MICROPARA FINALS

➢ Usually accompanied by dysuria,

CHAPTER 19: SEXUALLY TRANSMITTED dyspareunia, and vulvar irritation
INFECTION ○ TRICHOMONAS VAGINALIS — thin,
foamy, foul-smelling
Sexually transmitted infections (STI) ○ NEISSERIA GONORRHOEAE —
➢ Mostly caused by mixed infections and not greenish, purulent
just single organisms. ○ CANDIDA ALBICANS — thick, cheesy
○ The infections can be acquired exudates (milk curd-like appearance)
through: (1) unprotected sex URETHRAL DISCHARGE
(vaginal, oral, or anal) (2) skin to skin ➢ In males, any urethral discharge other than
contact with the genital area, (3) ejaculation is abnormal.
blood transfusion, or (4) perinatal Common STIs
transmission through transplacental SYPHILIS
transfer. ➢ Ranks third among the most common
Prevention and Control of Sexually Transmitted sexually transmitted diseases worldwide.
Infections ➢ It is caused by Treponema pallidum, a
➢ Practicing safe sex especially among spirochete with fine regular coils with
travelers. tapered ends.
➢ Correct use of condoms can lessen the ➢ It is a strict human pathogen.
chances of contracting STIs. ➢ It is sensitive to oxygen.
➢ Avoiding sharing of needles and razors as ➢ The organism cannot be grown in a cell-free
well as getting tattoos, body piercings, or culture medium.
acupuncture treatments also lessen the risk Modes of Transmission
of STI. Syphilis can be transmitted:
➢ Screening of blood donors is also being (1) through direct sexual contact;
implemented to prevent the contraction of (2) congenitally; and
STIs. (3) through blood transfusion.
Clinical Manifestations of STIs Clinical Findings
Skin Lesions 1. ADULT SYPHILIS
ULCERATIVE LESIONS PRIMARY SYPHILIS
a. CHANCRE — primary lesion of ➢ Highly infectious stage with abundant
syphilis; painless and well- organisms that can be isolated from the
delineated. ulcer.
b. CHANCROID — ulcer with ragged ➢ The primary lesion is called chancre which
edges; painful starts as a hard, painless papule that later
c. GENITAL HERPES — start as a vesicle becomes an ulcer with smooth or well-
that becomes an ulcer after rupture delineated borders.
GRANULOMATOUS REACTION — typical of ➢ Within 2 months, the ulcer heals
granuloma inguinale spontaneously even without treatment but
RASHES will continue to disseminate through the
➢ Commonly seen in secondary syphilis, blood and lymphatics and eventually
gonorrhea, and candidiasis progress to secondary syphilis.
WARTY LESIONS SECONDARY SYPHILIS
➢ Characteristics of condylomata acuminata ➢ Presents with flu-like symptoms,
and molluscum contagiosum. lymphadenopathy, and a generalized
Discharge mucocutaneous rash (including the palms
VAGINAL DISCHARGE and soles) which can be macular, papular,
or pustular.
MICROPARA FINALS
➢ The characteristic lesion is called ➢ Females are asymptomatic carriers of the
condyloma latum (plural: condylomata lata) infection.
which is a painless, wart-like lesion that is ➢ The risk after single exposure is higher in
highly contagious. females (50%) than in males (20%). It is
LATENT SYPHILIS caused by Neisseria gonorrhoeae, gram-
➢ The stage where the patient is clinically negative diplococci.
inactive or asymptomatic. Clinical Findings
➢ The patient may have reactivation of 1. Gonorrhea infection in males
secondary syphilis or may progress to ➢ Males are most often asymptomatic during
tertiary syphilis. the early stage of infection. The infection is
TERTIARY (LATE) SYPHILIS restricted to the urethra and manifests as
➢ Characterized by granulomatous skin purulent urethral discharge and dysuria.
lesions (summas) that are also found in 2. Gonorrhea infection in females
bones and other tissues as well as other ➢ The primary site of infection is the cervix.
organ involvement such as cardiovascular Women may manifest with purulent vaginal
syphilis (aortic aneurysm) or CNS discharge, dysuria, and abdominal pain.
involvement (neurosyphilis). 3. Disseminated infections
2. CONGENITAL SYPHILIS ➢ This occurs in 1%-3% of cases and present
EARLY CONGENITAL SYPHILIS as fever, migratory arthralgia, suppurative
➢ Right after birth, the infected newborn may arthritis of the wrists, knees, and ankles,
not present with any clinical manifestation. and pustules with erythematous base over
➢ Later the newborn may manifest with runny the extremities.
nose (snuffles), rash, and condylomata lata Laboratory Diagnosis
as well as hepatosplenomegaly. ➢ Gram-negative intracellular diplococci may
LATE CONGENITAL SYPHILIS be seen using microscopy.
