Microbio -11- Genitourinary Infection
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| What are the common clinical features of UTIs | Painful urination uncomplicated urethritis/cystitis
Fever, Sepsis, and decreased kidney function
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| What is the most common cause of UTIs | Escherichia Coli and other enterbacteria family
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| Why are UTIs more common in women than Men | Female Urethra is shorter and closer to perianal area. Also using spermicides in birth control increases risk
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| Why does Spermicide increase UTI risks | IT increases adherence of E. Coli to vaginal epithelial cells
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| What is Cystitis and what are the s/sx | Infection of the Bladder Wall w/ increased frequency and urge to void and dysuria, Urine is malodorous and can be bloody, Bacteruria and WBCs in urine
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| What is Pyelonephritis | infection of the kidney and renal pelvis most common follows a bladder infection.
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| What will you see in the urine w/ acute pyelonephritis | WBCs, cellular casts, bacteria and protein,
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| What is the concern with pyelonephritis becoming chronic | chronic pyelonephritis can result in gradual nephron loss and renal failure
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| What is urethritis | inflammation of the urethra usually caused by bacteria
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| Inflammation of the glomeruli in the nephrons, causing the glomerular capillary network to become leaky allowing plasma protein and blood cells to be excreted in urine | Glomerulonephritis
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| inflammation of the prostate gland generally an extension of bladder or urethra infection generally follows catheterization | Prostatitis
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| Apart from bacteria what else can cause UTIs | Yeasts such as candida
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| What are the virulence factors for UTI bacteria | adherance to vaginal and uroepithelial cells
cytotoxic, necrotizing factors
hemolysin
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| What are the genes for UTI virulence linked to | pathogenicity islands which are absent in normal fecal coliforms
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| What is a pahtogenicity island | mobile genetic elements that exist in addition to plasmids that encode for fimbriae, pili, outermembrane proteins that aid in colonization and attachment
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| What determines the anatomical location where a pathogen will cause a UTI | depends on adhesive properties of the pathogen what cells they can adhere to for colonization and infection
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| Gram - rods faculative anaerobe most common cause of UTIs | E. Coli
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| WHat is the pathogenicity of E. Coli | Adhere to mucosa via pili causing tissue damage and inflammation from endotoxin
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| What is the TX for E. Coli | penicillin and ciprofloxacin
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| How do E. Coli get to the urinary tract to cause infection | occurs after contamination of genital area with feces
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| Gram + Cocci nitrite negative nonhemolytic catalse positive coagulase negative resistant to novobiocin "honeymoon cystitis" | Staph. Saprophyticus
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| UTI that occurs in sexually active women | Staph. Saprophyticus
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| Gram - rods faculative anaerobes opportunistic pathogen gen transmitted via catheters enteric bacteria ureas positive and highly mobile | Proteus Vulgaris, Proteus mirabilis
same category as e. coli, salmonella, shigella enterobacter, serratia
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| This group used to be called group D streptococci GI tract normal flora causes endocarditis, cystitis, wound infection in other parts of the body | Streptococcus Faecalis
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| What are the lancefield classifications of enterococcal bacteria based on | based on antigenicity of C carbohydrate 13 different types A, B, D, and G are human pathogens
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| If streptococci don't have a C carbohydrate what are they | non typeable viridans streptococci
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| What type of hemolysis does enterococcus faecalis cause on blood agar | Gamma hemolysis
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| What is the tx for enterococcous faecalis | amoxicillin, ampicillin, vancomycin
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| What is the most common site for nosocomial infections and most common cause | urinary tract 60-80% follow catheterization
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| What do the following bacteria have incommon Escherichia coli Klebsiella Proteus Enterococcus sp. Pseudomonas cepacia ** Enterobacter Serratia marcescens ** Candida | they are all catheter associated urinary tract infection agents
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| What is different about the starred bacteria from the others listed Escherichia coli Klebsiella Proteus Enterococcus sp. Pseudomonas cepacia ** Enterobacter Serratia marcescens ** Candida | serratia marcescens and pseudomonas cepacia are not normal flora of the human GI tract there presence in a UTI following catheterization indicates exogenous source
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| HOw do you dx a UTI | urine should be sterile presence of bacteria can be indicative of a UTI
