Micobiology GU – Flashcards
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| Acidic pH of vagina |
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| Defense of female reproductive system |
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| SIgA |
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| Defense of female reproductive system |
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| Flushing action of urine |
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| Defense of urinary tract |
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| Shedding of epithelial cells lining the urinary tract |
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| Defense of urinary tract |
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| Acidity of urine |
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| Defense of urinary tract |
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| Lysozyme and lactoferrin in urine |
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| Defense of urinary tract |
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| SIgA |
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| Defense of urinary tract |
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| Normal biota of the male urethra and genital tract |
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| Nonhemolytic Streptococci |
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| Normal biota of the male urethra and genital tract |
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| Staphylococci |
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| Normal biota of the male urethra and genital tract |
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| Corynebacteria |
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| Normal biota of the male urethra and genital tract |
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| Lactobacillus |
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| Only anatomic areas of normal flora of the female genital tract |
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| Anterior urethra and vagina |
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| Flora of the vagina depends on these factors |
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| Age, pH, hormonal levels |
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| Greatly influences normal flora of the vagina |
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| Estrogen |
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| In utero, the fetal vagina contains these bacteria |
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| None |
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| How does a new born vagina acquire normal flora |
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| Hands of caregivers, infants feces |
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| In the first six weeks of life estrogens are present in the infant vagina, what normal flora predominates |
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| Lactobacillus |
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| In the absence of estrogen (pre puberty years) this bacteria is present as normal flora of the vagina |
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| Staphylococci |
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| In the absence of estrogen (pre puberty years) this bacteria is present as normal flora of the vagina |
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| Streptococci |
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| In the absence of estrogen (pre puberty years) this bacteria is present as normal flora of the vagina |
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| Enterobacteriaceae |
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| After menarche (in the presence of estrogen) the vagina is dominated by this normal flora |
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| Lactobacillus |
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| After menarche (in the presence of estrogen) the vagina is dominated by this normal flora |
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| Gram (+) and gram (-) anaerobes and facultative anaerobes |
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| After menopause (absence of estrogen) this bacteria decreases in numbers |
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| Lactobacillus |
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| May lead to UTI's in the anterior urethra of a female |
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| Lactobacillus |
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| May lead to UTI's in the anterior urethra of a female |
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| Streptococci |
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| May lead to UTI's in the anterior urethra of a female |
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| Staphylococci |
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| May lead to UTI's in the anterior urethra of a female due to fecal spread |
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| Enterobacteriaceae |
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| May lead to UTI's in the anterior urethra of a female due to fecal spread |
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| Enterococcus |
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| UTI infecting the bladder |
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| Cystitis |
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| UTI infecting the kidney |
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| pyelonephritis |
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| UTI infecting the urethra |
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| Urethritis |
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| UTI leading to a burning pain with urination |
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| dysuria |
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| Cloudy urine is consistent with presence of |
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| WBC |
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| Orange urine is consistent with presence of |
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| RBC |
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| Back pain is consistent with a UTI infecting this organ |
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| Kidney |
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| If pyelonephritis is inadequately treated it can lead to |
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| Septicemia |
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| Most common causative agent of UTI |
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| Escherichia coli |
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| Catalase (+) causative agent of UTI |
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| Staphylococcus saprophyticus |
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| Urease (+) causative agent of UTI, member of Enterobacteriaceae |
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| Proteus mirabilis |
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| Community acquired UTIs are usually a result of this form of transmission |
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| Endogenous |
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| UTIs are more common in women than men do to this anatomical feature of the urethra |
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| Shorter length of female urethra |
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| UTIs are more common in women than men do to the location of these anatomical structures |
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| Close proximity of anus and urethral opening |
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| Recurrent UTIs in some women are do to E coli invading deeper tissues of the urinary tract allowing for this |
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| Avoidance of antibiotics |
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| Most common nosocomial infection |
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| UTI |
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| Treatment for UTI includes antibiotics plus ____ to control burning and urgency |
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| Pyridium |
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| Bacteria causing Weils disease |
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| Leptospira interrogans |
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| Long Gram -, spirochetes with hooked ends |
