Reproductive System > GU Infections > Flashcards

GU Infections Flashcards

(55 cards)

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1
Q

How to epithelial cells in the female GU tract serve as a defense mechanism?

A
  • Provide a mechanical barrier
  • Produce and secrete antimicrobial molecules
  • Transport IgA
  • Process and present antigen
  • Communicate with underlying immune cells
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2
Q

How does the normal microbial flora of the female GU tract act as a defense mechanism?

A

Lactobacillus lowers the vaginal pH to 4.2-5.0

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3
Q

What are the defense mechanisms of the male GU tract?

A
  • Epithelial cells
  • Normal flora
  • Urethral length
  • Urine flow
  • Circumcision (possibly)
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4
Q

Evaluation, treatment, and counseling should be provided for sex partners of persons who are infected with an STI within the previous _____ days

A

Evaluation, treatment, and counseling should be provided for sex partners of persons who are infected with an STI within the previous **60 **days

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5
Q

What are some prevention methods for STI transmission?

A
  • Abstinence
  • Reduction of number of sex partners
  • Pre-exposure vaccines
  • Condoms
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6
Q

What are special populations to be considered in STI evaluation?

A
  • Pregnant women
  • Adolescents
  • Children
  • Persons in correction facilities
  • Men who have sex with men
  • Women who have sex with women
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7
Q

What are the 5 Ps of a sexual history?

A
  • Partners
  • Prevention of Pregnancy
  • Protection from STIs
  • Practices
  • Past history of STIs
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8
Q

What are the two forms of Chlamydia trachomatis?

What is the replication potential for each?

A
  • Elementary body - Metabolically inactive; cannot replicate
  • Initial body/Reticulate bodies - Intracellular inclusions that can divide
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9
Q

Which form of chlamydia is infectious? What types of cells does it infect?

A

Elementary bodies: infects non ciliated epithelial cells of the mucosa

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10
Q

Chlamydia trachomatis is hard to see on gram stain because it lacks…(2)

A

Peptidoglycan layer and muramic acid

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11
Q

What is the most common bacterial STD in the US?

What else can it cause besides GU infection?

A

Chlamydia trachomatis

Can also cause pneumonia and conjunctivitis

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12
Q

How is Chlamydia treated?

A

Azithromycin and Doxycycline

(Abx that target peptidoglycan wall are not effective)

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13
Q

How is Trichomonas Vaginalis highly motile?

A

Four flagella and undulating membrane (fin-like extension of membrane)

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14
Q

How is Trichomonas vaginalis diagnosed?

What is the treatment?

A

Diagnosed by direct microscopic examination of discharge

Metronidazole is the treatment of choice

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15
Q

What is the smallest free living bacteria?

Why are gram stain and ß-antibiotics useless against it?

A

Ureaplasma urealyticum

Has no cell walls

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16
Q

What is the rate of growth of Ureaplasma urealyticum?

How does it produce its “diagnostic” smell?

A

Very slow rate of growth - takes a long time to detect

Produces urease to break down urine into ammonia

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17
Q

How is Ureaplasma Urealyticum diagnosed?

How is it treated?

A

Diagnosed with culture (takes a long time) or PCR

Treatment of choice is erythromycin or doxycycline

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18
Q

Neisseria gonorrhea is a gram ______ and catalse ______ diplococci

A

Neisseria gonorrhea is a gram **negative **and catalse **positive **diplococci

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19
Q

What are the virulence factors for Neisseria gonorrhea?

How does the bacteria prevent lasting immunity?

A
  • Virulence factors: pili, porins, and opaque proteins (Opa)
  • Bacteria can switch surface antigens to prevent lasting immunity – reinfection is always possible (no vaccine)
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20
Q

How is Neisseria gonorrhea diagnosed?

How is it treated?

A

Culture was routine (chocoalte agar or Thayer Martin agar) but now PCR is routinely used

Ceftriaxone is treatment of choice (many strains are highly resistant to penicillin)

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21
Q

What diseases are associated with Neisseria gonorrhea in…

  • Males:
  • Females:
  • Both sexes:
A
  • Males: urethritis with painful urination and purulent discharge, epididymitis, prostatitis, urethral strictures
  • Females: urethritis, endocervicitis, can progress to PID
  • Both sexes: Bacteremia and Septic Arthritis
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22
Q

Chlamydia replicates ________ and Neisseria gonorrhea replicates _________

A

Chlamydia replicates **Intracellularly **and Neisseria gonorrhea replicates Extracellularly

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23
Q

What causes painful genital lesions?

What causes non-painful genital lesions?

Study These Flashcards
A
  • Painful: Herpes, Chancroid, Lymphogranuloma venereum
  • Non-painful: Syphilis, Molluscum, Genital wart
24
Q

What are the two lifecycles of the Herpes simplex virus?

What are the locations and symptoms of each?