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| how should you collect a urine specimen if you are looking for UTI | need to get midstream clean catch since bacteria reside at opening of urethra they can contaminate the first part of urine stream
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| What does the Nitrite test of urine indicate if positive | indicates bacteriuria because some bacteria convert nitrate in urine to nitrite
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| Why would leukocytes in urine be important | Testing for leukocytes in urine detects both intact and lysed WBC these normally shouldn't be in the urine and indicate bacterial infection or failing kidney
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| Most widespread zoonoses that affects humans is a spirochete with hooked ends enters through mucous membranes and is excreted in the urine of infected animal | Leptospirosis
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| What are the s/sx associated with infection w/ leptospirosis | headache, fever, chills, severe muscle pain, redness of eyes from dilation of blood vessels
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| This infection generally occurs when normal acidity of the vagina is decreased. You generally get strong fishy odor from vagina and Clue Cells | Bacterial Vaginosis
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| What are clue cells in bacterial vaginosis | sloughed off epithelial cells covered with bacteria
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| What is some bacteria that causes bacterial vaginosis | Gardnerella Vaginalis, Gardnerella Mobiluncus, Mycoplasma Hominus
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| How do you treat bacterial vaginosis | clindamycin, metronidazole
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| What are the s/sx of vulvovaginal candidiasis | itching, burning, and whitish vaginal discharge
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| Oportunistic mycoses of the vagina by candida sp. | vulvovaginal candidiasis
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| Where is the source of candida sp in vulvovaginal candidiasis | most commonly from the patient themselves can get some oxegenous transmission
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| how do you dx vulvovaginal candidiasis | direct microscopic examination with KOH prep looking for budding yeasts and pseudohyphae
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| How do you differentiate between the different candida infections | use a CHROMagar differentiation Albican=green Krusei=rose
tropicalis=steel blue
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| what is the tx for Vulvovaginal Candidiasis | azoles
antimetabolites- flucytosine
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| Infection with what organism can cause toxic shock | Strains of Staph Aureus that produce exotoxin casuing massive release of cytokines
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| What is associated with the use of tampons that abrade the vaginal wall | toxic shock syndrome
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| What are the s/sx of toxic shock syndrome | fever, chills, vomiting, diarrhea, muscle aches, rash and possible severe hypotension and multisystem dysfunction
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| what can occur 1-2 weeks after onsent of toxic shock syndrome to the palms and soles | you can get desquamation
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| what percent of TSS ends up being fatal | 5%
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| What is the exotoxin of Staph Aureus that causes the TSS in menstural toxic shock and what toxin causes it in nonmenstrual tss | menstrual TSS=TSST-1 toxic shock syndrome toxin 1
non-menstrual TSS= TSST1 or enterotoxin B or C
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| What is the toxic shock like syndrome caused by | streptococcal pyogenes also called toxic strep
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| HOw do you dx strep toxic shock like syndrome | you must isolate and indentify group A strep
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| What are the s/sx of strep toxic shock like syndrome | hypotension
renal impairment, coagulopathy, liver problems
rash
soft tissue necrosis
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| Bacterial STD caused by neisseria gonorrhoeae a gram negative diplococcus | Gonorrhea
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| How do Gonorrhea attach to host cells | Pili
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| What does the R plasmid in gonorrhea do | makes them resistant to antibiotics such as penicillin and tetracycline
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| What allows N. Gonorrhoeae to attach to many different types of cells | N. Gonorrhoeae can express many different types of pili that allow it to attach to many different types of cells
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| How does gonorrhoeae evade the immune system | antigenic variation of the pili allow gonorrhea to escape the immune system
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| is there a vaccine for gonorhhea | no
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| Apart from evading the immune system how does gonorrhea keep from being killed by the immune system | produces an enzyme that breaks down IgA antibody
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| What are opa proteins in Gonorrhea | proteins that increase adherence between gonococci
increase adherence to eukaryotic cells- Macrophages attach to CD4 T lymphocytes and prevent their activation and proliferation
aid in invasion of epithelial cells
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| What are the s/sx of gonorrhea in men | urethritis, thick pus-containing discharge
can get scar tissue that obstructs the urethra
sterility can result along w/ prstatic abcesses
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| What are the s/sx of gonorrhea in women | painful urination, vaginal discharge