➢ Manifested as 8th nerve deafness with ➢ Culture using modified Thayer-Martin
bone and teeth deformities (e.g., saddle medium as a selective medium allows the
nose, saber shins, Hutchinson's teeth, and growth of Neisseria only.
Mulberry or Moon's molars). Treatment and Prevention
Laboratory Diagnosis (1) CEFTRIAXONE, CIPROFLOXACIN, CEFICINE,
(1) DARK FIELD MICROSCOPY OR OFLOXACIN — For uncomplicated
(2) SEROLOGY gonorrhea
❖ Non-specific treponemal test - VDRL (2) DOXYCYCLINE or AZITHROMYCIN — For
(Venereal Disease Research Laboratory) and mixed infection with Chlamydia
RPR (Rapid Plasma Reagin) —
❖ Specific treponemal test - Fluorescent LYMPHOGRANULOMA VENEREUM (LGV)
Treponemal Antibody Absorption (FTA-ABS) ➢ LGV is caused by Chlamydia trachomatis,
Treatment and Prevention obligate intracellular bacteria that do not
PENICILLIN — Drug of choice have cell walls.
TETRACYCLINE or DOXYCYCLINE — Alternative ➢ The organism has a unique process of
drugs development involving two forms: the
— elementary bodies which are the
GONORRHEA metabolically-inactive infectious form and
➢ Second most common sexually transmitted reticulate bodies that are metabolically-
infection worldwide. It occurs only in active but non-infectious.
humans. Clinical Findings
➢ For it has no animal reservoir. 1. Urogenital tract infections
MICROPARA FINALS
➢ Most are asymptomatic. If symptomatic, it ➢ There are two types of HSV, type 1 and type
may manifest as cervicitis, endometritis, 2.
urethritis, salpingitis, bartholinitis, ➢ The virus is capable of latency in the
perihepatitis, and mucopurulent discharge. neurons hence the occurrence of recurrent
2. Lymphogranuloma venereum infections.
➢ A primary lesion appears at the site of Modes of Transmission
infection, either a papule or ulcer, which is ➢ The main mode of transmission is through
small, painless, and heals rapidly. oral secretions or sexual contact.
➢ The second stage is manifested by enlarged Clinical Findings
lymph nodes that are painful (buboes) and ➢ Genital herpes is caused by HSV types 1 and
ruptures to form draining fistulas. 2, but the majority of cases are caused by
Laboratory Diagnosis type 2
➢ The organism can be visualized using ➢ The lesions are seen in the vulva, vagina,
Giemsa-stained specimens obtained from cervix, or perianal area and are
scrapings from the lesion. accompanied by pruritus and mucoid
➢ Culture is the most specific diagnostic vaginal discharge.
method. Laboratory Diagnosis
Treatment and Prevention ➢ Tzanck smear and histopathologic
➢ Treatment of the infection involves giving of examination are done to demonstrate the
azithromycin, doxycycline, or characteristic cytopathologic effects that
erythromycin. includes Cowdry type A inclusions, syncytia
— formation, and ballooning of infected cells.
CHANCROID ➢ A more specific diagnostic test is PC or
➢ The etiologic agent is Haemophilus ducreyi, immunofluorescence.
a gram-negative coccobacillus. Treatment and Prevention
➢ Haemophilus means "blood-loving" and ➢ The drug of choice is acyclovir but it does
must be grown in a culture medium not prevent recurrences.
containing blood. —
Clinical Findings CONDYLOMATA ACUMINATA
CHANCROID ➢ Caused by the Human papillomavirus (HPV)
➢ Presented with a soft, painful papule with (serotypes 6 and 11).
an erythematous base that develops into an ➢ It is a DNA virus under the family of
ulcer with ragged edges associated with Papovaviruses that is transmitted through
inguinal lymphadenopathy. sexual contact.
