1
Q
What is cystitis?
A
Inflammation of the urinary bladder.
2
Q
What common general term is cystitis often grouped under?
A
UTI (urinary tract infection).
3
Q
What is the more specific meaning of cystitis?
A
Bladder inflammation.
4
Q
What organism causes about 75% of cystitis cases?
A
Escherichia coli (E. coli).
5
Q
What organism causes most of the remaining cystitis cases?
A
Staphylococcus saprophyticus.
6
Q
What is dysuria?
A
Painful or difficult urination.
7
Q
What does the prefix “dys-” mean in dysuria?
A
Dysfunctional or difficult.
8
Q
Is dysuria an early symptom of cystitis?
A
Yes.
9
Q
What happens to urination in dysuria?
A
The person voids in small amounts.
10
Q
How does a person with dysuria often feel?
A
They feel like they need to urinate, but only a small amount comes out or sometimes nothing comes out at all.
11
Q
What is pyuria?
A
Pus in the urine.
12
Q
What cells are found in the urine in pyuria?
A
Leukocytes.
13
Q
What does pyuria indicate?
A
Inflammation or infection.
14
Q
Why are leukocytes present in the urine during pyuria?
A
They are there to help fight the infection.
15
Q
What organism most commonly causes pyuria in cystitis?
A
Escherichia coli.
16
Q
Do males get UTIs?
A
Yes, but they are traditionally seen more often in males around age 50 or older.
17
Q
Why are UTIs more common in females?
A
Mainly because females have a shorter urethra.
18
Q
How does the shorter female urethra increase UTI risk?
A
Organisms from the anal opening can travel more easily through the short urethra into the bladder.
19
Q
What common source of bacteria can enter the female urinary tract?
A
Fecal bacteria.
20
Q
Why are fecal bacteria a problem in the bladder?
A
They are not normal residents of the urinary bladder.
21
Q
What is honeymoon cystitis?
A
A UTI that occurs after first sexual intercourse.
22
Q
About what percentage of UTIs are linked to first sexual intercourse?
A
About one-third, or 33%.
23
Q
In which group is honeymoon cystitis especially common?
A
Younger females.
24
Q
Why can contraceptive use increase UTI risk?
A
Contraceptives can create barriers and impede the flow of urine.
25
Why is urine flow important in preventing UTIs?
Urine flow helps flush organisms out of the urinary tract.
26
What type of immune defense is urine flow considered?
A first-line innate immune defense.
27
Why are UTIs more common in males later in life?
Because the prostate often enlarges with age.
28
How does an enlarged prostate increase UTI risk?
It impedes the flow of urine.
29
Why does reduced urine flow increase the risk of infection?
Because urine flow normally helps flush organisms out of the urinary tract.
30
What is the traditional microbiology explanation for UTIs being more common in older males?
Enlarged prostate causing reduced urine flow.
31
What common synergistic treatment can be used for cystitis?
A combination of trimethoprim and a sulfa drug.
32
Why may the sulfa drug dose be reduced in combination therapy?
Because it can be combined with the weaker trimethoprim.
33
What other antibiotic groups can be used to treat cystitis?
Fluoroquinolones and cephalosporins.
34
What antibiotics are commonly suitable for older males with cystitis?
Sulfa drugs, trimethoprim, cephalosporins, and fluoroquinolones.
35
Why must antibiotics for cystitis be chosen carefully?
Because factors like age, sex, and pregnancy can affect which antibiotics are safe.
36
What antibiotic group should be avoided if pregnancy may be involved?
Fluoroquinolones.
37
What should help guide antibiotic choice in cystitis?
Adverse effects and safety considerations from Chapter 20.
38
What usually causes pyelonephritis?
Untreated cystitis, especially caused by Escherichia coli.
39
How does pyelonephritis develop from cystitis?
Bacteria move upward from the bladder into one or both kidneys.
40
What is pyelonephritis?
Inflammation of one or both kidneys.
41
Why is pyelonephritis more serious than cystitis?
Because pathogens have reached the kidneys.
42
How can pyelonephritis first appear?
It may begin with symptoms similar to cystitis.
43
What symptoms suggest cystitis has progressed to pyelonephritis?
