STD's Overview

Question 1

4 Causes of genital ulcers

Answer 1

1. HSV-2 (and -1)
2. Primary syphilis: Treponema pallidum
3. LGV: Chlamydia trachomatis L1-L3
4. Chancroid: Haemophilis ducreyi

Question 2

6 Causes of “drips”

Answer 2

1. Chlamydia trachomatis D-K
2. Gonorrhea: Neisseria gonorrhoeae
3. Ureaplasma urelyticum
4. Trichomoniasis: Trichomonas vaginalis
5. Candidiasis: Candida albicans
6. BV: Gardnerella vaginalis + other anaerobes

Question 3

3 Causes of warts:

Answer 3

1. HPV
2. Secondary syphilis
3. Molluscum contagiosum (a Pox virus)

Question 4

HSV structure?

Answer 4

enveloped, large dsDNA

Question 5

HSV-__ is usually oral

HSV-__ is usually genital

Answer 5

1

2

Question 6

HSV diagnosis is via:

Answer 6

blood PCR

Question 7

What is a Tzanck smear?

Answer 7

smear used to visualized multinucleated giant cells, which are dx of HSV

Question 8

What is notable about the presentation of primary and recurrent herpes?

Answer 8

they are hard to distinguish: painful, clustered blisters (although 1’ may be more painful)

Question 9

Treponema palladium is what type of bacteria? Thus, it cannot be seen by _____, and must be visualized by _____.

Answer 9

spirochete
Gram stain
darkfield microscopy

Question 10

What are the classic symptoms associated with primary, secondary and tertiary syphilis?

Answer 10

1' = chancre
2' = maculopapular rash (even on hands)
3' = gummas, dementia, aortic aneurysm

Question 11

Preferred testing for syphilis?

Other options?

Answer 11

1. RPR
2. VDRL
   * *non-treponemal testing (cheaper, specific)

Other = Treponemal FTA-Abs

Question 12

DOC for syphilis?

Answer 12

PCN

Question 13

LGV: Chlamydia trachomatis L1-3 is characterized by what symptom?

Answer 13

swollen inguinal lesion

Question 14

Painless lesion on penis =

Answer 14

syphilis

Question 15

Painful lesion on penis =

Answer 15

herpes

chanchroid

Question 16

Dysuria + painful =

Answer 16

trich

Question 17

Itchy + discharge =

Answer 17

candida

Question 18

Exudate + smell =

Answer 18

BV

Question 19

Neisseria gonorrhoeae:

Structure?

Answer 19

G- diplococci

Kissing kidney beans

Question 20

Neisseria gonorrhoeae:

Clinical presentation?

Answer 20

purulent urethritis/cervicitis

PID

Question 21

Neisseria gonorrhoeae:

Dx?

Answer 21

growth on Thayer Martin medium or Gram stain of urethral smear

Question 22

Neisseria gonorrhoeae:

DOC?

Answer 22

ceftriaxone

+ azithro or doxy

Question 23

Neisseria gonorrhoeae:

What is notable about immunity?

Answer 23

antigenic variation = no permanent immunity

Question 24

Chlamydia trachomatis DK:

Structure?

Answer 24

obligate intracellular bacteria lacking a cell wall

Question 25

Chlamydia trachomatis DK: | Replication?

Answer 25

cyclical, between EB and RB

Question 26

Chlamydia trachomatis DK: | Clinical presentation?

Answer 26

non-gonococcal urethritis/cervicitis/PID

Question 27

Chlamydia trachomatis DK: | Dx?

Answer 27

NAAT on urine

Question 28

Chlamydia trachomatis DK: | DOC?

Answer 28

azithro or doxy (+/- ceftriaxone)

Question 29

Trichimonas vaginalis: | Structure?

Answer 29

flagellated parasite

Question 30

Trichimonas vaginalis: | Clinical presentation?

Answer 30

painful vaginitis | dysuria

Question 31

Trichimonas vaginalis: | Pathophys?

Answer 31

destruction of epith cells + inflammatory response

Question 32

Trichimonas vaginalis: | Dx?

Answer 32

wet mount looking for twitching motility of flagellates

Question 33

Trichimonas vaginalis: | DOC?

Answer 33

metronidazole

Question 34

Candida: | Structure?

Answer 34

budding yeast that use pseudohyphae for invasion

Question 35

Candida is associated with what additional factors/conditions?

Answer 35

DM Immunosuppression abx

Question 36

Candida: | Clinical presentation?

Answer 36

vulvovaginitis | commonly, recurrence

Question 37

Candida: | Dx?

Answer 37

KOH preps looking for budding yeast

Question 38

Candida: | DOC?

Answer 38

azoles or nystatin

Question 39

HPV: | Structure?

Answer 39

nonenveloped circular dsDNA

Question 40

HPV: | Causative agent for what conditions?

Answer 40

common warts genital/pharyngeal warts cervical cancer

Question 41

HPV establishes what type of infection, and in what type of cell?

Answer 41

persistent infections non-permissive cells (keratinocytes in our example)

Question 42

HPV: | Trx?

Answer 42

removal | imiquimod

Question 43

What is transformation (HPV)?

Answer 43

HPV infects cells and genome replicates, but no viruses are produced

Question 44

How does HPV shed?

Answer 44

keratinocytes mature normally; once they reach the surface mature viruses are released

Question 45

What is the difference between malignant and non-malignant HPV tumors?

Answer 45

malignant genome = partial, with loss of E6 and E7 nonmalignant genome = circular, full-length, extrachromosomal

Question 46

HPV-affected cells turn white when exposed to:

Answer 46

10% acetic acid

Question 47

Complications associated with HSV: in utero + adult?

Answer 47

congenital or in utero infection: - -disseminated disease - -encephalitis ``` adult: CNS infections (encephalitis or meningitis) ```

Question 48

Complications associated with syphilis: in utero + adult?

Answer 48

in utero: still births or spontaneous infection (which may not manifest for 2 yrs) adult: CNS, leading to meningitis or insanity

Question 49

Complications associated with gonorrhea: congenital + adult?

Answer 49

congenital: ophthalmia neonatorum adult: - -rash - -arthritis - -fever - -PID

Question 50

Complications associated with chlamydia?

Answer 50

congenital: - -ophthalmia neonatorum - -infant pneumonia adult: PID

Question 51

Complications associated with HPV?

Answer 51

cervical, throat and anal cancers

Question 52

T/F: concurrent infections are common.

Answer 52

T

Question 53

Often, unapparent infections lead to:

Answer 53

spread + significant complications (e.g. PID)