Laboratory Diagnosis ➢ HPV is capable of immortalizing or
➢ Definitive diagnosis is made through culture transforming an infected cell leading to
on at least two kinds of enriched media malignancy (usually types 16 and 18).
containing vancomycin. Clinical Findings
Treatment and Prevention ➢ Genital warts or condylomata acuminata
➢ Antibiotics for treatment include occur most commonly in the genital or
cephalosporins, azithromycin, perianal areas.
erythromycin, or ciprofloxacin. Laboratory Diagnosis
— ➢ Histologic examination and Papanicolaou
GENITAL HERPES smear.
➢ Caused by Herpes Simplex Virus (HSV). It is Treatment and Prevention
a DNA virus under the family of Human ➢ Injection of interferon is the preferred and
Herpesviridae. most beneficial treatment.
—
MICROPARA FINALS
ACQUIRED IMMUNODEFICIENCY SYNDROME ➢ The infestation is highly contagious and
(AIDS) spreads easily. It is commonly seen in jails
➢ The virus possesses the enzyme reverse and sexually-active individuals.
transcriptase that allows it to integrate its Diagnosis
genome into the host cell's DNA. ➢ Identification of the parasite attached to
➢ It possesses a glycoprotein known as g$120 hair.
on its envelope that binds to the CD4+ Treatment and Prevention
receptor on helper T cells and ➢ Insecticidal creams, lotions, and shampoos
macrophages. that contain 1% malathion or permethrin
➢ Another envelope glycoprotein, g$41, may be used.
facilitates the adsorption of the virus to the
CD4+ T cells. CHAPTER 20: INFECTIONS OF THE URINARY
Modes of Transmission TRACT
(1) sexual
(2) parenteral (blood transfusion, tattooing, ear URINARY TRACT
piercing, injections) ➢ Usually protected from pathogenic
(3) transplacental contact. organisms by the frequent flushing action of
Clinical Findings urination and by the constant sloughing of
➢ The incubation period lasts from less than a the epithelium.
year to about 10 years where the patient is ➢ The acidity of normal urine also inhibits the
asymptomatic. growth of many microorganisms.
➢ Initially, patients present with flu-like or There are two routes by which bacteria can reach
infectious mononucleosis-like symptoms the kidneys:
accompanied by chronic diarrhea and (1) through the bloodstream
generalized lymphadenopathy. (2) ascending infection from the lower urinary tract
Laboratory Diagnosis — most common
(1) ENZYME-LINKED IMMUNOSORBENT ASSAY Predisposing Factors to UTI
(ELISA) 1. Gender - UTI is more common in females
(2) POLYMERASE CHAIN REACTION (PCR) especially school-aged girls and those above
— 60 years of age.
PEDICULOSIS PUBIS (PUBIC LICE OR CRABS) 2. Mechanical factors - catheterization, sexual
Etiologic Agent intercourse, kidney stones, and improper use of
Phthirus Pubis tampons and douches contribute to contracting
➢ Etiologic agent for pubic lice. The organism UTI.
is tiny, about 2 millimeters (mm) long, and 3. Metabolic disorders - increased sugar content of
visible to the naked eye. It is a parasitic urine, due to diabetes for instance, is conducive for
insect that feeds on the blood of the host. bacterial growth.
➢ The lice are primarily seen attached to the 4. Anatomic abnormalities of the urinary tract -
pubic hair and in coarse hairs found in other can lead to obstruction or incomplete voiding of
parts of the body like the chest, beard, urine or reflux of urine.
mustache, and armpits.
Mode of Transmission Etiology
Pediculosis Pubis A. Common etiologic agents
➢ Primarily spread through sexual contact. 1. Enterobacteriaccae - Escherichia coli (50%-80%
➢ On rare occasions, it is spread through of cases); Klebsiella pneumoniae
inanimate objects like towels, linens, or 2. Staphylococcus saprophyticus
clothes. 3. Enterococci (Enterococcus faecalis)
Clinical Findings
MICROPARA FINALS
4. Opportunistic pathogens - Pseudomonas, primarily from the hands of hospital
Proteus, Serratia personnel.
