Los stimulate inflammation, lots of pus.
What are some virulence factors of Nisseria gonorrhea?
1. pilin: attachment, internalization
2. Por: intracellular survival, assist invasion to epithelial cells.
3. Opa: firm attachment to host cell, internalization.
4. Rmp: protect Por from antibodies.
5. Ironbinding protein
6. LOS: endotoxin
7. IgA protease
3.
What factors of Nisseria gonorrhea assist in organism internalization?
1. pilin
2. opa
What factors of Nisseria gonorrhea prevent neutrophils and complement actions?
1. Por: prevent degranulation and intracellualr killing.
What factors of Nisseria gonorrhea inhibit antibodies actions?
1. Rmp
2. IgA protease
What factors of Nisseria gonorrhea act as a endotoxin and cause syptoms such as pus?
LOS: stimulate inflammation
Where do resistant strains of Nisseria gonorrhea disseminate to?
joints
What factors of Nisseria gonorrhea has antigenic variations?
1. pilin
2. por
3. opa
What is the complication involved in action of antibodies against Nisseria gonorrhea?
antigenic variation.
But antibodes are protective against homologous strains.
How does N. gonorrhea transmit?
rectal transmission.
oral gonorrhea also occurs.
Periannal transmission to infants.
A guy has dysuria, discharge. 1. What organism do you suspect?
2. what is the name of this symptom?
3. How to treat him?
1. N. gonorrhea or chlamydia.
2. acute urethritis
3. 3rd generation cephalosporin if chlamydia ruled out. If not, add azithromycin.
A women complains about vaginal dischage, dysuria, intermenstural bleeding.
1. What does she have?
2. If left untreated, what disease might she develop?
1. N. gonorrhea or chlamydia
2. salpingitis, tubo-ovarian abscess, perliv inflammatory disease.
N gonrrhea is tested in pregnant women during ___ trimester to avoid spontaneous abortion.
1st trimester.
A women complains about abdominal pain, fever. On examination,she has high WBC, endometritis.
1. What is the cause?
2. What symptoms might she have when she becomes bacteremic?
1. N. gonorrhea. or chlamydia
2. septic arthritis and dermatitis.
What are some clinical menifestation of neonatal gonorrhea? How to treat it?
gonococcal conjuctivitis (ophthalmia neonatum).
antibiotic eye ointment: erythromycin or tetracyclin.
How to diagnose N. gonorrhea?
1. culture: Thayer-Martin agar. Positive oxidase test and gram stain.
2. gram stain of exudate:intracellular GNB. Men only. Not useful to women.
3. DNA probe: not used in legal situation.
How to treat gonorrhea?
1. if Chlamydia ruled out: 3rd generation cephalosporin.
2. if not: also use azithromycin or doxycyclin.
Which two of the following are obligate intracellular organisms?
A. mycobacterium leprae
B. treponemal pallidum
C. chlamydia trachomatis
D. trichinella spiralis
A. C.
Why can't you used penicillin drug family to treat chlamydia?
Chlamydia trachomatis lack peptidoglycan in the cell wall.
Why is chlamydia trachomatis an obligate intracellular paraite?
can not synthesize ATP
Give an organism which is not a virus that may caues aseptic meningitis?
Chlaymdia trachomatis

Virus: enterovirus, HSV,
Describe the two forms of chlamydia trachomatis.
1. extracellular elementary body: infective, nonreplicating small coccus, has rigid cell wall(major outer membrane protein).
2. intracellular reticulate body: noninfective, replicating, larger, less rigid, metabolically active.
What are the functions of outer membrane protein(OMP) in Chlamydia trachomatis?
1. contribute to cell wall rigidity (elementary body).
2. antigenic: attachment and phagocytosis
3. antigenic: species, serovar specific.
OMP antigens in chlamydia trachomatis contribute to ____.
A. genus specificity
B. species specificity
C. serovar specificity
B. C.
Describe the lifecycle of chlamydia trachomatis.
1. elementary bodies bind to columnar epithelial cell and internalized: OMP
2. fusion of phagolysosome inhibited, host cell protein synthesis inhibited.
3. transit to reticular body
4. replication: bonary fission, protein-carbohydrate complex formation.
5. vacule ruptures, elementary body released extracellularly.
Acute disease of chlamydia is a result of _____, inflammation following response to necrotic debris is mediated by ____ initially, and _______ eventually. _____ formation result in submucosa. Fibrosis and scarring can ocur with repeated infection.
1. tissue damage following replication
2. neutrophils
3. lymph and macrophage
4. lymphoid follicle
What immune response is important in acute manifestations of chlamydia? and what is important in control of intracellular stage?
1. antibody response
2. CMI
How many serovars of chlamydia trachomatis are there? Give the serovars that cause the following manifestations:
A. trachoma (eye infection)
B. genital infections, oculogenital infections
C. infant pneumonia
D. lymphogranuloma venereum
19
A. serovars A-C
B. serovars D-K
C. serovars D-K
D. serovars L1-3
A Middle East woman presents with rough eyelids.