lead to spread in cervix and fallopian tubules
pelvic inflamattory disease scar tissue can cause sterility and etopic pregnancy
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| How does gonorrhea get up into the fallopian tubules what problems can this cause | hitches a ride on sperm by attaching to them this can cause scar tissue formation blocking the fallopian tube leading to ectopic pregnancy
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| What is opthalmia neonatorum and how is it combated | newborn infection of the eyes by gonorrhea
tx by giving 1% silver nitrate or .5% erythromycin treatment
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| What is it called when Gonorrhea gets into your joints | disseminated gonococcal infection you get fever, rash and arthritis
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| WHat is the tx for honorrhea | fluoroquinolones, cephalosporins
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| What is the STI that mimics gonorrhea with urethritis and testical and fallopian tube damage can also attach to sperm to cause pelvic inflammatory disease. | Chlamydia Trachomatis
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| What is the type of chlamydial infection that causes lymph nodes in the groin to swell and drain pus leading to gross swelling of the genitalia | lymphogranuloma venereum
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| What is the chronic eye disease caused by 4 strains of chlaymdia called that can cause blindness | trachoma
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| This is a shperical obligate intracellular bacterium that in its infectious form is called an elementary body. Attaches to receptors of epithelial cells and gets taken into cell by endocytosis | Chlamydia Trachomatis
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| What is the tx for chlamydia | Azithromycin, tetracyclin, erythromycin
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| Chracterized in its first stage by painless red ulcer called chancre | syphilis
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| What is the secondary stage of syphilis marked by | Runny nose, water eyes, aches, sore throat, rash on palms and soles
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| What is the tertiary stage of syphilis marked by | mental illness, blindness, stroke
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| What is the organism that causes syphilis | T. Pallidum
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| What is the tx for syphilis | penicillin
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| What does the chancre in syphilis indicate | it shows the site of entrance of the syphilis organism T. Pallidum
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| Why do you need to be careful with the rash and mucous membrane sores that develop with syphilis | they contain the organism and can potentially pass on infection
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| what can a hypersensitivity rxn to Treponema Pallidum cause | can cause blindness
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| Can T. Pallidum be cultured in vitro | no only invivo grown in rabit testicles
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| What type of technique do you use to identify T. Palldum in a sample | use darkfield microscopy
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| How does T Pallidum cause miscarriage and still-born problems and congenital syphilis | the bacteria can cross the placenta infecting the fetus
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| What is the tooth problem that can develop with infection from T Pallidum | Hutchinson's teeth, teeth get notched and spread apart
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| This urogenital infection is makred by fluid filled blisters that form when a virus causes infected cells to lyse. Generally develops into painful ulcerations. | HSV-2, Genital Herpes can also be HSV-1 but HSV-2 is more common in genital herpes
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| IF a mother has primary infection near delivery time what is the concern | baby has 1 in 3 chance of getting infected with HSV virus which can result in death or permanent disability
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| What is the tx for HSV infections | acyclovir, famiclovir not a cure but helps reduce severity and number of recurrences
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| What causes genital warts | HPV virues
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| WHat is the most common sexually transmitted disease | HPV
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| How many types of HPV are there and how many are associated with cervical cancer | 100 types 15 associated with cervical cancer
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| Can you get genital warts from hand or plantar warts | NO
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| What is the tx for genital warts | laser removal or freezing with liquid nitrogen OUCHY and imiquimod immune modifying cream
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| Protozoal STD that can cause itching of the vulva and vagina along with a frothy yellowish green vaginal discharge and painful urination | Trichomoniasis caused by Trichomonas Vaginalis
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| What would you expect to see upon cervical examination with patient who is infected with Trichomoniasis | a strawberry cervix bright red
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| How does trichomonas appear when viewed by microsope in the discharge | it has jerky motility, doesn't have mitochondria
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| If you find a child infected with trichomonas what should you suspect | child sex abuse
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| what is the tx for trich | metronidazole
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