B. Less common etiologic agents STAPHYLOCOCCUS SAPROPHYTICUS
1. Bacteria - S. aureus, Corynebacterium, ➢ Gram-positive coccus and a common cause
Lactobacilli of urinary tract infections in sexually active
2. Yeast - Candida young women. It is a common colonizer of
3. Viruses - Adenovirus type 2 the urinary tract.
○ Cystitis — inflammation of the
ESCHERICHIA COLI urinary bladder. It is the most
➢ Gram-negative bacillus that is part of the common type of urinary tract
normal microbial flora of the human body, infection and is most commonly
specifically the colon hence, infections are caused by E. coli.
endogenous. ○ Urethritis — inflammation of the
➢ It is the most common cause of community- urethra.
acquired UTIs. ■ The organisms involved are
PROTEUS MIRABILIS usually sexually transmitted,
➢ Proteus mirabilis are gram-negative bacilli the common causes of which
that are members of the family are Neisseria gonorrhea and
Enterobacteriaceae. Chlamydia trachomatis
➢ The organism produces urease which (non-gonococcal urethritis or
causes alkalinization of urine, making the NGU).
patient more prone to development of ○ Pyelonephritis — inflammation of
urinary stones. kidneys
➢ It is the second most common cause of Clinical Manifestations
community-acquired UTI and is a major Lower Urinary Tract Infection
cause of nosocomial infections. Urethritis
SERRATIA SPP. ➢ Dysuria, frequency, urgency
➢ Gram-negative bacilli that belong to the Cystitis
family Enterobacteriaceae. ➢ Suprapubic pain and tenderness, frequency,
➢ These organisms are major entities in occasional hematuria
nosocomial infections. Almost all infections Urethrocystitis
caused by these organisms are associated ➢ May be asymptomatic; usually malodorous
with underlying disease. urine, especially in women; incontinence
➢ The organism produces a bright red Upper Urinary Tract Infection
pigment called prodigiosin which imparts a Acute Pyelonephritis
red color to the colonies. ➢ Flank pain, fever, and chills; hematuria; (+)
➢ The most frequently isolated species is kidney punch
Serratia marcescens.
ENTEROCOCCUS FAECALIS Diagnosis
➢ They grow in 6.5% NaC1 and are more URINALYSIS
resistant to penicillin G. Enterococcus ➢ One of the oldest clinical laboratory
faecalis is the most common among the procedures.
Enterococci. ➢ The diagnosis involves gross observation
➢ These are also frequent causes of and assessment of general appearance of
nosocomial infections, particularly in urine, dipstick analysis, and microscopic
intensive care units. Enterococci are examination of formed elements in urine.
transmitted from one patient to another URINE CULTURE
MICROPARA FINALS
➢ 100,000/mL or more — in a clean voided ➢ Manifestations of the infection include:
midstream specimen, there is significant ○ (1) eye irritation
bacteriuria. ○ (2) reddening of the conjunctiva
➢ less than 1,000 colonies/mL — this ○ (3) swelling of the eyelids
represents contamination. ○ (4) mucopurulent discharge
➢ between 1,000 and 100,000/mL — there is ○ (5) sensitivity to light (photophobia).
a single microbial species, this represents Etiologic Agents
possible or probable infection and the HAEMOPHILUS INFLUENZAE BIOGROUP
culture should be repeated. AEGYPTUS
Treatment ➢ (Koch-Weeks bacillus) is a gram-negative
➢ Culture and susceptibility testing are rod or coccobacillus.
important for pyelonephritis and ➢ It is associated with epidemics of acute,
complicated cases, and when the patient is purulent conjunctivitis that commonly occur
not responding to the antibiotic therapy. during the summer months.
➢ For uncomplicated infection with E. coli, the STREPTOCOCCUS PNEUMONIA
recommended drug of choice is ➢ Gram-positive diplococci, arranged in pairs
Trimethoprim-Sulfamethoxazole given 3-7 or short chains and are encapsulated.
days. ➢ The organism is alpha hemolytic when
➢ For infections with Proteus and grown aerobically and beta hemolytic when
Pseudomonas, Fluoroquinolone is the grown anaerobically.
antibiotic of choice. ➢ One side of the bacteria is slightly pointed
➢ In cases of acute pyelonephritis, assuming a "lancet-shape" appearance.
Fluoroquinolones or third generation ➢ The virulence can be attributed to adhesins
cephalosporins may be given for a period of on its surface, capsule, toxin pneumolysin,
3-10 days. and IgA protease.
CHLAMYDIA TRACHOMATIS
CHAPTER 21: INFECTIONS OF THE EYES ➢ Resembles gram-negative bacteria,
however, it does not have peptidoglycan in
Infections involving the eyes may be in the form of: its outer wall. The cell membrane has very
(1) conjunctivitis — inflammation or infection high lipid content.
involving the conjunctiva ○ CONJUNCTIVITIS “swimming pool
(2) keratitis — inflammation or infection involving conjunctivitis”— is usually acquired
the cornea through swimming in non-
(3) keratoconjunctivitis — inflammation or chlorinated or poorly chlorinated.
infection involving both the conjunctiva and the ○ INCLUSION CONJUNCTIVITIS —
cornea. infection in newborns; can be
Bacterial Infections acquired upon passage through the
BACTERIAL CONJUNCTIVITIS “pink eye” infected birth canal.
