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Session 2 Microbio11
Microbio -11- Genitourinary Infection
| Question | Answer |
|---|---|
| What are the common clinical features of UTIs | Painful urination uncomplicated urethritis/cystitis Fever, Sepsis, and decreased kidney function |
| What is the most common cause of UTIs | Escherichia Coli and other enterbacteria family |
| 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 |
| Why does Spermicide increase UTI risks | IT increases adherence of E. Coli to vaginal epithelial cells |
| 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 |
| What is Pyelonephritis | infection of the kidney and renal pelvis most common follows a bladder infection. |
| What will you see in the urine w/ acute pyelonephritis | WBCs, cellular casts, bacteria and protein, |
| What is the concern with pyelonephritis becoming chronic | chronic pyelonephritis can result in gradual nephron loss and renal failure |
| What is urethritis | inflammation of the urethra usually caused by bacteria |
| 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 |
| inflammation of the prostate gland generally an extension of bladder or urethra infection generally follows catheterization | Prostatitis |
| Apart from bacteria what else can cause UTIs | Yeasts such as candida |
| What are the virulence factors for UTI bacteria | adherance to vaginal and uroepithelial cells cytotoxic, necrotizing factors hemolysin |
| What are the genes for UTI virulence linked to | pathogenicity islands which are absent in normal fecal coliforms |
| 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 |
| 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 |
| Gram - rods faculative anaerobe most common cause of UTIs | E. Coli |
| WHat is the pathogenicity of E. Coli | Adhere to mucosa via pili causing tissue damage and inflammation from endotoxin |
| What is the TX for E. Coli | penicillin and ciprofloxacin |
| How do E. Coli get to the urinary tract to cause infection | occurs after contamination of genital area with feces |
| Gram + Cocci nitrite negative nonhemolytic catalse positive coagulase negative resistant to novobiocin "honeymoon cystitis" | Staph. Saprophyticus |
| UTI that occurs in sexually active women | Staph. Saprophyticus |
| 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 |
| 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 |
| 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 |
| If streptococci don't have a C carbohydrate what are they | non typeable viridans streptococci |
| What type of hemolysis does enterococcus faecalis cause on blood agar | Gamma hemolysis |
| What is the tx for enterococcous faecalis | amoxicillin, ampicillin, vancomycin |
| What is the most common site for nosocomial infections and most common cause | urinary tract 60-80% follow catheterization |
| 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 |
| 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 |
| HOw do you dx a UTI | urine should be sterile presence of bacteria can be indicative of a UTI |
| 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 |
| What does the Nitrite test of urine indicate if positive | indicates bacteriuria because some bacteria convert nitrate in urine to nitrite |
| 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 |
| 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 |
| What are the s/sx associated with infection w/ leptospirosis | headache, fever, chills, severe muscle pain, redness of eyes from dilation of blood vessels |
| 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 |
| What are clue cells in bacterial vaginosis | sloughed off epithelial cells covered with bacteria |
| What is some bacteria that causes bacterial vaginosis | Gardnerella Vaginalis, Gardnerella Mobiluncus, Mycoplasma Hominus |
| How do you treat bacterial vaginosis | clindamycin, metronidazole |
| What are the s/sx of vulvovaginal candidiasis | itching, burning, and whitish vaginal discharge |
| Oportunistic mycoses of the vagina by candida sp. | vulvovaginal candidiasis |
| Where is the source of candida sp in vulvovaginal candidiasis | most commonly from the patient themselves can get some oxegenous transmission |
| how do you dx vulvovaginal candidiasis | direct microscopic examination with KOH prep looking for budding yeasts and pseudohyphae |
| How do you differentiate between the different candida infections | use a CHROMagar differentiation Albican=green Krusei=rose tropicalis=steel blue |
| what is the tx for Vulvovaginal Candidiasis | azoles antimetabolites- flucytosine |
| Infection with what organism can cause toxic shock | Strains of Staph Aureus that produce exotoxin casuing massive release of cytokines |
| What is associated with the use of tampons that abrade the vaginal wall | toxic shock syndrome |
| What are the s/sx of toxic shock syndrome | fever, chills, vomiting, diarrhea, muscle aches, rash and possible severe hypotension and multisystem dysfunction |
| what can occur 1-2 weeks after onsent of toxic shock syndrome to the palms and soles | you can get desquamation |
| what percent of TSS ends up being fatal | 5% |
| 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 |
| What is the toxic shock like syndrome caused by | streptococcal pyogenes also called toxic strep |
| HOw do you dx strep toxic shock like syndrome | you must isolate and indentify group A strep |
| What are the s/sx of strep toxic shock like syndrome | hypotension renal impairment, coagulopathy, liver problems rash soft tissue necrosis |
| Bacterial STD caused by neisseria gonorrhoeae a gram negative diplococcus | Gonorrhea |
| How do Gonorrhea attach to host cells | Pili |
| What does the R plasmid in gonorrhea do | makes them resistant to antibiotics such as penicillin and tetracycline |
| 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 |
| How does gonorrhoeae evade the immune system | antigenic variation of the pili allow gonorrhea to escape the immune system |
| is there a vaccine for gonorhhea | no |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| What is it called when Gonorrhea gets into your joints | disseminated gonococcal infection you get fever, rash and arthritis |
| WHat is the tx for honorrhea | fluoroquinolones, cephalosporins |
| 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 |
| 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 |
| What is the chronic eye disease caused by 4 strains of chlaymdia called that can cause blindness | trachoma |
| 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 |
| What is the tx for chlamydia | Azithromycin, tetracyclin, erythromycin |
| Chracterized in its first stage by painless red ulcer called chancre | syphilis |
| What is the secondary stage of syphilis marked by | Runny nose, water eyes, aches, sore throat, rash on palms and soles |
| What is the tertiary stage of syphilis marked by | mental illness, blindness, stroke |
| What is the organism that causes syphilis | T. Pallidum |
| What is the tx for syphilis | penicillin |
| What does the chancre in syphilis indicate | it shows the site of entrance of the syphilis organism T. Pallidum |
| 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 |
| what can a hypersensitivity rxn to Treponema Pallidum cause | can cause blindness |
| Can T. Pallidum be cultured in vitro | no only invivo grown in rabit testicles |
| What type of technique do you use to identify T. Palldum in a sample | use darkfield microscopy |
| How does T Pallidum cause miscarriage and still-born problems and congenital syphilis | the bacteria can cross the placenta infecting the fetus |
| What is the tooth problem that can develop with infection from T Pallidum | Hutchinson's teeth, teeth get notched and spread apart |
| 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 |
| 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 |
| What is the tx for HSV infections | acyclovir, famiclovir not a cure but helps reduce severity and number of recurrences |
| What causes genital warts | HPV virues |
| WHat is the most common sexually transmitted disease | HPV |
| How many types of HPV are there and how many are associated with cervical cancer | 100 types 15 associated with cervical cancer |
| Can you get genital warts from hand or plantar warts | NO |
| What is the tx for genital warts | laser removal or freezing with liquid nitrogen OUCHY and imiquimod immune modifying cream |
| 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 |
| What would you expect to see upon cervical examination with patient who is infected with Trichomoniasis | a strawberry cervix bright red |
| How does trichomonas appear when viewed by microsope in the discharge | it has jerky motility, doesn't have mitochondria |
| If you find a child infected with trichomonas what should you suspect | child sex abuse |
| what is the tx for trich | metronidazole |
Created by:
smaxsmith
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