Study These Flashcards
A
  • Latent infection (quiescent) – limited to neurons (sacral ganglion) – not associated with symptoms
  • Lytic replication – active; produces infectious viruses at mucosa/skin at site of initial inoculation
25
Describe the structure of HSV
Double stranded DNA virus DNA is encased into a capsid, which is further wrapped in a lipid bilayer (envelope)
26
What is the term describing the switch of HSV from a latent to lytic lifecycle?
Reactivation
27
How long is an HSV infection? What is the treatment for each lifecycle?
Infection is life long - no vaccine * Lytic: Antivirals such as **acyclovir** are nucleotide analogs that specifically target viral DNA polymerase and inhibit replication * Latent: **No treatment for latent infection**
28
How is HSV diagnosed?
Clinical presentation (vesicles), detection of virus in the lesions (culture, IFA, PCR), or detection of HSV-1 or HSV-2 specific antibodies
29
What disease is associated with Haemophilus ducreyi?
**Chancroid -** tender papule with an erythematous base that progresses to painful ulceration with associated lymphadenopathy
30
How is Haemophilus Ducreyi diagnosed? What is the treatment?
* Diagnosis: **Culture or PCR** of ulcer or lymph node aspirates * Treatment: **Azithromycin, ceftriaxone, ciprofloxacin**
31
What type of organism is Trepona Pallidum? What disesase is it is associated with?
Gram negative spirochete bacteria Causative agent of **Syphilis**
32
Describe the primary and secondary stage of Syphilis?
* Primary stage: painless chancre at inoculation site – **highly infectious** * Secondary: systemic spread to multiple organs and CNS – systemic (fever and rash) and local (condyloma latum) symptoms
33
Describe the latent and tertiary stages of Syphillis
* Latent: Asymptomatic and noninfectious (except during pregnancy) – can relapse back to secondary * Tertiary: due to immune system driven damage to multiple organs (skin, bones, vessels, nerves)
34
What is the rate of growth of Trepona Pallidum? What type of infection is associated with a high mortality rate?
**Very slow growth** compared to other bacteria **Congenital infection** is associated with high mortality rates
35
How is Syphilis diagnosed? How is it treated?
Diagnosed with **darkfield microscopy**, serology, PCR Treated with **benthazine penicillin** (modified penicillin that is slowly absorbed) - antibiotics not effective against tertiary stage
36
What are the types of tertiary syphilis?
* **Gummatous syphilis**: localized granulomatous lesions within skin or bones, non-infectious. * **Cardiovascular syphilis**: aneurysm in the ascending aorta or aortic arch – due to destruction of small arterioles supplying the aorta. * **Neurosyphilis**: can be asymptomatic, subacute or meningiovascular
37
Antibiotics given within the first __ months of pregnancy can prevent congenital syphilis
Antibiotics given within the first **4 months** of pregnancy can prevent congenital syphilis
38
What is the Jarisch-Herxheimer Phenomenon of Syphilis?
Acute worsening of symptoms immediately after start of antibiotics – due to pyrogen released by killed organism
39
Is there a vaccine for syphilis?
No (immunity is not protective)
40
To what family does Molluscum Contagiosum belong? What type of virus is it?
Poxvirus family Large double stranded DNA virus
41
Where does Molluscum contagiosum replicate? What is seen on histology of lesions?
Replicates exclusively in the cytoplasm of the infected cell (unique feature for a DNA virus) Histology: Molluscum bodies (large eosinophlic inclusion in the cytoplasm)
42
Describe the appearance of the Molluscum Contagiosum virion Describe the appearance of the disease
Virion: **ovoid to brick shaped**; complex structure with several membranes Disease: **Nodular to wart-like skin lesions**, begin as papules and become umbilicated with central caseous plug; occur in cluster of 5-20 nodules
43
How is Molluscum Contagiosum diagnosed? How is it treated?
* Diagnosis: **Based on the presentation of lesions** * Treatment: **Nodules can be removed by scraping**, application of liquid nitrogen, or iodine treatment. More severe disease can be treated with ritonavir or cidofovir; **No vaccine is available**
44
What type of virus is HPV? To which family does it belong?
Small, double stranded DNA virus from the Papovavirus family
45
How does HPV replicate and lead to infection?
* Initial infection requires access to basal epithelial layer (skin damage) * Active replication is mostly in the upper epithelium layers to escape immune system * Virus DNA has to be maintained as an episome for productive replication
46
Occasionally HPV DNA is accidentally integrated into the host genome. What are the two outcomes of this?
* In most cases this leads to abortive infection, as the virus cannot use integrated DNA to replicate * In other cases, integration leads to cancer
47
What is the mechanism of HPV integration and induction of cancer?
Viral DNA integration disrupts the expression of viral E2 genes which are a negative regulator of viral E6 and E7 oncogenes
48
What is the vaccine against high risk strains of HPV?
Gardasil
49
What is Amsel's criteria in diagnosing bacterial vaginosis? How is diagnosis done currently?
* Amsel’s criteria – old technique but still used (highly specific and highly sensitive) * Vaginal pH greater than 4.5 * Presence of clues in vaginal fluid * Milky, homogenous vaginal discharge * Fishy (amine) odor after addition of 10% KOH to vaginal fluid * Current diagnosis is done with PCR
50
How does Gardernella vaginalis (type of BV) cause disease? What normally prevents overgrowth of this bacteria?
Part of normal vaginal flora; disturbance of normal flora leads to outgrowth, causing disease (Abx treatment) Vaginal lactobactillus keeps G. vaginalis in check
51
How is Gardernella Vaginalis treated?
Nitroimidazoles (**Metronidazole or Tinidazole**) or **Clindamycin**
52
What is the disease appearance of gardernella vaginalis?
Vaginitis, pruritis, dysuria, foul smelling copious vaginal discharge with a fishy odor.
53
When does Candida cause disease?
**When Candida is allowed to expand and outgrow normal microbial community** (this can happen following Abx, oral contraceptives, menses, pregnancy, diabetes, or use of corticosteroids)
54
How is Candida diagnosed? Why is culture not useful? What is the treatment for Candida?
Diagnosed by **microscopic - abnormally high presence of candida** Culture is not very useful because yeast is a part of the normal flora Treatment: **Imidazole** vaginal suppositories or a single dose of **fluconazole**
55
What are GU tract consequences of STIs?
* Spontaneous abortion * PID; Ectopic pregnancy * Infertility in women * Urethral strictures in men * Cervical penile carcinoma * Death
Reproductive System
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