GU dz (lec 19, 20)

Question 1

Treponema pallidum (syphilis) microbe characteristics?

Answer 1

G- spirochete
Obligate parasite
Ulcerative (inflamm response)

Question 2

T. pallidum virulence factors?

Answer 2

Fibronectin coat -> antiphago

Hyaluronidase -> infiltration

Question 3

T. syphilis epidemiology?

Answer 3

Human
Horizontal/Vertical transmission
Direct contact

Question 4

T. syphilis 1º?

Answer 4

Subepith entry
Local multiplication -> lymph nodes/blood
Chancre (raised/firm border)-> heals 3-8 wks

Question 5

T. syphilis 2º?

Answer 5

Dormancy 2-10 wks
↑↑ contagious rash (doesn’t spare palms/plantar)
Immune complexes in arteries

Question 6

T. syphilis latent?

Answer 6

No sxs
Early - can relapse
> 1 yr - immune to relapse

Question 7

T. syphilis 3º?

Answer 7

5-20 yrs post
Meningovascular/neuro Δs or
CV w/ aortic aneurysm or
Granulomata in skin/bones

Question 8

Congenital syphilis presentation?

Answer 8

Signs @ 3 wks:
Rash,
Nasal obstruction w/ infectious d/c,
Osteitis of nasal bone,
Neurosyph

Question 9

Hutchinson’s Triad is?

Answer 9

w/ congen syph:
Notched incisors,
Interstitial keratitis,
8th nn deafness

Question 10

Syphilis tests?

Answer 10

Darkfield/immunofluo -> 1º or 2º
Serum antibodies:
Screen w/ VDRL, RPR
Confirm w/ treponemal Ab tests

Question 11

N. gonorrhoeae microbe characteristics?

Answer 11

G- kidney bean diplo

Question 12

N. gonorrhoeae virulence factors?

Answer 12

Antigenic variation of pili
Plasmid/Chromo resistance to abx
Nonpili phase -> Φ antibodies
Porin proteins -> attachment
IgA protease

Question 13

N. gonorrhoeae resistant to what abx?

Answer 13

PCN
TCN
Fluoroq

Question 14

N. gonorrhoeae epidemiology?

Answer 14

(U) adolescents

(U) asymp carrier

Question 15

N. gonorrhoeae infection mechanism?

Answer 15

Epith attachment (pili, memb prot)
Δ surface proteins (anti-ant, antiphago)
LOS/pepgly cell injury
Pilar spread

Question 16

N. gonorrhoeae presentation:

W?

M?

Answer 16

Colonization of endocirvix/urethra

Colonization of ant urethra w/ white d/c

Question 17

N. gonorrhoeae complications?

Answer 17

Acute salpingitis (fallop tube)
PID
Disseminated Gonococcal Infection (DGI)

Question 18

DGI presentation?

Answer 18

fever/rash

purulent arthritis

Question 19

N. gonorrhoeae tests?

Answer 19

Nucleic Acid Amp (PCR) dx

Question 20

C. trachomaits microbe characteristics?

Answer 20

G-
Obligate intracell (req host ATP)
Elementary bodies/reticulate bodies

Question 21

C. trachomaits presentation?

Answer 21

similar to gonorr

(P) lymphogranuloma vereum

Question 22

Chlamydia infection mechanism?

Answer 22

Host mucosal cells collapse -> pull away from e/o

Toxin B

Question 23

Chlamydia tests?

Answer 23

Isolation cx (standard)
PCR (better)

Question 24

Mycoplasma hominis causes?

Answer 24

pyeloneph, PID

Question 25

M. genitalium causes?

Answer 25

non-gonn GU infection

Question 26

Ureaplasma urealyticum causes?

Answer 26

Very common cause of non-gonn GU infection

Cause of most NGU in men

Causes chorioamnionitis/postpartum fever

Question 27

Main types of vaginitis?

Answer 27

Trichomoniasis
Bacterial vaginosis
Yeast vaginitis

Question 28

Types of Trichomoniasis? (3)

Answer 28

t. tenax -> + mouth
t. hominis -> + intestines
t. vaginalis -> causes STD

Question 29

Tricho. vaginalis microbe characteristics?

Answer 29

Flagellated protozoan
Trophozoite
Extracellular anaerobe

Question 30

T. vaginalis presentation:

W?

M?

Answer 30

↑↑ frothy/smelly d/c

(U) asympt

Question 31

T. vaginalis tests?

Answer 31

Wet mount

DNA probe

Question 32

Bacterial Vaginosis epidemiology?

Answer 32

NOT STD
(U) overgrowth due to ↑ pH
IUDs, prior STD

Question 33

Bacterial Vaginosis tests?

Answer 33

Clue cells
Fishy odor when add KOH
Curved G-/+ rods
Gray, homogenous d/c

Question 34

Candidiases etiology?

Answer 34

opportunistic mycoses

N skin/mucous flora

Question 35

Triggers for Candidiases?

Answer 35

Φ competing flora
Abnormal site
Pathologic environment change
Immun defect
Abx use

Question 36

Vulvovaginal Candidiasis etiology?

Answer 36

(yeast infection)

c. ablicans

Question 37

Yeast infect presentation?

Answer 37

Thick, white, frothy d/c
No smell
Itching/burning

Question 38

C. albicans virulence factors?

Answer 38

several morph -> all can attach

Germ tube most adhesive

Question 39

C. albicans tests?

Answer 39

Micro exam = large G+ cells

Cx germ tube, hyphae, chromagar

Question 40

Haemophilus microbe characteristics?

Answer 40

G- coccobacillus

non-motile

Question 41

H. ducreyi causes?

Answer 41

chancroid

Question 42

Chancroid presentation:

W?

M?

Answer 42

regional LAD
soft chancre

W: asympt or nondescript lesion

M: tender papule -> ulcer w/ sharp margins

Question 43

Soft chancre presentation?

Answer 43

Single blister/papule -> pustule/ulcer
Autoinoculates -> multiple ulcers
Painful, bleeds easily, soft/ragged edges w/ pus

Question 44

Chancroid tests?

Answer 44

Isolate h. ducreyi

PCR

Question 45

PID is?

Answer 45

microbe ascension into endometrium, fallopians, etc

Question 46

PID caused by?

Answer 46

n. gonorr, c. trach, e coli

Question 47

PID presentation?

Answer 47

low abd pain
vag d/c
painful sex
fever/chills
irreg cycle

Question 48

PID diagnostics?

Answer 48

Clinical

Evidence of inflamm: fever, leukocytosis, ↑ ESR