Fever, chills, nausea, vomiting, profuse perspiration, tenderness over the kidney area, and back pain.
44
Why is profuse perspiration important in pyelonephritis?
It is much more severe than ordinary sweating and is a clue that the kidneys are involved.
45
Why does pyelonephritis cause back pain?
Because the kidneys become inflamed.
46
What long-term damage can pyelonephritis cause?
Scarring of kidney tissue and the tubular system.
47
What can happen if pyelonephritis severely damages the kidneys?
One or both kidneys can fail.
48
Is kidney damage from pyelonephritis always reversible?
No, it can cause irreversible loss of kidney function.
49
What antibiotics are commonly recommended for pyelonephritis?
Cephalosporins or fluoroquinolones.
50
How long is treatment for pyelonephritis usually needed?
Longer than cystitis, often 4–6 weeks.
51
What happens if the person cannot take antibiotics by mouth?
IV antibiotics may be needed.
52
What organism causes gonorrhea?
Neisseria gonorrhoeae.
53
Why does gonorrhea infect so easily?
Because it attaches very well to mucosal cells.
54
About how often can first-time contact lead to gonorrhea infection?
About 90% of the time.
55
What body areas can gonorrhea infect?
The oral region and genital region.
56
Can gonorrhea infect the mouth and throat?
Yes, it can cause oral gonorrhea.
57
Why can oral gonorrhea be mistaken for strep throat?
Because it can look like pharyngitis.
58
What feature makes oral gonorrhea different from regular strep throat?
Oral gonorrhea produces pus.
59
What virulence factors help gonorrhea attach and infect?
Fimbriae and a capsule.
60
How does gonorrhea avoid being destroyed by the immune system?
It evades phagocytosis.
61
What is the common external symptom of gonorrhea in males?
Pus discharge from the external genitalia.
62
What is the male pus discharge in gonorrhea often called?
The drip.
63
What would a Gram stain of gonorrhea pus show?
Neisseria gonorrhoeae and nearby leukocytes.
64
Why can gonorrhea be harder to recognize in females?
Because symptoms are less obvious.
65
What urinary symptoms can females with gonorrhea have?
Painful urination and burning during urination.
66
What reproductive area can become irritated in female gonorrhea?
The cervix.
67
What serious condition can develop if gonorrhea spreads into the female pelvis?
Pelvic inflammatory disease (PID).
68
What symptoms can pelvic inflammatory disease cause?
Chronic abdominal pain and inflammation of reproductive structures.
69
Which female reproductive structure is especially affected in PID?
The uterine tube.
70
What long-term complications can gonorrhea cause in females?
Irreversible sterility and ectopic pregnancy.
71
What can oral gonorrhea look like?
Pharyngitis with pus.
72
What can untreated gonorrhea spread to?
The heart, meninges, and joints.
73
What eye infection can a newborn get from gonorrhea during birth?
Neonatorum ophthalmia / neonatal gonorrheal ophthalmia.
74
Why is neonatal gonorrheal ophthalmia dangerous?
It can cause blindness.
75
How are newborns often protected from gonorrheal eye infection?
By placing a mild antibiotic solution in each eye.
76
What antibiotic was mentioned for newborn eye prevention?
Mild Erythromycin eye solution.
77
What tests can diagnose gonorrhea?
Gram stain, immunoassay, and PCR.
78
What antibiotics can be used to treat gonorrhea?
Fluoroquinolones and cephalosporins.
79
Which antibiotic group is especially useful for gonorrhea in pregnancy?
Cephalosporins.
80
What organism usually causes non-gonococcal urethritis?
Chlamydia trachomatis.
81
What does “non-gonococcal” mean?
It means the infection is not caused by gonorrhea.
82
What part of the body is inflamed in non-gonococcal urethritis?
The urethra.
83
Can chlamydia also lead to pelvic inflammatory disease (PID)?
Yes.
84
Why is Chlamydia trachomatis important in PID?
Because it is another major cause of PID.
85
Can chlamydia and gonorrhea work together in PID?
Yes, they can act together.
86
Why is pelvic inflammatory disease often called polymicrobial?
Because it may be caused by gonorrhea, chlamydia, or both together.
87
What urinary symptom is common in non-gonococcal urethritis?