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| Leptospira interrogans |
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| Invasion is via mucosa or broken skin, there is no lesion at site of entry, may lead to severe systemic disease |
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| Leptospira interrogans |
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| Generalized infection may lead to systemic infection including: renal and hepatic failure, extensive vasculitis, myocarditis, and death. Invasion of CNS leads to meningitis |
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| Leptospira interrogans |
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| Symptoms including fever with relapses, Jaundice may occur in severe cases with renal failure being the most common cause of death |
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| Leptospira interrogans |
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| Worldwide zoonotic disease with a variety of hosts. Rodents (mainly rats) can shed the bacteria their entire lives through urine |
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| Leptospira interrogans |
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| In the US rats, dogs, farm animals are the major source of human infection. Bacteria are discharged through urine and transmitted to humans via infected soil, water, and food |
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| Leptospira interrogans |
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| Organisms can survive for months in water or wet soils, no person to person transmission has been documented |
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| Leptospira interrogans |
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| Culture and microscopy are insensitive, main form of diagnosis is through microscopic agglutination using the patients serum and live bacteria |
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| Leptospira interrogans |
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| Treatment includes antibiotics, there is a vaccine available but only targets specific strains used primarily for the military |
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| Leptospira interrogans |
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| Vaginal itching, burning, inflammation |
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| Vaginitis |
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| Vaginal itching, burning, discharge |
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| Vaginosis |
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| Most common cause of vaginosis |
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| BV |
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| Gram +, but appears gram - |
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| Gardnerella vaginalis |
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| Increased prevalence indicates a role in BV but not a sole etiologic agent |
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| Gardnerella vaginalis |
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| Gram +, thought to maintain acidic pH by metabolism of glucose |
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| Lactobacillus crispatus, Lactobacillus jensenii |
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| In females with BV these bacteria are replaced by Gardnerella vaginalis and other anaerobic flora |
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| Lactobacillus crispatus, Lactobacillus jensenii |
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| No gram reaction, higher incidence in women with BV |
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| Mycoplasma hominis |
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| Gram +, obligate anaerobe, very high incidence in women with BV |
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| Mobiluncus |
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| Gram -, obligate anaerobe, higher incidence in women with BV |
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| Fusobacterium |
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| This bacteria uses lactic acid production (low pH) and production of H2O2 (high oxidation-reduction) to inhibit overgrowth of less desirable anaerobic vaginal flora from causing vaginosis |
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| Lactobacillus |
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| Product of Mobiluncas causing irritation of the mucus membranes |
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| Malic acid |
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| Amines, malic acid, endotoxin, collagenases, proteases play a role in causing |
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| BV |
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| This virulence factor of Mobiluncus and Gardnerella vaginalis increases with increasing pH |
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| Adherence |
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| Not considered a sexually transmitted disease but is more common in women that are sexually active |
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| BV |
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| Clinical diagnosis includes Vaginal fluid with pH>4.5, homogenous adherent discharge, fishy odor on 10% K (due to metabolic products), clue cells (obscure borders) |
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| BV |
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| Gram stain diagnosis based on quantization of large gram + bacilli |
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| Lactobacillus |
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| Gram stain diagnosis based on quantization of smaller gram - |
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| Gardnerella |
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| Complications include pelvic inflammatory disease, adverse outcome of pregnancy (preterm birth, premature rupture of membranes, postpartum endometritis, cellulitis |
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| BV |
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| Treatment includes metronidazole (PO, cream, lactate gel), clindamycin (cream), |
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| BV |
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| Bacterial infection usually from intestinal tract, may be a consequence of a UTI |
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| Acute prostatitis |
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| Often bacterial infection, sometimes not, cases do not respond to antibiotics and are thought to be of mixed populations of bacteria in biofilms |
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| Chronic prostatitis |
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| Symptoms include pain: pelvic, back, genital, ejaculation. Frequent urge to urinate, blood in urine, |
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| Prostatitis |
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| Gram -, cocci poses fimbriae and capsules |
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| Neisseria gonorrhea |
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| Diplococci within PMNs, adjacent flattened ends |
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| Neisseria gonorrhea |
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| Facultative anaerobe susceptible to environmental conditions. Fastidious, enhanced growth at high CO2, thayer martin medium |
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| Neisseria gonorrhea |
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| Fimbriae for adherence, antigenic variation, and promotion of endocytosis |
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| Neisseria gonorrhea |
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| Contain IgA protease that cleaves IgA on mucosal surfaces |
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| Neisseria gonorrhea |
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| Outer membrane contains Lipooligosaccharide (LOS) |
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| Neisseria gonorrhea |
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| This virulence factor of Neisseria gonorrhea elicits an inflammatory response causing purulent discharge |
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| Neisseria gonorrhea |
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| Lack of immunity leads to repeat infections due to phase variation |
