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Session 2 Microbio10
Microbio -10- STI/STD
| Question | Answer |
|---|---|
| Why is syphillis called the great imitator | symptoms are similar to many other diseases |
| Why has the syphilis rate increased so much in the last decade | surge in cases among homosexual and bisexual men |
| What is the causative organism of syphilis | treponema pallidum |
| How is syphilis trasmitted | person to person by sexual intercourse direct contact with lesions rarely spreads disease |
| What is the second most common cause of genital ulceration | Syphilis |
| What is the progression of syphilis | 4 stages primary -> secondary -> to late/tertiary and latent neurosyphilis is seperate from the 4 stages |
| What is the initial symptom of syphilis | chancre ulcer painless nodule or ulcer at point of entry of bacterium |
| When does the chancre ulcer appear after infection | appears 10 days to 3 months post exposure |
| Where do you typically find the chancre ulcer | usually found on penis, vulva or vagina can occur on lips as well disappears in a few weeks w/o treatment |
| When would you typically not visualize the chancre ulcer with syphilis | when it is on the cervix, tongue or buccal mucosa |
| what is secondary syphilis marked by | T. Pallidum enters lymphatics and bloodstream disseminates throught the body and causes skin rash 2 to 8 weeks after exposure |
| Why do you need to be careful in touching the rash found in secondary syphilis | the lesions carry active bacteria |
| Where is the most common area to find the rash in secondary syphilis | on the palms of the hands and the soles of the feet |
| What are some other signs and symptoms of secondary syphilis that can cause it to be confused w other diseases | flulike sypmotms, mild fever, fatigue, headache, sore throat and lymphadenopathy patchy hairloss, condyloma lata in moist groin area |
| what is the latent stage of syphilis | disease enters a stage in which it is not contagious and there are no symptoms which can last 20-30yrs. 40% will enter late or tertiary syphilis |
| What are the final results of syphilis | mental illness, blindness, other neurological problems heart disease and death |
| What joint condition can you see in tertiary syphilis | charcot joint |
| What is neurosyphilis | when bacteria invades the nervous system |
| What are some s/sx associated with neurosyphilis | headaches, stiff neck, fever, seizures, strokes if blood vessels are involved. |
| Why is neurosyphilis viewed seperately from normal syphilis | neurosyphilis is harder to treat |
| how do you dx syphilis | recognize s/sx microscopic identification of syphilis bacteria blood tests |
| What type of microscopic technique will you use to identify syphilisq | darkfield microscopy |
| What blood test is done for syphilis | RPR, rapid plasma reagin |
| What is the confirmatory test for RPR | fluorescent treponemal antibody absorption or T. Palladium hemaglutination assay |
| Why most you perform a lumbar puncture on latent or late phase syphilis patients | need to check for neurosyphilis |
| What is the tx for syphilis | use IM penicillin or other antibiotic in case of PCN allergy |
| What is the followup protocol for syphilis treatment | serological tests should be repeated at 6,12 and 24 months to ensure tx was succesful |
| How can you prevent syphilis | avoid contact with sores and body fluids of infected persons use condoms during sex test and treat in early pregnancy to avoid neonatal syphilis |
| What will occur 25% of the time in a pregnant women infected w/ syphilis | They will miscarry, have stillbirth or neonatal death |
| What other STI will you test for in patients w/ syphilis infection | HIV |
| What is the organism that causes gonorrhea | neisseria gonorrhoeae gram negative diplococci found only in humans |
| what is the incubation period for gonorrhea | 2-5 days in males and 10 days in females |
| Do you get immunity from having gonorrhea before | no protection from previous infections and there is no vaccine available |
| What is the second most commonly reported notifiable disease in the US | Gonorrhea |
| what coinfection do you see with gonorrhea | C. Trachomatis |
| What are the clinical presentations of gonorrhea | purulent discharge for cervix/vagina or urethra vaginal itching, burning & irritation severe dysuria, urgency cervicitis-inflammed, swollen, friable urinary frequency pharyngitis anal GC conjunctivitis 85% of infected females are asymptomatic |
| How do you dx gonorrhea | Gram STain of discharge Thayer Martin Medium Culture-gold standard DNA hybridization Nucleic acid amplification assays-expensive serologic tests-expensive not clinically sig. |
| What are the tx guidlines for gonorrhea | use appropriate antibiotic treat for concomitant chlamydia, treat sexual partners. Have them abstain from sex for 7 days test for other STIs |
| Do you need to do followup testing w/ gonorhhea | no but rescreening in 2-3 months is beneficial (chance of reinfection) |
| what is the new form of gonorrhea that is becoming more prevalent | quinolone resistant N. Gonorrhoeae |
| What can hapen in untreated gonorrhea in pregnancy | preterm labor/delivery and premature rupture of membranes |
| what is the most reported infectious disease in the US | chlamydia |
| what is the pathogen that causes chlamydia | chlamydia Trachomatis |
| What are sequelae in women with chlamydia | PID, ectopic pregnancy and infertility |
| Why is chlymdia infection infection rate so high | often infection is asymptomatic |
| What else can chalmydia cause when you get perinatal transmission from mother to child or person to person transmission with flies as a vector | blindness |
| What is lymphogranuloma venereum | chronic lymphadenitis of femoral or inguinal nodes caused by a serotype of chlamydia |
| How do you dx chlamydia | women- urine or endocervix/vaginal swab men- urine or urethral swab rectal infections by rectal swab culture, direct immunoflourescence, EIA, nucleic acid hybridization test or NAATs |
| What should you test for when a patient tests + for chlamydia | test for other STIs |
| What patient education will you give to someone with chlamydia | no sex for 7 days after 1 time treatment or until finishing 7 day treatment no sex until partners are treated as well |
Created by:
smaxsmith
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