HIV and Other STIs

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Questions and Answers

What is the causative agent of Chlamydia?

Streptococcus agalactiae

Chlamydia trachomatis (correct)

Neisseria gonorrhoeae

Treponema pallidum

What is the morphology of Chlamydia?

Gram negative spirochete

Gram negative coccobacillus (correct)

Gram positive bacillus

Gram positive cocci

Which sexually transmitted infection is most frequently reported in the USA?

Trichomoniasis

Syphilis

Gonorrhea

Chlamydia (correct)

How is Chlamydia primarily transmitted?

Through oral, anal, or vaginal sex Signup and view all the answers

Who is at the greatest risk for chlamydia?

Young people with a cervix Signup and view all the answers

What is the gold standard diagnostic testing for Chlamydia?

Nucleic acid amplification test (NAAT) Signup and view all the answers

From which of the following can a specimen be collected for Chlamydia testing?

Discharge from the cervix, urethra, penis, anus, throat, or urine Signup and view all the answers

Why is testing for gonorrhea done at the same time as chlamydia?

Gonorrhea and Chlamydia can have similar symptoms Signup and view all the answers

What is the recommended timing for retesting for chlamydia after treatment?

3 months after treatment Signup and view all the answers

Which antibiotic is commonly used in the treatment of chlamydia?

Azithromycin Signup and view all the answers

What is the alternative antibiotic used in the treatment of chlamydia if someone is allergic to azithromycin?

Doxycycline Signup and view all the answers

What are the potential complications of untreated chlamydia?

PID, ectopic pregnancy, and infertility Signup and view all the answers

What is a potential risk factor associated with chlamydia during pregnancy?

Ectopic pregnancy in the mother Signup and view all the answers

Which of the following clinical signs is associated with chlamydia?

Milky white discharge on the cervix Signup and view all the answers

How is gonorrhea primarily transmitted?

Via unprotected sexual contact Signup and view all the answers

Which antibiotic is commonly used in the treatment of gonorrhea?

Ceftriaxone Signup and view all the answers

What is the potential life-threatening complication associated with disseminated gonorrhea?

Sepsis Signup and view all the answers

What is the morphology of Neisseria gonorrhea, the bacterium causing gonorrhea?

Gram negative diplococci Signup and view all the answers

What is the causative agent of syphilis?

Treponema pallidum Signup and view all the answers

What is the common name for the bacteria Treponema pallidum?

The Great Imitator Signup and view all the answers

Which of the following best describes the characteristic of the initial primary lesion in syphilis?

Painless, round, and firm Signup and view all the answers

If the chancre heals but the syphilis infection is left untreated, what will happen?

The progression of the infection will continue Signup and view all the answers

Which of the following is a characteristic feature of secondary syphilis?

Non-pruritic body rash spread all over the body Signup and view all the answers

What is the diagnostic test for syphilis?

Fluorescent treponemal antibody absorption test (FTA-ABS) & Treponema pallidum particle agglutination assay (TPPA) Signup and view all the answers

What is the screening test for syphilis?

Venereal Disease Research Lab (VDRL) & Rapid Plasma Reagent (RPR) Signup and view all the answers

Which of the following internal organ damages is most commonly associated with tertiary syphilis?

Cardiovascular damage Signup and view all the answers

What is the characteristic feature of tertiary syphilis?

Gummatous lesions in organs Signup and view all the answers

Which of the following neurological manifestations is associated with tertiary syphilis?

Tabes dorsalis (damage to CNS) Signup and view all the answers

One has complete immunity after having syphilis.

False Signup and view all the answers

What is the primary treatment for syphilis?

Single injection of long-acting Benzathine penicillin G Signup and view all the answers

What is the gold standard diagnostic testing for syphilis?

Darkfield microscopy Signup and view all the answers

How is genital herpes primarily transmitted?

Through contact with lesions or viral shedding Signup and view all the answers

What is the characteristic presentation of genital herpes?

Painful ulcers Signup and view all the answers

What is the causative agent of genital herpes?

HSV I Signup and view all the answers

What is the condition as seen in the photo?

Herpes Signup and view all the answers

What is the recommended dosage of valacyclovir for the treatment of herpes?

1000mg taken twice daily for 7-10 days Signup and view all the answers

What is the treatment duration for acyclovir in the management of herpes?