➢ Highly contagious ○ TRACHOMA — chronic
➢ The infection can be transmitted through: keratoconjunctivitis caused by
○ (1) human-to-human transmission serotypes A, B, Ba, and C; it is a
via contact with eye and respiratory leading cause of preventable
discharges. blindness in developing countries. It
○ (2) contaminated fingers can be transmitted eye-to-eye by
○ (3) fomites like clothing, facial droplet, fomites, and by eye-seeking
tissues, eye makeup, eye flies.
medications, and ophthalmic
instruments.
MICROPARA FINALS
NEISSERIA GONORRHOEAE MEASLES VIRUS
➢ Also known as gonococcus, is a common ➢ Conjunctivitis is only one of the classical
cause of sexually transmitted diseases. manifestations of Rubeola observed in
➢ It can cause a neonatal infection known as children.
OPHTHALMIA NEONATORUM, which is ➢ It is also associated with photophobia or
acquired upon passage through the infected sensitivity to light.
birth canal.
Viral Infections QUESTIONS
➢ Eye infections due to viruses may also take CHAP 19
the form of conjunctivitis, keratitis, or Case: A 32-year old seaman consulted a local hospital
keratoconjunctivitis. because of a hard, painless nodule over the inferior
aspect of his penis. There is no other manifestation. The
➢ The infection is highly contagious and can
patient allegedly had unprotected sexual contact with a
spread through airborne means like
sex worker while he was abroad.
sneezing and coughing.
1. The most probable diagnosis is:
➢ The infection is self-limited. a. Chancroid
➢ Clinically, viral conjunctivitis differs from c. Genital herpes
bacterial conjunctivitis in that there is no b. Lymphogranuloma venereum
purulent eye discharge. d. Syphilis
Etiology 2. Condyloma latum is seen in which stage of the
ADENOVIRUSES infection?
➢ Double stranded DNA viruses. a. Primary
➢ A unique characteristic of these viruses is c. Latent
b. Secondary
the fiber that projects from each penton
d. Tertiary
base.
3. Late syphilis is associated with the following EXCEPT:
➢ The fiber functions for attachment and acts
a. Snuffles
as hemagglutinin. c. Saber shin
➢ Latent in the adenoids and tonsillar tissues b. Hutchinson's teeth
and have affinity to mucous epithelium of d. Mulberry molars
the conjunctiva. 4. Patients with full blown AIDS die of complications.
➢ The virus is resistant to mild chlorination. The most common cause of death is pneumonia due to
ENTEROVIRUS 70 AND COXSACKIE A24 VIRUS which of the following organisms?
➢ Causes acute hemorrhagic conjunctivitis, a a. Streptococcus pneumoniae
highly contagious eye infection. c. Staphylococcus aureus
➢ The infection is characterized by b. Pneumocystis jiroveci
d. Haemophilus influenzae
conjunctival congestion, vascular dilatation,
5. Which of the following sexually transmitted infections
and onset of edema. There is no available
is caused by gram-negative diplococci described as
treatment.
coffee bean-shaped?
HERPES SIMPLEX VIRUS a. Chancroid
Herpes simplex virus type 1 b. Gonorrhea c-pp
➢ Causes severe keratoconjunctivitis and c. Candidiasis
recurrences are common, which may d. Lymphogranuloma venereum
present as dendritic keratitis and corneal 6. Human papillomavirus serotypes most commonly
ulcers which may lead to blindness. HSV associated with malignant
type 1 is the second leading cause of transformation are:
blindness in the United States. a. Serotypes 1, 2, 3, and 4
b. Serotypes 6 and 11
c. Serotypes 16 and 18
d. B and C
MICROPARA FINALS
7. Which of the following is correct regarding genital b. Proteus spp.
herpes? 5. Which of the following common causes of UTI
a. The most common cause is Herpes simplex virus type produces red pigment?
