Term
| What STIs are considered Curable? |
|
Definition
- Chlamydia
- Gonorrhea
- Trichomoniasis
- Syphilis
- Chancroid |
|
|
Term
| Which STIs are incurable? |
|
Definition
- HIV/AIDS
- HPV
- Hepatitis B
- Herpes |
|
|
Term
| Consequences of STIs for women |
|
Definition
- Pelvic Inflammatory Disease
- Infertility, ectopic pregnancy
- Cervical cancer
- Adverse pregnancy outcomes |
|
|
Term
| Consequences of STIs in infants |
|
Definition
- Eye infections
- Blindness
- Death |
|
|
Term
| Consequences of STIs in men |
|
Definition
- Infertility
- Narrowing of urethra |
|
|
Term
| What is the prognosis of HIV/AIDS? |
|
Definition
| eventually fatal (even with treatment) |
|
|
Term
| What kind of bacteria is gonorrhoea? |
|
Definition
- Aerobic Gram negative diplococci
- very fastidious
- Often appear intracellular on a gram stain |
|
|
Term
| What are some risk factors for N. gonorrhoea? |
|
Definition
- Age < 25
- Street youth, homeless
- New sexual partners
- > 2 sexual partners/year
- Non-barrier contraception |
|
|
Term
What are the risks of transmission of N. gonorrhea in the following situations:
- Infected female to male
- Infected male to female
- Anal sex |
|
Definition
- 20% per episode
- 50% per episode
- not well quantified but also high |
|
|
Term
| What are some clinical manifestations of gonorrhoea? |
|
Definition
- Acute urethritis/cervicitis
- Ano-rectal or pharyngeal gonorrhea
- PID
- Septic arthritis |
|
|
Term
| What are the major virulence factors associated with N. gonorrhoea? |
|
Definition
1. Pili --> helps the bacteria adhere to the mucosal surface and inhibit killing by neutrophils
2. Outer membrane --> outer membrane proteins facilitate invasion of epithelial cells
--> LPS posses and endotoxin activity that results in ciliary death |
|
|
Term
| What type of cells does N. gonorrhoea infect? |
|
Definition
| columnar or cuboidal epithelial cells |
|
|
Term
| How long does it take for epithelial cells to be penetrated by gonorrhoea? |
|
Definition
|
|
Term
| Where can the N. gonorrhoea infection spread? |
|
Definition
- the proximal genital tract
- Bloodstream
- joints |
|
|
Term
| We used to be able to treat gonorrhoea with penicillin but now it is resistant to it. What are treatment alternatives? |
|
Definition
- Plasmid mediated beta-lactamaes
(fluoroquinolones and tetracycline have very high resistance) |
|
|
Term
| What does the CDC recommend for gonorrhoea treatment? |
|
Definition
- Cefixime which is a cephalosporin
- It is the only oral agent for uncomplicated url-genital or rectal gonorrhea |
|
|
Term
| What needs to be on your plate when culturing for gonorrhoea? |
|
Definition
| - Some antibiotics to suppress the normal flora |
|
|
Term
| Gonorrhoea doesn't grow on sheep blood agar plates, but it does grow on ____ plates |
|
Definition
|
|
Term
| It is more common to use PCR techniques to test for gonorrhoea. What samples do we use for males and females? |
|
Definition
Males: 1st voided urine (want to get the bacteria that have built up in the urethra...don't care about what is in the bladder)
Females: vaginal swabs that can be self collected |
|
|
Term
| IF doing a culture for gonorrhoea, what type of samples do you need? |
|
Definition
| A urethral swab for males (ouch) and a cervical swab for females |
|
|
Term
| What are the three species of Chlamydia? and which one do we care about? |
|
Definition
1. C. psittaci
2. C. pneumoniae
3. C. trachomatis --> care about this one since it usually the cause of chlamydia |
|
|
Term
| Describe the life cycle of C. trachomatis |
|
Definition
- It is biphasic
- It has an elementary body which is the inactive form
- And a reticular body which divides |
|
|
Term
Chlamydia commonly causes urethritis in men.