7-10 days Signup and view all the answers

Which medication is prescribed at a dosage of 250mg three times daily for the treatment of herpes?

Famciclovir Signup and view all the answers

Which types of HPV are responsible for the majority of HPV-caused cancers?

HPV types 16 and 18 Signup and view all the answers

Which types of HPV are responsible for the majority of HPV-caused genital warts?

HPV types 6 and 11 Signup and view all the answers

In the USA, what is the most common sexually transmitted infection?

HPV Signup and view all the answers

Which virus is prevented with the Gardasil-9 vaccine?

HPV Signup and view all the answers

What type of genetic material encodes the genes of HIV?

Single-stranded RNA Signup and view all the answers

Which type of virus is HIV?

Lentivirus (retrovirus) Signup and view all the answers

How is HIV not transmitted?

Ingesting contaminated food or water Signup and view all the answers

Which cells does HIV infect?

Cells expressing the CD4 antigen Signup and view all the answers

What is the median time to development of AIDS without treatment for HIV?

11 years Signup and view all the answers

What is the initial screening test for HIV?

Enzyme linked immunosorbent assay (ELISA) Signup and view all the answers

Which of the following tests is used to confirm HIV infection after a positive ELISA test?

Western Blot test Signup and view all the answers

What is the recommended age group for HIV screening according to CDC?

13-64 Signup and view all the answers

What is the average time for an HIV antibody test to show as positive?

25 days Signup and view all the answers

What is the primary components of antiretroviral therapy (ART) for HIV?

Two nucleoside reverse-transcriptase inhibitors (NRTIs) plus an HIV protease inhibitor (PI) Signup and view all the answers

What is the impact of antiretroviral therapy (ART) on morbidity and mortality in HIV patients?

Morbidity and mortality fell by more than 80% with ART Signup and view all the answers

What CD4 level indicates the development of AIDS in HIV patients?

Below 200 Signup and view all the answers

In HIV patients, where is candidiasis most often seen?

Esophageal Signup and view all the answers

At what CD4 count is candidiasis usually observed in HIV patients?

Below 200 Signup and view all the answers

What is the common treatment for Candidiasis?

Fluconazole Signup and view all the answers

Which organism is responsible for causing Pneumocystis jirovecii pneumonia (PJP)?

Fungus Signup and view all the answers

What does a chest radiograph show in a clinical diagnosis for PJP?

Bilateral ground glass opacities Signup and view all the answers

Which stain or test is used for the definitive diagnosis of PJP?

Wright-giemsa stain Signup and view all the answers

What is the diagnosis according to the X-ray?

PJP Signup and view all the answers

What is the recommended dosage of Trimethoprim/sulfamethoxazole (TMP-SMX) for the treatment of PJP?

2 DS tabs every 8 hours for 10-21 days Signup and view all the answers

What is the most common space-occupying CNS lesion in HIV-infected persons?

Toxoplasmosis Signup and view all the answers

Which lesions of Kaposi Sarcoma are characteristic of the condition?

Non-blanching, purplish, papular Signup and view all the answers

What should be avoided to minimize the risk of toxoplasmosis?

Changing the cat's litter box Signup and view all the answers

In late-stage HIV patients, which opportunistic infection is most commonly associated with a low CD4 count <50?

MAC Signup and view all the answers

What is the most common progression of Cytomegalovirus (CMV) infection?

Retinitis Signup and view all the answers

What is the recommended treatment duration for Cytomegalovirus (CMV) with oral valganciclovir?

21 days Signup and view all the answers

What is the effectiveness of pre-exposure prophylaxis (PREP) in preventing HIV transmission by sex?

99% Signup and view all the answers

Study Notes

Chlamydia

Causative agent is Chlamydia trachomatis.
Morphology: Gram-negative bacterium, typically appearing as small, spherical, and intracellular.
Most frequently reported sexually transmitted infection (STI) in the USA.
Primarily transmitted through sexual contact.
Highest risk groups include sexually active young individuals, particularly those aged 15-24.
Gold standard diagnostic testing is nucleic acid amplification test (NAAT).
Specimens can be collected from urine, cervical swabs, urethral swabs, or rectal swabs.
Gonorrhea testing is conducted simultaneously due to the high co-infection rate with Chlamydia.
Retesting is recommended three months after treatment.
Commonly used antibiotic for treatment is Azithromycin.
Alternative antibiotic for those allergic to Azithromycin is Doxycycline.
Potential complications of untreated Chlamydia include pelvic inflammatory disease (PID), infertility, and chronic pain.
During pregnancy, it can lead to adverse outcomes such as preterm birth and conjunctivitis in newborns.
Clinical signs include abnormal discharge and pelvic pain.