Painful urination.
88
What type of discharge is common in non-gonococcal urethritis?
Watery discharge.
89
Why can non-gonococcal urethritis become serious?
Because it may already have spread into the pelvic region before it is noticed.
90
What female reproductive structures may become involved in chlamydial infection?
The ovaries and other pelvic structures.
91
What can happen to pelvic structures after chlamydial infection?
They can become inflamed and scarred.
92
What organism causes syphilis?
Treponema pallidum.
93
How is syphilis usually transmitted?
As a sexually transmitted disease.
94
Can syphilis spread without sexual contact?
Yes.
95
How can non-sexual transmission of syphilis happen?
Through minute skin breaks or mucosal breaks.
96
Does syphilis need a large opening to enter the body?
No, even very small breaks in the skin or mucosa are enough.
97
What is the main lesion seen in primary syphilis?
Chancres.
98
Where are chancres usually found in males?
On the external genitalia.
99
What do chancres look like?
Deep ulcer-like lesions.
100
What may be present in a syphilitic chancre?
Pus discharge or exudate.
101
What would be seen if a chancre was swabbed and stained?
Thousands of spirochetes.
102
Where are chancres often found in females?
In hidden internal areas such as the cervix.
103
Why can primary syphilis be harder to notice in females?
Because chancres are often internal and not easily visible.
104
Is primary syphilis highly infectious?
Yes.
105
Why is primary syphilis very infectious?
Because chancres release spirochetes that can spread to a sexual partner.
106
What happens during secondary syphilis?
The organism spreads through the cardiovascular and lymphatic systems.
107
Why does syphilis become widespread in secondary syphilis?
Because many spirochetes enter the blood and lymphatic circulation.
108
Where can lesions and rashes appear in secondary syphilis?
Almost anywhere on the body.
109
Can secondary syphilis cause rashes on the palms?
Yes.
110
Can lesions appear in the mouth during secondary syphilis?
Yes.
111
Why might lesions appear in the mouth during secondary syphilis?
Because of oral sexual transmission.
112
What happens to females in secondary syphilis compared with primary syphilis?
They may now show obvious external lesions.
113
What are the main symptoms of secondary syphilis?
Skin rashes, mucosal rashes, hair loss, extreme fatigue, and fever.
114
Do the rashes in secondary syphilis contain spirochetes?
Yes.
115
What happens during the latent phase of syphilis?
The person may have no symptoms.
116
Does the latent phase mean the person has recovered?
No.
117
Can bacteria still be present during latent syphilis?
Yes.
118
How long can the latent phase of syphilis last?
Months to years.
119
Why is the latent phase of syphilis dangerous?
Because the infection can still spread to a fetus during pregnancy.
120
How can latent syphilis affect a fetus?
Through transplacental spread.
121
What can congenital syphilis cause in a fetus?
Severe neurological damage.
122
What happens in the tertiary phase of syphilis?
The disease can reappear after the latent phase.
123
What are the deep lesions in tertiary syphilis called?
Gummas.
124
How are tertiary syphilis lesions different from earlier lesions?
They are much deeper and more severe.
125
Where can gummas appear?
For example, on the forearm.
126
Why should tertiary syphilis be uncommon today?
Because modern antibiotics usually treat syphilis before it reaches this stage.
127
What does it suggest if tertiary syphilis occurs?
That the infection has reappeared after the latent phase.
128
What is the usual treatment for syphilis?
Penicillin.
129
Why is regular penicillin not ideal by itself for syphilis?
Because it does not stay in the body long enough.
130
What long-lasting form of penicillin is often used for syphilis?
Benzathine penicillin.
131
Why is benzathine penicillin useful for syphilis?
It is long-lasting, inexpensive, easy to formulate, and does not require months of treatment.
132
During which stage is non-sexual transmission of syphilis most likely?
Secondary syphilis.
133
Why is secondary syphilis the stage most likely to spread non-sexually?
Because rashes and lesions all over the body contain spirochetes.
134
Which healthcare workers are especially at risk of non-sexual syphilis exposure?
Nurses, doctors, and dentists.
135
Why are healthcare workers at risk of syphilis transmission?
Because the organism can enter through very small skin breaks.
Microbiology
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