STIs for Quiz 2

Neisseria Gonorrheae:

  • What diseases can this cause?
  • Gonorrhea
  • Gonococcal Urethritis
  • Cervicitis
  • PID
  • What type of organism is this?
  • Capnophilic, Facultative Intracellular, Gram Negative, Diplococcus
  • Kidney Bean Shaped
  • Is this considered an STI?
  • Yes
  • What are the Virulence Factors?
  • LOS – Lipid A with no O Antigen
  • Can cause Arthritis in Disseminated Cases
  • Pili with Antigenic Variation
  • Outer Membrane Proteins
  • IgA Proteases
  • Lacks a Capsule
  • Is this found more often in Men or Women?
  • Men – Women are asymptomatic
  • What would you see on a Gram Stain?
  • Mostly intracellular bacterial, but some extracellular.
  • Pink – Gram Negative Bacteria
  • How would you culture this?
  • Thayer Martin/NYC Agar  Selective and Nutritive Medium for Neisseria Species (Specialized Chocolate)
  • What other diagnostic properties do you see with this?
  • Oxidase Positive
  • Catalase Positive
  • Glucose Fermentation
  • How is the discharge characterized?
  • Thick, Mucopurulent Discharge.
  • Do we worry about transmission to Neonates?
  • Yes
  • How would you treat this?
  • Cephalosporins (Ceftriazone + Azithromycin)
  • There is widespread resistance.

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Clamydia Trachomatis:

  • What diseases can this cause?
  • Non-Gonococcal Urethritis
  • Cervicitis
  • PID
  • What type of organism is this?
  • Obligate Intracellular Bacteria (cannot make ATP)
  • Is this considered an STI?
  • Yes
  • What are the two forms that it has?
  • Elementary Body (EB) – Infection
  • Reticulate Body (RB) – Replication
  • What strains cause the specific diseases listed above?
  • Strains D-K
  • Is it found more in Men or Women?
  • Men
  • What would you see on a Gram Stain?
  • Nothing – cannot be Gram Stained
  • How could this be diagnosed?
  • Wet Prep Microscopy
  • Inclusion Bodies
  • DFA
  • Cell Culture
  • McCoy Cells
  • NAAT
  • How is the discharge characterized?
  • Thin, Mucopurulent Discharge
  • Friable Cervix
  • Do we worry about transmission to Neonates?
  • Yes

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UreaplasmaUrealyticum:

  • What diseases can this cause?
  • Non-GonococcalUrethreitis
  • What type of organism is this?
  • Cell Wall-Less Bacteria (Mycoplasma)
  • Is this considered an STI?
  • No – overgrowth
  • Is it found more in Men or Women?
  • Men
  • What is unique about the diagnosis of Ureaplasma?
  • It is a Diagnosis of Exclusion, meaning that you first test and exclude for Clamydia and Gonorrhea, and this is all that is left.
  • What would you see on a Gram Stain?
  • Nothing – cannot be Gram Stained
  • How do you culture this?
  • Using A8 Agar.
  • Because it is Urease Positive, it forms Brown Colonies in the Agar.
  • This agar is used because Mycoplasma need a lot of Cholesterol to grow.
  • How is the discharge characterized?
  • Thin, Mucopurulent Discharge
  • Are we worried about transmission to Neonates?
  • No

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TrichomonasVaginalis:

  • What diseases can this cause?
  • Vaginitis
  • What type of organism is this?
  • Protozoan with no Cyst Form
  • Fermentative
  • Motile
  • It is found more in Men or Women?
  • Women
  • What is a Risk Factor in Women?
  • Basic Vaginal pH
  • Is this considered an STI?
  • Yes
  • How do you diagnose this?
  • Wet Prep with Motile Trophozoites
  • Immunofluorescent Staining
  • NAATS
  • How do you treat this?
  • Metronidazole or Tinidazole – both are Prodrugs
  • How is the discharge characterized?
  • Frothy Discharge
  • How does it present clinically?
  • Strawberry Cervix – Capillary Dilation with Petechial Hemorrhages on Cervix
  • Are we worried about transmission to Neonates?
  • Yes

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Candida Albicans:

  • What diseases can this cause?
  • Vaginitis
  • What type of organism is this?
  • Yeast (Fungus)
  • Is it found more in Men or Women?
  • Women
  • What is a Risk Factor in Women?
  • Basic Vaginal pH.
  • Diabetic
  • Is this considered an STI?
  • No – overgrowth of Normal Flora
  • How do you diagnose this?
  • Wet Prep – KOH
  • Pseudohyphae/Germ Tubes if mixed with serum
  • How is this discharge characterized?
  • Curd-Like Discharge

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GardenerallaVaginalis:

  • What diseases can this cause?
  • Vaginosis
  • What type of organism is this?
  • Gram Variable Pleomorphic Rod
  • What are the Virulence Factors?
  • Vaginolysin (Pore Forming, Quorum Sensing)
  • Is this considered an STI?
  • No – Overgrowth
  • What is a Risk Factor in Women?
  • Basic Vaginal pH
  • How do you diagnose this?
  • Wet Prep
  • Clue Cells – Bacterial are speckled on Epithelial Cells
  • Whiff Test – Fishy Odor – KOH
  • How is the discharge characterized?
  • Thin, White, Milky Discharge

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HemophilusDucreyi:

  • What is the Clinical Disease associated with this organism?
  • Chancroid
  • What type of organism is this?
  • Gram Negative Rod
  • What are some Virulence Factors?
  • Cytolethal Distending Toxin (T-Cell Toxin)
  • Pili
  • How are the ulcers characterized?
  • Painful, Soft Genital Ulcers
  • Is this considered an STI?
  • Yes
  • What are some Risk Factors?
  • Endemic in Africa, Asia, Latin America India
  • How do you diagnose this?
  • NAAT
  • Culture is difficult
  • How do you treat this?
  • Azithromycin
  • Ciprofloxacin

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KlebsiellaGranulomatis:

  • What is the Clinical Disease associated with this?
  • Granuloma Inguinale
  • Donovanosis
  • What type of organism is this?
  • Facultative Intracellular Gram Negative Ros
  • What is the Virulence Factor?
  • Capsule
  • How are the ulcers characterized?
  • Painless, Bright/Beefy Red, Bleed Easily
  • What are some Risk Factors?
  • Endemic in Caribbean, New Guinea, South American, and Africa
  • How do you diagnose this?
  • Donovan Bodies on Wet Prep (Bipolar Staining Intracellular Rods)