UGI 3

Question 1

common site of gonorrhea infection in men and women and associated symptom

Answer 1

men: urethra; purulent urethral discharge
women: cervix; vaginal discharge

Question 2

clinical presentation of gonorrhea

Answer 2

vaginal and urethral discharge, erosive vesiculobullous lesions, mucopurulent gonococcal cervicitis

Question 3

features of neisseria gonorrhea

Answer 3

gram neg diplococci, non motile non spore forming, fastidious, oxidase positive,

Question 4

virulence factor of neisseria gonorrhea

Answer 4

pili, Opa, por protein, LOS, iron binding protein

LIPOP

Question 5

pathogenesis of neisseria gonorrhea

Answer 5

it binds to columnar epithelial cells of distal cervix or urethra using PILI and outer surface proteins then multiplies

Question 6

in women gonorrhea spreads to the fallopian tube. how does it spread if its not motile?

Answer 6

uterine or urethral contractions

Question 7

what can chronic infections of neisseria gonorrhea lead to

Answer 7

scarring and stricture of fallopian tube or urethra

Question 8

how do you diagnose gonorrhea

Answer 8

1. intracellular gram neg diplococci for women only
2. non culture lab test
3. thayer martin or chocolate agar with oxidase pos colonies

Question 9

treatment of gonorrhea

Answer 9

250mg single dose of ceftriaxone together with 1g oral azithromycin

-there is resistance to fluoroquinolones so can only see cephalosporin (beta lactamase resistant)

Question 10

when treating gonorrhea what else do you treat for

Answer 10

chlamydia since a good portion of people have both

Question 11

increases the transmission of HIV

Answer 11

bacterial vaginosis, trichomoniasis, gonorrhea, chlamydia

Question 12

most commonly reported notifiable disease

Answer 12

chlamydia

Question 13

chlamydia trachomatis is associated with what disease

Answer 13

conjunctivitis, infant pneumonia, urogenital disease (D-K)
lymphogranuloma venerum (LGV1, 2, 3)

Question 14

since chlamydia is mostly asymptomatic, it often goes untreated. What could happen if chlamydia goes untreated in women

Answer 14

they can develop PID (pelvic inflammatory disease) which leads to infertility, ectopic pregnancy, chronic pelvic pain

Question 15

what happens if men have chlamydia that goes untreated (though this is rare)

Answer 15

epididymitis and urethritis

Question 16

features of chlamydia

Answer 16

• gram neg but atypical bacteria
• infectious form - elementary bodies
• replicative/non infectious form - reticulate bodies
• obligate intracellular
• gains entry via ulceration and laceration

Question 17

why can’t you view chlamydia with a gram stain although it is gram neg

Answer 17

it is atypical in that it is intracellular

Question 18

receptors for elementary bodies

Answer 18

– mucous membranes of the urethra
– endocervix, endometrium, fallopian tubes
– anorectum
– respiratory tract and conjunctivae

Question 19

specimen used for testing in chlamydia

Answer 19

• urine or swab from urethra if male and vagina or endocervix if female
• for those that engage in anal or oral sex, rectum and oropharynx swab

Question 20

best test for chlamydia

Answer 20

NAAT (like in trichomoniasis)

Question 21

why are swabs and not exudate used as specimen for chlamydia

Answer 21

because it is an intracellular parasite

Question 22

treatment for chlamydia

Answer 22

• azithromycin 1g orally, single dose

- doxycycline 100mg orally 2x/day for 7 days