1. a. Staphylococcus aureus
b. It is characterized by pruritic vesicular lesions. c. Pseudomonas aeruginosa
c. Draining lymph nodes are often seen in most patients. b. Candida albicans
d. Purulent vaginal discharge is a distinctive d. Serratia marcescens
manifestation. 6. Females are more prone to UTI because:
8. The following sexually transmitted diseases may a. Women have shorter urethra
present with skin fashes EXCEPT: b. Close proximity of the urethra to the anus
a. Secondary syphilis c. Women have monthly menstruation
c. Candidiasis d. A and B
b. Gonorrhea e. A, B, and C
d. Chancroid 7. The most common cause of non-gonococcal
9. The HIV receptor that binds with the CD4 T cells of urethritis.
the host is a. E. coli
a. gp120 c. P. vulgaris
c. p24 b. C. trachomatis
b. gp41 d. P. aeruginosa
d. p17 8. The organism which is a common cause of UTI in
10. Sexually transmitted disease that is caused by a sexually active young women.
parasite: a. E. coli
a. Candidiasis b. S. epidermidis
c. Pediculosis c. S. saprophyticus
b. Syphilis d. Klebsiella
d. Chlamydia 9. Fever, chills, flank pains, and positive kidney punch
CHAP 20 are suggestive of:
Case: A 28-year old housewife consulted a physician a. Cystitis
because of scanty urine, increased frequency of c. Pyelonephritis
urination, and burning sensation at the end of urination. b. Urethritis
Urinalysis showed numerous bacteria, white blood cells, d. Urethrocystitis
and pus cells. Diagnosis is Urinary Tract Infection. 10. Which of the following is correct about urinary tract
1. The most common cause of UTI in humans. infections?
a. S. aureus a. It is least likely caused by indigenous flora of the
c. E. coli human body.
b. K. pneumoniae b. UTI must always be treated with antibiotics.
d. Serratia c. Infections are always the result of trauma to the
2. Urine culture colony count of more than 100,000/m L urinary tract.
urine is indicative of: d. Organisms may reach the kidneys through the
a. Probable infection bloodstream.
c. Significant bacteriuria CHAP 21
b. Contamination Case: A 10-year old boy scout is experiencing a fever,
d. None of the above sore throat, and redness of the eyes after participating
3. The most common method of urine collection. in a 3-day camping activity. He was diagnosed
a. Catheterization with acute
b. Midstream catch early morning urine pharyngoconjunctival fever.
c. Suprapubic aspiration 1. The most common cause of this eye infection is:
d. None of the above a. Herpes simplex virus
4. Which of the following bacteria is associated with b. Enterovirus 70
stone formation? c. Coxsackie A24
a. E. coli d. Adenovirus
c. Serratia spp. 2. Which of the following is correct regarding the
d. Enterococcus faecalis causative agent for the above case?
MICROPARA FINALS
a. The causative agent is a single stranded DNA virus. b. Neisseria gonorrhoeae
b. It possesses fibers attached to penton bases. d. Streptococcus pneumonia
c. It is easily destroyed by chlorination.
d. It is latent in the neurons.
3. Which of the following is correct regarding epidemic
keratoconjunctivitis due to adenovirus?
a. The most common causes are serotypes 6 and 11.
b. It is associated with dendritic keratitis.
c. It leaves residual corneal opacities.
d. It is the most common cause of blindness.
4. Acute hemorrhagic conjunctivitis is caused by which
of the following viruses?
a. Enterovirus 70
d. A and B
b. Coxsackie A24
e. A, B, and C
c. Adenoviruses
5. A common cause of purulent conjunctivitis that may
be transmitted through gnats.
a. Chlamydia trachomatis
c. Streptococcus pneumonia
b. Haemophilus aegyptius
d. Neisseria gonorrhoeae
6. The mode of transmission of ophthalmia
neonatorum.
a. Through traumatic inoculation
b. Upon passage through infected birth canal
c. Through fomites
d. From aerosolized organism
7. Which of the following is correct regarding C.
trachomatis?
a. It has no peptidoglycan in its outer wall.
b. It is sensitive to sulfonamides.
c. It is an obligate intracellular parasite.
d. A and B
e. A, B, and C
8. The second most common cause of blindness in the
US which is characterized by dendritic keratitis and
corneal ulcerations.
a. C. trachomatis
b. HSV type 1
c. Adenovirus
d. N. gonorrhoeae
9. Which of the following is NOT a manifestation of viral
conjunctivitis?
a. Redness
c. Purulent discharge
b. Swelling
d. Photophobia
10. Which of the following organisms possesses
glycogen-filled vacuoles?
a. Chlamydia trachomatis
c. Haemophilus aegyptius