The most comm organism to cause STD’s and what other bacteria is usually ass. with?
-C.Trachomatis and usually **co-infection with Gonorrhea. **
Chlamydia mechanism and chacteristic about it?
-GRAM- obligated intracellular (dosent make own ATP), poor muramic acid (peptidoglycan layer)–>NO staining in GRAM stain.
-Exist in 2 forms: Elementary (gets endocytosed by cells)–>transforms into Reticulate body–>metabolic active (Fission)–>Lyse cells and further infects.
Types of serotypes of Chlamydia??
-Ass infections in males and females?
1.A-C: Thracoma=Conjuctivitis
2.
2.D-K=Chlamydia–>
Male: urethritis,prostatitis,epidimytis and PROCTATIS (MSM–>gay)
Female: urethritis, vulvovaginitis, cervicitis—>PID
3.L1-L3: Lymphograuloma venerum.
Complication relating Chlamydia and Ghonorrhea??
PID
Classify warts and ulcers in STD’s??
Warts–>HPV 6 and 11
Ulcers–> A)Painfull: HSV2 and H.Ducreyi
B)Painless: Syphylis and Klebsiella (Donovanosis=Granuloma Inguinalis)
Diagnosis
Inflamed INGUINAL lymph-nodes that are painful + ulcers that are NOT painfull
-How do we describe lesions?
LymphoGranulosum Venerum
-lesion decsribed as buboes
-L1-L3 Chlamydia
Sympts of conditions
-Male urethritis
Female urethritis
Female cervicitis
Female salpingitis
Conjuctivitis
Prostatitis
Pyelonephritis
Cystitis
-Dysuria + NO fever and no back pain
-Mucopurulent discharge,Dysuria,Pruritis, NO fever
-Easy bleeding (post-coidal)
-RUQ pain tenderness,Violing adhesion
-Mucopurulent discharge
Fever,dysuria,back pain, urgency
-Fever,No dysuria,pyuria,Costovertebral angle tenderness.
-NO fever,dusyria,urgency,NO back pain
What the diffrence between non-specific treponema antibodies and specific ??
-Use
-What molecules do they involve
-Why are they usefull
-Diagnosis syphylis
-Non-specific detects cardiolepin (molecule rel in cellular damage)–>once treatment is initiated it will go away.
Specific identifies antibodies against bacteria–>LIFE LONG.
-Non-specific good for prognosis of treatment
Wha are the names of this test?
Non-specific
Specific
-VDRL and RPR–> non-specific
-FTA-ABS and MHA-TP (TPA)–>done after a positive non-specific and life long positive result.Confirm syphylis.
Specific presentation in diffrent stages of syphylis?
1–>chancre (hard based with raised borders with central exudate that has spirochetes_
2–> non-itchy maculopapular rash + const sympt. + condylomata lata ( warts in moist area)
Latent (3-30yrs)
3*–> Neurosyphylis (Tabes Dorsalis/ Argyl-Robertson Pupil/ Genral Paresis) Cardiacsyphylis (aortitis–>incr risk of aneurysm), Gumma (granulomas)
What diagnostict method do we use in syphhlis stages?
-Specific–> every stage
1–> Fluoroscent and dark microscopy
2 and 3–>non specific first and then confirm with specific
3–>CSF analysis
Gonorrhea 3 important facts about bacteria?
-NO polyssacharide capsule
-NO Maltose Fermentation
-Antigenic variation (pilli gene mutation–>dosen’t allow for Immune response to work and NO vaccione)
-GRAM- diplococci, obligated intracellular.
Complications of N.Gonorrhea infections?
-Neonatal conjuctivitis (2-3 days after infection).PID and Septic arthritis (inflamed knee joint–>aspiration reveals >50k WBC)
What infect are associated with Gonorrhea?
-Urethritis, conjuctivitis,pharyngitis, cervicitis
-Pre-pubertal females–> vulvovaginitis (sign of abuse usually)
-With purulent discharge
What do you give in Conjuctivitis assoaciating Gonorrhea and to prevent what?
Topical Erythromycin to prevent blindness.
Jarisch-Herxheimer reaction?
-After iniating treat towars syphylis or lyme dis.–>massive antigen rel.–>flu-like sympt.
If you see a genital wort that is painless you thing of….
What do you see in micgroscopy??
HPV 6 and 11
-Koilocytes (peri-nuclear halo)
-Wart is described as coli-flower looking.
H.Ducreyi charact.?
Grows?
Transmission?
Presentation?
-GRAM- coccobacilli that is encapsulated
-Grows on Chocalate Agar (app school of fish)
-Transm via skin breaks (Hemolysin
- Papules–>Pustules -rupture–>Canchre
- Presentation is lymp node enlargement that are painful + painfull ulcers
How does a Herpis Genitalis presents?
-What smear do you use and what do you see?
-Latency where?
-Pianful vesicle or ulcers in genital region
**Most comm cause of genital ulcers. ** with fevers and myalgias.
-get into skin cell–>painfull ulcer that are itchy with lymphadenopathy and travels to neurons and remains latent–>SACRAL GANGLIA
-Tzank smear (piece of the vesicle)–>you see multi-nucleated cells.
Why latency of Herpe virus family is import?
-How will reativation present.
-Recurrent activation–> presenting sympt. keep occuring.
-Trigger: stress, sunlight, fatigue, Immunosuppression.Prodorme phase of itching and burning sensation.
Vaginal pH along the yr??
-Starts as pH >7 –>estrogen is rels.–> promotes squamoys glycogen deposists–>favor growth of Lactobacilli (secrtes Hydrogen Peroxidase) Ex: E.coli and Strep Group B.–>protect vagina during reproductive age,where pH<4—->post menopausal incr pH again.
Trichonomas Vaginitis??
-Diagnosis
-Vagina pH
-Treat
-Causes Vaginal infect with foul smelling yellow-grenn discharge
-Motile trichonomads on microscopy
-pH>4.5 (favors the growth)
-Metronidazole
What the diffrence between Candida vaginitis + Bacterial Vaginosis vs Thrichomonas vaginitis?
The firts 2 are ass with decr lactobacilli in vagina (alter flora, NOT sexually transmited) and the other is ass with sexual transmission.
Risk factors for developing altered vaginal flora(3)?
-Multiple sex partners, Antibiotic treatment, Intra-uterine devices.