Gonorrhea

Primarily transmitted through sexual contact.
Commonly treated with Ceftriaxone.
Life-threatening complication associated with disseminated gonorrhea includes septic arthritis.
Neisseria gonorrhoeae, the causative agent, has a Gram-negative cocci morphology.

Syphilis

Causative agent is Treponema pallidum.
Commonly referred to as the "kissing disease."
The initial primary lesion (chancre) is typically painless and firm.
If the chancre heals without treatment, the infection can progress to secondary syphilis.
Characteristic feature of secondary syphilis includes rash and lymphadenopathy.
Diagnostic test for syphilis is the Rapid Plasma Reagin (RPR) test.
Screening test recommended is the Venereal Disease Research Laboratory (VDRL) test.
Tertiary syphilis is associated with damage to the cardiovascular and nervous systems.
Characteristic feature of tertiary syphilis includes gummas (granulomatous lesions).
Neurological manifestations in tertiary syphilis can include tabes dorsalis.
No immunity is developed post syphilis infection.
Primary treatment of syphilis is Penicillin.
Gold standard diagnostic testing is the Treponemal test.

Genital Herpes

Primarily transmitted through skin-to-skin contact during active outbreaks.
Characteristic presentation includes painful blisters or ulcers in the genital area.
Causative agent is the Herpes Simplex Virus (HSV), mainly HSV-2.
Recommended dosage of Valacyclovir for treatment is 1 gram twice daily.
Treatment duration for Acyclovir is typically 7-10 days.
Medication commonly prescribed at 250 mg three times daily is Acyclovir.

Human Papillomavirus (HPV)

High-risk types linked to majority of HPV-caused cancers are HPV 16 and 18.
Types responsible for the majority of genital warts are HPV 6 and 11.
Most common STI in the USA.
Gardasil-9 vaccine prevents certain HPV strains.

Human Immunodeficiency Virus (HIV)

Genetic material encoded in RNA.
HIV is a retrovirus.
Not transmitted through saliva, urine, or sharing food.
Primary target cells include CD4 T-lymphocytes.
Median time to development of AIDS without treatment is about 10 years.
Initial screening test for HIV is the Enzyme-Linked Immunosorbent Assay (ELISA).
Confirmatory test after a positive ELISA is the Western blot test.
CDC recommends HIV screening for individuals aged 13-64 years.
Average time for an HIV antibody test to become positive is 3-12 weeks.
Primary components of antiretroviral therapy (ART) include a combination of nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs).
ART significantly reduces morbidity and mortality in HIV patients.
CD4 count below 200 cells/mm³ indicates the development of AIDS.
Candidiasis is most often observed in the oral cavity or esophagus at low CD4 counts (typically below 200).
Common treatment for candidiasis includes fluconazole.

Opportunistic Infections in HIV

Pneumocystis jirovecii pneumonia (PJP) is caused by Pneumocystis jirovecii organism.
Chest radiographs typically show bilateral interstitial or alveolar infiltrates in PJP.
Definitive diagnosis of PJP is made through Giemsa or Gomori's methenamine silver (GMS) stain.
Recommended dosage of Trimethoprim/sulfamethoxazole (TMP-SMX) for PJP treatment is 15-20 mg/kg/day.
Most common CNS lesion in HIV-infected individuals is primary CNS lymphoma.
Lesions of Kaposi Sarcoma appear as violaceous, raised lesions on the skin.
To minimize the risk of toxoplasmosis, avoid undercooked meat and exposure to cat feces.
Low CD4 count (<50) is commonly associated with disseminated opportunistic infections like PJP and CMV.
Common progression of Cytomegalovirus (CMV) infection is retinitis leading to vision loss.
Recommended treatment duration for CMV with oral Valganciclovir is typically 3-6 weeks.

HIV Prevention

Pre-exposure prophylaxis (PrEP) is highly effective in reducing HIV transmission risk associated with sex.

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