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?

    <p>Through oral, anal, or vaginal sex</p> Signup and view all the answers

    Who is at the greatest risk for chlamydia?

    <p>Young people with a cervix</p> Signup and view all the answers

    What is the gold standard diagnostic testing for Chlamydia?

    <p>Nucleic acid amplification test (NAAT)</p> Signup and view all the answers

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

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

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

    <p>Gonorrhea and Chlamydia can have similar symptoms</p> Signup and view all the answers

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

    <p>3 months after treatment</p> Signup and view all the answers

    Which antibiotic is commonly used in the treatment of chlamydia?

    <p>Azithromycin</p> Signup and view all the answers

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

    <p>Doxycycline</p> Signup and view all the answers

    What are the potential complications of untreated chlamydia?

    <p>PID, ectopic pregnancy, and infertility</p> Signup and view all the answers

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

    <p>Ectopic pregnancy in the mother</p> Signup and view all the answers

    Which of the following clinical signs is associated with chlamydia?

    <p>Milky white discharge on the cervix</p> Signup and view all the answers

    How is gonorrhea primarily transmitted?

    <p>Via unprotected sexual contact</p> Signup and view all the answers

    Which antibiotic is commonly used in the treatment of gonorrhea?

    <p>Ceftriaxone</p> Signup and view all the answers

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

    <p>Sepsis</p> Signup and view all the answers

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

    <p>Gram negative diplococci</p> Signup and view all the answers

    What is the causative agent of syphilis?

    <p>Treponema pallidum</p> Signup and view all the answers

    What is the common name for the bacteria Treponema pallidum?

    <p>The Great Imitator</p> Signup and view all the answers

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

    <p>Painless, round, and firm</p> Signup and view all the answers

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

    <p>The progression of the infection will continue</p> Signup and view all the answers

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

    <p>Non-pruritic body rash spread all over the body</p> Signup and view all the answers

    What is the diagnostic test for syphilis?

    <p>Fluorescent treponemal antibody absorption test (FTA-ABS) &amp; Treponema pallidum particle agglutination assay (TPPA)</p> Signup and view all the answers

    What is the screening test for syphilis?

    <p>Venereal Disease Research Lab (VDRL) &amp; Rapid Plasma Reagent (RPR)</p> Signup and view all the answers

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

    <p>Cardiovascular damage</p> Signup and view all the answers

    What is the characteristic feature of tertiary syphilis?

    <p>Gummatous lesions in organs</p> Signup and view all the answers

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

    <p>Tabes dorsalis (damage to CNS)</p> Signup and view all the answers

    One has complete immunity after having syphilis.

    <p>False</p> Signup and view all the answers

    What is the primary treatment for syphilis?

    <p>Single injection of long-acting Benzathine penicillin G</p> Signup and view all the answers

    What is the gold standard diagnostic testing for syphilis?

    <p>Darkfield microscopy</p> Signup and view all the answers

    How is genital herpes primarily transmitted?

    <p>Through contact with lesions or viral shedding</p> Signup and view all the answers

    What is the characteristic presentation of genital herpes?

    <p>Painful ulcers</p> Signup and view all the answers

    What is the causative agent of genital herpes?

    <p>HSV I</p> Signup and view all the answers

    What is the condition as seen in the photo?

    <p>Herpes</p> Signup and view all the answers

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

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

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

    <p>7-10 days</p> Signup and view all the answers

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

    <p>Famciclovir</p> Signup and view all the answers

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

    <p>HPV types 16 and 18</p> Signup and view all the answers

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

    <p>HPV types 6 and 11</p> Signup and view all the answers

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

    <p>HPV</p> Signup and view all the answers

    Which virus is prevented with the Gardasil-9 vaccine?

    <p>HPV</p> Signup and view all the answers

    What type of genetic material encodes the genes of HIV?

    <p>Single-stranded RNA</p> Signup and view all the answers

    Which type of virus is HIV?

    <p>Lentivirus (retrovirus)</p> Signup and view all the answers

    How is HIV not transmitted?

    <p>Ingesting contaminated food or water</p> Signup and view all the answers

    Which cells does HIV infect?

    <p>Cells expressing the CD4 antigen</p> Signup and view all the answers

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

    <p>11 years</p> Signup and view all the answers

    What is the initial screening test for HIV?

    <p>Enzyme linked immunosorbent assay (ELISA)</p> Signup and view all the answers

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

    <p>Western Blot test</p> Signup and view all the answers

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

    <p>13-64</p> Signup and view all the answers

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

    <p>25 days</p> Signup and view all the answers

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

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

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

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

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

    <p>Below 200</p> Signup and view all the answers

    In HIV patients, where is candidiasis most often seen?

    <p>Esophageal</p> Signup and view all the answers

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

    <p>Below 200</p> Signup and view all the answers

    What is the common treatment for Candidiasis?

    <p>Fluconazole</p> Signup and view all the answers

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

    <p>Fungus</p> Signup and view all the answers

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

    <p>Bilateral ground glass opacities</p> Signup and view all the answers

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

    <p>Wright-giemsa stain</p> Signup and view all the answers

    What is the diagnosis according to the X-ray?

    <p>PJP</p> Signup and view all the answers

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

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

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

    <p>Toxoplasmosis</p> Signup and view all the answers

    Which lesions of Kaposi Sarcoma are characteristic of the condition?

    <p>Non-blanching, purplish, papular</p> Signup and view all the answers

    What should be avoided to minimize the risk of toxoplasmosis?

    <p>Changing the cat's litter box</p> Signup and view all the answers

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

    <p>MAC</p> Signup and view all the answers

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

    <p>Retinitis</p> Signup and view all the answers

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

    <p>21 days</p> Signup and view all the answers

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

    <p>99%</p> 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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