Micro: Chapter 26 – Flashcards

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Sturcture and Function of the Urinary System
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  • Urinary system
    • Two kidneys
    • Two ureters
    • One uniary bladder
    • One urethra
  • Infection prevented by 
    • Valves that prevent backflow to kidneys
    • Acidity of urine
    • Mechanical flushing
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Female Reproductive System
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  • Two ovaries
  • Two uterine (fallopian) tubes
  • The uterus, indlucing the cervix; the vagina
  • External genitals
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Male Reproductive System
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  • Two testes
  • Accessory glands
  • Penis
  • Epididymis
  • Ductus (vas) deferens
  • Ejaculatory duct
  • Urethra
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Normal Microbiota
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  • Urinary bladder and upper urinary tract are strerile
  • Lactobacilli are predominant in the vagina
    • Produce hydrogen peroxide
    • Grow on glycogen secretions
  • Infection is indicated by 
    • >10,000 bacteria/ml
    • 100 coliforms/ml
    • Positive urine leukocyte esterase (LE) test
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Cystisis
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  • An inflammation of the urinary bladder
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Urethritis
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  • An inflammation of the urethra
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Pyelonephritis
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  • An inflammation of one or both kidneys
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Cystitis
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  • Usual causative agents
    • E. coli
    • S. saprophyticus
  • Symptoms
    • Dysuria (difficult or painful urination)
    • Pyuria (pus in urine)
  • Diagnosis: >100 CFU/ml of potential pathogens and positive LE test
  • Treatment: trimethoprim-sulfamethexazole 
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Pyelonephritis
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  • Causative agent: usually E. coli
  • Symptoms: fever, back or flank pain
  • Diagnosis: 10,000 CFU/ml and positive LE test
  • Treatment: cephalosporin 
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Leptospirosis
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  • Causative agent: leptospira interrogans 
  • Reservoir: dogs and rats
  • Trasmission: skin/mucosal contact from urine-contaminated water
  • Symptoms: headaches, muscular aches, fever, kidney failure is a possible complication
  • Diagnosis: Serological test
  • Treatment: Doxycycline
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Sexually Transmitted Infections (STI's)
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  • Prevented by condoms
  • Bacterial infections are treated with antibiotics
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Gonorrhea
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  • Caused by Neisseria gonorrheae
  • Attaches to oral or urogenital mucosa by fimbriae
  • Opa proteins prevent proliferation of CDF+ T cells
  • Anal gonorrhea, pharyngeal gonorrhea
  • If left untreated, may result in
    • Endocarditis
    • Meningitis
    • Arthritis
    • Opthalmia neonatorum
  • Symptoms
    • Men: painful urination and discharge of pus
    • Women: few symptoms but possible complications, such as PID
  • Diagnosis: Gram stain, ELISA, PCR
  • Treatment: cephalosporins
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Nongonococcal Urethritis (NGU)
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  • Nonspecific urethritis
    • Chlamydia trachomatis
    • Mycoplasma hominis
    • Ureaplasma urealyticum
  • Symptoms: painful urination and watery discharge; in women, possible complications, such as PID
  • Diagnosis: culture, PCR
  • Treatment: doxycycline, azithromycin
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Pelvic Invlammatory Disease
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  • Polymicrobic, usually:
    • N. gonorrhoeae
    • C. trachomatis
  • Salpingitis (infection of uterine tubes)
  • Symptoms: chornic abdominal pain
  • Treatment: doxycycline and cefoxitin
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Syphilis
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  • Caused by Treponema pallidum
  • Invades mucosa or through skin breaks
  • Primary stage: chancre at site of infection 
  • Secondary stage: skin and mucosal rashes
  • Latent period: no symptoms
  • Tertiary stage: gummas on many organs
  • Treatment: benzathine penicillin
  • Congenital syphilis: neurological damage
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Diagnosis of Syphilis
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  • Direct diagnosis
    • Staining with fluorescent-labeled monoclonal antibodies
  • Indirect, rapid screening
    • VDRL, RPR, EIA
  • Confirming
    • FTA-ABS tests for anti-treponemal antibodies
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Lymphogranuloma Venereum (LGV)
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  • Causative agent: Chlamydia trachomatis
  • Initial lesion on genitals heals
  • Bacteria spread through lymph
  • Symptoms: swelling in lymph nodes in groin
  • Diagnosis: microscopic identification and culture
  • Treatment: doxycycline
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Chancroid (Soft Chancre)
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  • Causative agent: Haemophilus ducreyi
  • Symptoms: painful ulcers of genitals, swollen lymph nodes in groin 
  • Diagnosis: culture
  • Treatment: erythromycin; ceftriaxone
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Bacterial Vaginosis
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  • Causative agent: Gardnerella Vaginalis
  • Symptoms: copious fishy, gray-white, thin, frothy discharge
  • pH: ;4.5
  • Diagnosis: clue cells
  • Treatment: metronidazole
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Genital Herpes
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  • Caused by herpes simplex virus 2 (human herpes virus 2, or HSV-2)
  • Painful vesicles on genitals
  • Neonatal herpes transmitted to fetus or newborns
  • Recurrences from viruses latent in nerves
  • Suppression: Acyclovir 
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Genital Warts
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  • Human papillomaviruses
  • Warts in genital area
  • HPV serotype 16 causes cervical cancer and cancer of the penis 
  • Treatment: podofilox; imiquimod
  • Prevention: vaccination against HPV strains
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Candidiasis
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  • Causative agent: Candida albicans
  • Grows on mucosa of mouth, intestinal tract, and genitourinary tract
  • NGU in males
  • Vulvogavinal candidiasis, yeasty discharge
  • pH: ;4
  • Diagnosis: microscopic and cultuer
  • Treatment: clotrimazole; fluconazole
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Trichomoniasis
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  • Causative agent: Trichomonas vaginalis
  • Found in semen or urine of male carriers
  • Vaginal infection causes irritation and profuse foul, greenish yellow frothy discharge
  • pH: 5-8
  • Diagnosis: microscopic identification, DNA probe
  • Treatment: metronidazole
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TORCH
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  • Toxoplasmosis
  • Other (such as syphilis, hepatitis B, enterovirus, Epstein-Barr virus, varicella-zoster virus)
  • Rubella
  • Cytomegalovirus
  • Herpes simplex virus
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