LECOM Micro Ch 21 STD
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| 3 manifestations of congenital syphilis | - intrauterine death – congenital abnormalities – silent infection until at 2yo face and tooth abnormalities
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| Scrapings from a lesion grown nothing on multiple types of culture; thin, tightly wound slender coiled organism with pointed ends is seen on dark field; Not seen on gram-stain. Present in biopsy with silver impregnation. Dx? | Treponema pallidum
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| 2 Non-specific syphilis screening tests | VDRL and RPR
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| DOC for Syphilis? If allergic? | PCN; doxy
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| Where can organisms be found proliferating during Primary syphilis? Regional lymph nodes |
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| Secondary Syphilis Sxs described as what? | Flu like illness
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| Where are organisms multiplying in Secondary Syphilis? Pt infectious or not? | everywhere; skin, musouc membranes, lymph nodes, liver, spleen; VERY CONTAGIOUS
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| What is possibly responsible for the ability of T. pallidum to evade recognition | Thick coat w/ sialic acid
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| 3 parts of tertiary syphilis | neurosyphilis, tabes dorsalis, insane; Cardiovascular syphilis with aortic lesions and hear failure; Progressive destructive disease with “gummas” in skin, bone, and testes
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| N. gonorrhoeae: shape and stain | gram negative diplococcus
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| N. gonorrhoeae: motile? | no
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| N. gonorrhoeae: pili? | yes
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| N. gonorrhoeae: IgA protease? | yes
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| N. gonorrhoeae: capsule? | yes
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| N. gonorrhoeae: exotoxin? | no
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| N. gonorrhoeae: other than pili what is antigenic ? | Por proteins
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| What allows N. gonorrhoeae to bind to epithelial cells? | Opa proteins
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| What does N. gonorrhoeae Rmp protein do? | inhibits “cidal” activity in serum
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| N. gonorrhoeae: endotoxin? | yes
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| What is LOS in N. gonorrhoeae? | lipooligosacharide, endotoxin activity
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| 2nd most common bacterial STD. Man presents with painful, inflamed glans, with purulent penile discharge. What do you treat with? | ceftriaxone (cipro) cover w/ doxycycline for chlamydia
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| What cells do gonorrhea invade? | non-cilliated epithelial cells
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| A woman with no previous Dx of STD is found to be sterile after chronic pelvic pain. What bug caused this? | N. gonorrhoeae
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| What grows on Thayer-Martin agar? | Neisseria
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| Eye infection in neonate with non-symptomatic mother. Dx? | N. gonorrhea
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| 4 possibilities of systemic spread of gonorrhea in asymptomatic women | skin lesion, endocarditis, arthritis, to baby opthalmia neonatorum
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| Serotypes of chlamydia that cause STD | D-K (DicK)
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| Asymptomatic in chlamydia is more common in what sex? | women
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| Chlamydia D-K infects what cells? | columnar or transitional epithelia cells
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| A random petri dish is looked at. It has some words on the bottom. McCoy cells/cyclohexamide/Iodine. You see cytoplasmic inclusion bodies under microscope Dx? | Chlamydia D-K
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| DOC for Chlamydia in adult? In baby? What class in inactive? | doxycycline in adults; erythromycin in babies; beta-lactams don’t work
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| Infectious life and mechanism of Chlamydia | Eb attaches to cell->”parasite-specified endocytosis”->change to RB->multiply in vacuole->change back to EB->release to other cells
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| Serious complications in Chlamydia in men | systemic spread, Reiter’s syndrome(pee hole, eye, joints, mucocutaneous lesions
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| Serious complications in C. trachomatis in women | ectopic pregnancy, infertility, systemic spread
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| Clinical syndrome and complication w/ C. trachomatis w/ Neonate | conjunctivitis and pneumonia
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| South American male. Ulcerated papule on penis, heals, but bilateral inguinal lymph nodes are massive, tender, and skin is erythematous over the nodes. Dx? Tx? What if it was in a pregnant woman? | Lymphogranuloma Venereum LGV (C. trachomatis L1-3) ; doxycycline or erythromycin in pregnant/child
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| BUZZ: School of Fish on gram stain: describe and Dx | large number of short Gram-Negative rods and chains: Haemophilus Ducreyi
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| DOC for Chancroid | erythro- azythro-mycin(macrolide) or ceftriaxone
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| Gram Negative Rods and Chains grow at 33*C but not at anything higher |
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| Ulcerative nodule on genitalia that bleed with contact on a Caribbean man. What is seen on smear from lesion. | mononuclear cells with blue/black clusters in cytoplasm w/ Wright or geimsa stain; C. granulomatis
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| DOC for Donovanosis | tetracycline or co-trimoxazole
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| Causes PID, postabortal postpartum fevers | M. hominis
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| Irritated vagina with cheesy vaginal discharge. Dimorphic fungus. Dx? Tx? | Candida Albicans; oral Fluconazole or topical nystatin
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| Vaginitis with copious foul-smelling discharge; increased vaginal pH. DDx? | Trichomonas vaginalis vs Gardnerella vaginalis
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| Trichomonas on micro? | actively motile trophozoites
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| DOC for trichomonas | metronidazole
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| Excessive vaginal discharge, fishy odor, epi’s coated w/ bacteria, Dx and Tx? | G. vaginalis; mmetronidazole
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| MCC of venereal herpes | HSV-2
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| Tx of herpes | acyclovir
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| Ulcerating vesicular lesion from the glans. Micro: ballooning degenerating cells with multinucleated giant cells present | HSV- 2 maybe 1
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| Cervix shows white plaques when acetic acid is placed on it. Dx? Serotypes associated w. cancer? What can be seen on vulva? Tx? | HPV; 16 and 18 with cervical cancer; condylomata acuminate; podophylin
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| Gp41 and gp120 are what? | HIV envelope proteins
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