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| Neisseria gonorrhea |
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| Primary sites of infection include: urethra in ment, urethra and cervix in women. Men are more symptomatic than women |
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| Neisseria gonorrhea |
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| In males clinical symptoms include burning on urination and yellow purulent discharge. Complications may occur but are uncommon |
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| Neisseria gonorrhea |
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| In females clinical symptoms include burning or frequent urination, vaginal discharge, abdominal pain. Infection can spread externally to the rectum in about 1/2 the cases. Major complication is PID leading |
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| Neisseria gonorrhea |
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| Opthalmia neonatorumthis occuring through passage of infected birth canal, rationale for mixed antibiotic prophalxis for newborns |
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| Neisseria gonorrhea |
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| One of the most frequently reported diseases in the US and 2nd most common cause of venereal disease |
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| Neisseria gonorrhea |
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| Almost always sexually transmitted with humans being the only reservoir |
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| Neisseria gonorrhea |
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| One of the more common cause of purulent arthritis in adults (mainly women) |
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| Neisseria gonorrhea |
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| Very low percentage of cases (mainly women) develop arthritis dermatitis syndrome which includes arthritis and dermatitis of the wrists, elbows and ankles |
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| Neisseria gonorrhea |
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| Gram stain conclusive for male purulent material. In females cervical secretions not conclusive, need to do either ELISA or PCR for confirmation |
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| Neisseria gonorrhea |
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| Used for testing antibiotic sensitivity of Neisseria gonorrhea |
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| Neisseria gonorrhea |
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| Disadvantage of using this type up test is no antibiogram |
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| NAAT |
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| May be resistant to penicillin or tetracycline |
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| Neisseria gonorrhea |
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| Very small gram -, contains LPS but little peptidoglycan |
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| Chlamydiaceae |
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| Obligate intracellular parasite, development occurs in 3 phases |
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| Chlamydiaceae |
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| Infection of mucosa membranes through small abrasions, may lead to granuloma formation |
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| Chlamydia trachomatis |
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| Most females are asymptomatic, however, manifestation includes mucopurulent cervicitis and PID |
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| Chlamydia trachomatis |
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| PID more severe than N gonorrhoeae |
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| Chlamydia trachomatis |
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| In males most genital infections are symptomatic, manifestation includes mucopurulent urethritis |
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| Chlamydia trachomatis |
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| Manifestation leads to proctitis |
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| Chlamydia trachomatis |
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| Bacteria causing lymphogranuloma venereum |
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| Chlamydia trachomatis |
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| Primary lesion at site of infection is usually overlooked by it is small, and heals rapidly. Later manifestation includes painful enlargement of lymph nodes draining site of infection (usually inguinal) |
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| Lymphogranuloma venereum |
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| Neonatal conjunctivitis from exposure at birth as well as infant pneumonia |
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| Chlamydia trachomatis |
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| Most common bacterial disease |
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| Chlamydia trachomatis |
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| Most common sexually transmitted disease |
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| Chlamydia trachomatis |
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| Most common cause of epididymitis in sexually active men |
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| Chlamydia trachomatis, Neisseria gonorrhoeae |
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| Chlamydia trachomatis disease epidemic to Africa, asia, and S america. |
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| Lymphogranuloma venereum |
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| Most common form of neonatal conjunctivitis in the US |
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| Chlamydia trachomatis |
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| Gold standard for diagnosis of Chlamydia trachomatis, however, is starting to be replaced by molecular diagnosis |
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| Culture |
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| Urine samples of Chlamydia trachomatis can be used for this test if purulent discharge is not available |
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| NAAT |
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| Treatment includes agents that are taken up by host cells effectively |
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| Chlamydia trachomatis |
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| Gram -, but lacks a true cell wall |
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| Ureaplasma urealyticum, Mycoplasma genitalium |
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| Cause GI infections (urethritis in men) that are nongonnoccocal and nonchlamydial |
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| Ureaplasma urealyticum, Mycoplasma genitalium |
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| In women, known to cause chorioamnionitis and postpartum fever |
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| Ureaplasma urealyticum, Mycoplasma genitalium |
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| Diagnosis is usually not done |
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| Ureaplasma urealyticum, Mycoplasma genitalium |
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| If urethritis persists after doxycycline treatment, treat with azithromycin |
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| Ureaplasma urealyticum, Mycoplasma genitalium |
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| Gram -, spirochete, helically coiled, long corkscrew-shaped |
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| Treponema pallidum |
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| Too thin too observe with light microscope |
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| Treponema pallidum |
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| Periplasmic flagella allow corkscrew movement |
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| Treponema pallidum |
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| Microaerophile, long generation time contributing to long incubation |
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| Treponema pallidum |
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| Can infect almost every tissue in the body making it a great imitator |
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| Treponema pallidum |