What is the incubation period and what % of men are asymptomatic? |
|
Definition
- incubation period is 7-21 days
- as many as 25% of men are asymptomatic |
|
|
Term
| Cervicitis and PID are common complications of chlamydia. What % of women with cervicitis are asymptomatic? |
|
Definition
|
|
Term
| What are the first and second line therapy for Chlamydia? What is the benefit to the 1st line therapy? |
|
Definition
1st: 1 gram of Azithromycin (It's a single dose! Yay! We call this direct observed therapy or DOT)
2nd: 100 mg BID of doxycycline (10 day course - no one likes that!) |
|
|
Term
| How do we diagnose Chlamydia in the lab? |
|
Definition
- Antigen detection
- Immunofluorescence
- Cell culture
- PCR (used most! male urine/female vaginal swab) |
|
|
Term
| What kind of virus is Herpes simplex? |
|
Definition
| - An enveloped, ds-DNA virus with an icosahedral capsid |
|
|
Term
| What percentage of the US population has HSV-2? |
|
Definition
| 24%...but that may just be the tip of the iceberg (since many are unrecognized or asymptotic) |
|
|
Term
| HSV-1 is most frequently associated with --> |
|
Definition
oral and ocular infections
(causing more genital infections! 340% increase) |
|
|
Term
| HSV-2 is most frequently associated with --> |
|
Definition
|
|
Term
| Describe % transmission through viral shedding of HSV during asymptomatic vs. symptomatic outbreak |
|
Definition
asymptomatic = 70%
symptomatic = 30% |
|
|
Term
| What % of people who are over the age of 30 in the US are HSV2 +? |
|
Definition
|
|
Term
| Explain why newly recognized outbreaks in a monogamous couple does not equal infidelity. |
|
Definition
| Many recognizes first outbreaks may actually be reoccurrences (also keep in mind latency) |
|
|
Term
| Which HSV (1 or 2) involves more relapses? |
|
Definition
HSV-2
(90% have 1 reoccurrence, 28% have 6 or more, 20% have 20 or more) |
|
|
Term
| When is neonatal herpes transmitted? |
|
Definition
In utero it is very rare
Intrapartum is 75-80% |
|
|
Term
| What complications can arise from neonatal herpes? |
|
Definition
- Severe disseminated infections
- Encephalitis
- 80% fatal without treatment |
|
|
Term
| What happens if a woman has recurrent break outs of herpes and gets pregnant? |
|
Definition
- will give prophylaxis
- may opt for a C section |
|
|
Term
| How do we diagnose Herpes Simplex virus? |
|
Definition
- Viral culture
- Serology --> but you can't differentiate between HIV-1 and HIV-2
- PCR --> way more sensitive and quite specific |
|
|
Term
| What kind of virus is human papilloma virus? |
|
Definition
- Naked icosahedral virus
- Circular double stranded viral DNA |
|
|
Term
| How many types of HPV viruses are there? |
|
Definition
|
|
Term
| What kind of Skin-to-skin HPV infections are common? What types cause it? |
|
Definition
1, 2, 3 and others
--> plantar and common warts |
|
|
Term
| What mucosal HPV infections are low risk and what types cause it? |
|
Definition
| 6 and 11 --> associated with genital warts |
|
|
Term
| What mucosal HPV infections are high risk and what types cause them? |
|
Definition
| - invasive cancers --> HPV 16, 18 and others |
|
|
Term
| How long does the development of cervical cancer take? |
|
Definition
|
|
Term
| Can you detect HPV using a pap smear? |
|
Definition
| Nope, you look for changes in the cervix cause by the virus |
|
|
Term
| Is there a risk of getting HPV from the vaccine? |
|
Definition
NO
Because to make the vaccine, they excise a gene from the virus that codes for the nuclear capsid... put it in a eukaryotic cell and build the capsid. There is no genetic material inside
--> inject it into the patient and antibodies will be made in response |
|
|
Term
| What strains does the HPV vaccine target? |
|
Definition
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|
Term
| When do you get your HPV vaccine doses? |
|
Definition
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