1. What infection is this? be specific.
2. Reinfection of this type would result in what conditions?
3. What is the technical name for this symptom?
1. chlamydia trachomatis serovars A-C
2. scarring, eyelid inversion, blindness.
3. trachoma
What is the leading cause of blindness?
trachoma
A guy presents with urethral discharge, itching, and dysuria.
1. What are the possible causes of this?
2. What test can you use to make the differential diagnose?
1. gonorrhea and chlamydia
2. PCR or culture using Thayer Martin agar.
What is the tropism for chlamydia?
nonciliated columnar, cuboidal, and transitional. (urethra, endocervix, endometrium, fallopian tubes, anorectum, respiratory tract, conjunctiva)
A homosexual man presents with proctitis.
1. what do you suspect he has?
2. what should you also concern with?
1. chlamydia
2. may have other accompanying organisms
What is Reiter's syndrom and what are the causes?
1. immune mediated form of arthritis associated with HLA-B27.
2. chlamydia, salmonella, shigella, campylobacter.
A 25 yr old white man presents with arthritis, redness of the eyes, and urinary tract signs.
1. What is the technical name for these symptoms?
2. What organisms may cause this?
3. When do you think he got this infection?
4. what HLA type do you think he has?
1. Reiter's syndrome
2. chlamydia, shigella, salmonella, campylobacter.
3. 1-3 wks ago.
4. HLA-B27
A week old infant presents with progressive pneumonia and conjuctivits with purulent discharge.
1. What does the baby have?
2. If the kid doesn't have pneumonia, what do you suspect he has?
1. chlamydia
2. gonorrhea
What chlamydia serovars cause multisystem infections?
Lymphogranuloma venereum (L1-3)
A guy presents with painless papule on his genitalia with enlarged inguinal nodes which have become necrotic.
1. what do you suspect the guy has? be specific.
2. what other organism may also caues this?
3. what are some late complications?
1. Chlamydia (LGV)
2. syphilis
3. pregressive ulceration/infiltration, rectal scarring, genital elephantiasis.
If you decide to use culture to diagnose chlamydia, what sample should you choose? What are the disadvantages of this type of test?
1. scrapings of cells, not purulent discharge.
2. time consuming, loss of organism when delayed, need tissue to culture(obligate intracellular).
If you decide to do a gram stain to diagnose chlamydia, what should you look for?
inclusion bodies.
What is the most sensitive test for chlamydia?
PCR.
How to treat chlamydia?
Azithromycin or doxycyclin.
Alternative: erythromycin, or ofloxacin, or levofloxacin.
What other organisms can the treatment for chlamydia get rid of?
1. mycoplasma hominis
2. mycoplasma genitalium
3. ureaplasma urealytium
What are some normal flora of the vagina?
1. lactobacilli: H2O2 producing
2. yeast: small amounts

In general: obligate and falcultative anaerobes.
Which flagellate protozoan causes vaginosis? How to treat it?
trichomona vaginitis
metronidazole, also treat partners
What is the host response to trichomonas vaginitis?
alternative complement pathways, attract PMNs.
Why do you also need to treat partners of women who are infected with trichomonas vaginalis?
Infected men are often asymptomatic. So need to prevent spread to other women.
What is the common cause of candida vaginosis?
disruption of normal flora, lack of balance. Not usually sexually transmitted.
How to treat candida infection?
Azole: miconazole, butoconazole, or clotrimazole.
Partners not routinely treated.
A women presents with odorous, yellow-green vaginal discharge.
1. What is the causative agent?
2. What do you see under microscope?
3. how to treat it?
4. is vaginal pH normal in this case?
1. Trichomonas vaginalis.
2. PMNs and motile trichomonas
3. azoles
4. no, more basic.
A women presents with curdy-white vaginal discharge.
1. What is the causative agent?
2. What do you see under microscope?
3. how to treat it?
4. is vaginal pH normal in this case?
1. candida
2. pseudohyphae, yeast.
3. intravaginal cream (clotrimazole, miconazole),oral fluconazole.
4. yes
A women presents with odorous gray-white vaginal discharge.
1. What is the causative agent?
2. What do you see under microscope?
3. how to treat it?
4. is vaginal pH normal in this case?
1. bacterial vaginosis
2. change in background flora from large nonmotile rods to tiny clumped coccobacilli.
3. Metronidazole, clindamycin
4. no, more basic.
What is the test for odor called?
KOH Whiff test
What is the cause of bacterial vaginosis?
loss of H2O2 producing lactobacilli sp, and accumulation of anaerobic bacilli (gardnerella vaginalis, morbiluncus sp)
List two arthropods that cause STD.
1. scabies: sarcptes scabiei
2. crab lice: phthirus pubis
A patient presents with itchy eczematous skin eruptions.
1. What is the causitive agent?
2. How to treat it?
1. scabbies
2. topical permethrin or oral ivermectin
What preventative measure will prevent scabbies?
launder clothing, bedding.
A patient presents with itchy skin lesion arround hairfollicles.
1. What is the causative agent?
2. How to treat it?
1. phthirus pubis
2. topical permethrin or pyrethrins.