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| Painless slow evolving chronic granulomas disease |
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| Syphilis |
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| Causative agent of syphilis |
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| Treponema pallidum |
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| Fluctuates between short symptomatic and long asymptomatic stages |
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| Syphilis |
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| Impedes access to bacterial antigens when coated with fibronectin which protects against phagocytosis |
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| Treponema pallidum |
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| Long incubation, invasion through mucus membrane or abrasion in skin, dissemination via lymphatics or blood |
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| Treponema pallidum |
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| This bacteria causes progression of disease that manifests in 3 clinical stages: primary, secondary, tertiary. The disease can go into a latent stage |
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| Treponema pallidum |
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| This stage of syphilis is characterized by a hard chancre with painless regional lymph node enlargement. There are no other systemic signs and the majority of patients may not know they have the disease |
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| Primary |
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| This stage of syphilis is characterized by several alternating relapses. Hallmark is a rash commonly on the palms and soles. Condylomata may occur on the mucous membranes |
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| Secondary |
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| Stage of syphilis classified as the first 4 years between secondary and tertiary stages |
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| Early latency |
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| Stage of syphilis classified as 4-40 year period between secondary and tertiary stages |
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| Late latency |
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| Stage of syphilis that progresses slowly painless granulomas of the skin and bones develop known as gummas |
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| Tertiary |
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| Congenital disease via transplacental infection. Manifestations include: interstitial keratitis, notched incisors, CN 8 deafness |
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| Syphilis |
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| Primary stage is a risk factor for HIV |
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| Syphilis |
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| Cannot be cultured in vitro, can be grown on tissue culture at reduced O2 |
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| Treponema pallidum |
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| Bacteria can be observed in lesion material using dark field microscopy for those patients with primary chancre, secondary lesions, and congenital infections |
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| Treponema pallidum |
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| Wasserman Ab are specific for |
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| Cariolipin |
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| If positive wasserman Ab suspect this bacteria |
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| Treponema pallidum |
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| VDRL, RPR are tests for |
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| Wasserman Ab |
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| This test is used to confrim nontreponemal tests |
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| FTA-Ab |
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| Treatment for early stages of syphilis |
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| Benzathine penicillin |
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| Used to treat late and congenital stages of sypihlis |
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| Penicillin G |
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| Due to the slow growth of this bacteria, treatment needs to be prolonged for it to be effective |
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| Treponema pallidum |
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| Sexually transmitted infection characterized by painful sores in the genital area |
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| Chancroid |
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| Similar to primary syphilis however a painful ulcer develops known as chancroid |
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| Haemophilus ducrey |
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| Family of HSV1 and HSV2 |
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| Herpesviridae |
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| Genome and structure of HSV1 and HSV2 |
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| dsDNA, enveloped |
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| Viral infection can be lytic or latent usually a result of direct inoculation of the: eyes, respiratory, mouth, genitals, and anus |
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| HSV1, HSV2 |
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| For fast results do PCR of DNA, virus can be obtained from vesicles but not crusted lesions. Tzanck smear shows epidermal multi-nucleated cells and eosinophilic intranuclear inclusions |
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| HSV1, HSV2 |
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| Active lesions of this virus should be cared for away from high risk group including: burn patients, eczema, neonates, immunocomprimised |
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| HSV1, HSV2 |
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| Treatment for HSV1 or HSV2 in immunocomprimised |
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| Acyclovir |
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| What is used to treat herpes keratitis |
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| Trifluridine |
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| Family HPV belongs to |
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| Papovaviridae |
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| Genome and structure of HPV |
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| dsDNA, naked |
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| Virus causing warts know as papillomas |
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| HPV |
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| Genital warts from this virus rarely cause discomfort or pain but may lead to cancer of the genitals, anus, mouth, and URT |
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| HPV |
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| These serotypes are in the vaccine for HPV |
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| 6,11,16,18 |
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| HPV squamous cell with a larger irregular nucleus appear rounded and in clumps |
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| Koilocytotic |
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| Visible warts typically do not cause cancer from this virus. hard to detect warts may be made more visible by using vinegar |
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| HPV |
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| If pap smear is inconclusive, follow up test is a ___ DNA test for this virus |
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| HPV |
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| The most common STD |
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| HPV |
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| Asymptomatic shedding promotes transmission usually through direct contact, warts may spread through auto inoculation and fomties |
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| HPV |
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| HPV treatment for immunocompromised |
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| Cidofovir |
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