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Microbiology Exam 4 > 45 - Genitourinary Infections > Flashcards

45 - Genitourinary Infections Flashcards

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1
Q

What genus is predominant in normal vaginal flora during childbearing years?

A

Lactobacillus

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2
Q

Lactobacillus features

A

Gram-positive, microaerophilic/anaerobic rods

Cannot grow in urine (no UTIs)

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3
Q

How does Lactobacillus affect the conditions of the vagina?

A

Metabolize glycogen into lactate, resulting in vaginal pH of ~4-5

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4
Q

Factors that can alter normal vaginal flora

A

Age
Menstruation

Hysterectomy

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5
Q

Hysterectomy affects on normal vaginal flora

A

Particular increase in prevalence of Bacteroides fragilis

Also increase in E. coli and Enterococcus

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6
Q

Bacterial vaginosis (BV) cause

A

Overgrowth of anaerobic bacterial species

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7
Q

BV symptoms

A

May be asymptomatic
Discharge

Odor

Pain

Itching

Burning

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8
Q

BV diagnosis

A

Discharge
Clue cells

Positive “whiff test”

Elevated vaginal pH

Nugent score

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9
Q

Whiff test

A

Volatile amines produced by anaerobic metabolism

KOH added results in a strong, fishy odor

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10
Q

Nugent score

A 
0-3 = normal (Lactobacillus dominant)
4-6 = intermediate (mixed)

7-10 = BV (absence of Lactobacillus, predominance of two other morphotypes)

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11
Q

Complications associated with BV

A

STD-susceptible
Increased transmission of HIV

More likely to develop other infections

Effects on baby during pregnancy

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12
Q

BV treatment

A

Oral metronidazole
Clindamycin

Recurrence is common

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13
Q

Vulvovaginal candidiasis (VVC) symptoms

A

Common fungal infection in women of childbearing age

Thick, odorless, white vaginal discharge

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14
Q

Two classifications of VVC

A

Uncomplicated

Complicated

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15
Q

Uncomplicated VVC

A

Sporadic or infrequent mild-to-moderate symptoms in otherwise healthy patient

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16
Q

Complicated VVC

A

Recurrent or severe
Non-albicans candidiasis

Uncontrolled diabetes, debilitation, or immunosuppression

17
Q

Candida species features

A

Oval, yeastlike forms

Produce buds, pseudohyphae, and hyphae (GERM TUBES diagnostic for C. albicans)

18
Q

Common symptoms of C. albicans

A

Vaginitis
Diaper rash

Oral thrush

19
Q

When are C. albicans infections most common?

A

After taking antibiotics

20
Q

C. albicans diagnosis and treatment

A

KOH microscopy reveals hyphae and budding yeast
1-3 days of topical azole for uncomplicated VVC

7-14 days of topical, or two doses of oral fluconazole for complicated VVC

21
Q

Trichomoniasis symptoms

A

Most women are asymptomatic
Symptoms range from vaginitis, painful urination, yellow-green, frothy, foul-smelling discharge

Men are primarily asymptomatic carriers, but can have some UT problems

22
Q

Trichomonas vaginalis features

A

Small, pear-shaped protozoa
Motile

Rigid axostyle (attachment)

Anaerobic

ONLY exists in trophozoite form

23
Q

Pathogenesis of T. vaginalis

A

Squamous epithelium of GU tract results in epithelial cell destruction, neutrophil influx, and petechial hemorrhages

24
Q

T. vaginalis diagnosis and treatment

A

Detection of T. vaginalis in exudate or Pap smear

Metronidazole - treat both partners

25
Q

Menstrual toxic shock syndrome cause

A

TSST-1 producing strains of S. aureus

26
Q

TSST-1 features

A

Heat- and proteolysis-resistant exotoxin
Can penetrate the mucosal barrier and is responsible for systemic effects

Superantigen

27
Q

TSST-1 effects

A

Macrophages release IL-1beta and TNFalpha
T cells release IL-2, IFNgamma, TNFbeta

IL-1beta release results in fever

TNFalpha and TNFbeta release is associated with hypotension and shock

28
Q

TSS symptoms

A

Diarrhea
Malaise

High fever

Nausea and vomiting

29
Q

TSS diagnosis - major criteria

A

Hypotension (systolic BP <90)
Orthostatic syncope

Macular erythroderma

High fever

Late skin desquamation

30
Q

TSS diagnosis - minor criteria

A

GI (diarrhea/vomiting)
Mucous membrane involvement

Muscular (myalgia, CPK more than doubled)

31
Q

TSS treatment

A

Supportive measures

Administer beta-lactamase-resistant penicillin or vancomycin

Microbiology Exam 4 (4 decks)

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