Bacteria in the Genitourinary Tract Flashcards

1
Q

E. coli will test positive for which of the following tests?
A. Indole
B. Citrate
C. VP
D. Methyl Red

A

A. Indole
D. Methyl Red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most severe UTI?

A

pyelonephritis or urosepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

58% of UPEC belongs to which serotypes?

A

O1, O2, O4, O6, O8, O9, O18, O83

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Of the 10 pathogen-specific genome islands, 3 contain ____

A

P fimbriae and other virulence factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why are women more susceptible to UPEC?

A

proximity of urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Enumerate all 7 UPEC Components

A
  • LPS
  • Capsular (K protein)
  • toxins
  • iron acquisition systems
  • flagellar (H) Ag (O:K:H serotype)
  • fimbrial and afimbrial adhesins
  • haemolysin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TRUE OT FALSE: UPEC lacks the type III secretion
system to inject VFs

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most external part of cell wall for UPEC?

A

O Ag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This structure is made up of repeating units of polysaccharide that makes UPEC resistant to heat and alcohol.

A

O Ag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The capsule is external to the ____ and serves as the attachment to ______.

A

lipopolysaccharide, epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What UPEC structure may interfere with agglutination by anti-O Ab?

A

Flagellar (H ag)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The flagella may be denatured or removed by ______

A

heat or alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Enumerate fimbriae types of UPEC

A
  • Type 1
  • P fimbriae
  • F1C
  • S Fimbriae
  • Ygi and Yad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

FimA: Main structural subunit; FimH: ____

A

Adhesin, at the tip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of Type 1 fimbriae?

A

invade bladder cells by binding mannose moietis and increase inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The presence of this pili is a marker of a highly virulent strain

A

pap: pyelonephritis-associated pili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the function of P fimbriae?

A

enhance severity of UTI by promoting adherence to vascular endothelium & bladder epith

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

P fimbriae is mannose-_______, and is specific to _ blood group antigen

A

mannose-resistant, specific to O blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TRUE OR FALSE: papG is the main subunit of P fimbriae

A

FALSE, papA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the function of F1C fimbriae?

A

adherence to the endothelium and muscular layer of the bladder kidneys: distal tubules and collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which fimbriae type is genetically identical to F1C except for the tip adhesin?

A

S fimbriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

SfaS (tip adhesin) binds _______ on kidney epithelial cells

A

sialic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the function of S fimbriae?

A

binds to kidney tubules, collecting ducts, glomerulus, and epith and musc. layers of bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the function of Ygi & Yad fimbriae?

A

biofilm formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

1: Ygi - kidney epith cells
2: Yad: Muscular epith cells

A. First statement is correct. Second is Wrong
B. First statement is wrong. Second is correct.
C. Both statements are true
D. Both statements are false

A

A. Yad is for bladder epith. cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

______ are proteins that undergo type V secretion

A

Autotransporters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Autotransporters are secreted into ______ or remain attached to bacterial cell surface.

A

extracellular matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

TRUE OR FALSE; Autotransporters is involved in neuropathogenesis and promotes biofilm formation.

A

FALSE: uropathogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

UPEC pathogenesis is ____ and _____

A

ascending and hematogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Signs and Symptoms of UPEC

A
  • Urinary frequency
  • Dysuria
  • hematuria
  • pyuria
  • flank pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Dysuria is characterized by ____

A

Sensation of pain and/or burning, stinging, or itching of the urethra or urethral meatus associated with urination (NCBI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which of the the following are NOT treatment drugs for UPEC?

sulfonamides
ampicillin
penicillin
cephalosporins
fluoroquinolones
aminoglycosides

A

penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Individually, Neisseriae appears _____-shaped

A

Kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In pairs, Neisseriae the _____ sides are adjacent

A

flat or concave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Neisseriae appears ______, ______, ______, ______ in enriched media

A

convex, glistening, elevated, mucoid colonies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

TRUE OR FALSE: Neisseriae appears pigmented, hemolytic in media

A

FALSE: transparent/opaque,
nonpigmented, nonhemolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Neisseriae grows best under _______ conditions

A

aerobic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What test is key in identifying Neisseriae species?

A

Oxidase Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which bacteria is nonmotile, non-spore-forming, non-acid-fast?

A

Neisseriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Neisseria produces ______ enzymes which causes rapid swelling and lysis at 25 C, alk pH

A

autolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Neisseriae grows best in __% CO2

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Neisseriae is rapidly killed by:

A

drying
sunlight
moist heat
disinfectants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

TRUE OR FALSE: Neisseria has bigger colonies than neisseriae

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

N. gonorrhoeae requires ____, _____, and ___ for growth

A

arginine, hypoxanthine, uracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

N. gonorrhoeae can grow in which of the following carbohydrates

Maltose
Lactose
Sucrose
Glucose
Fructose

A

Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Enumerate N. gonorrhoeae surface structures

A
  • Pili (fimbriae)
  • POR (fimbriae)
  • OPA Proteins
  • RMO (Protein III)
  • LIPOOLIGOSACCHARIDE
  • H8
  • Fbp
  • IgA1 Protease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

This protein associates with Por in formation of pores

A

RMP (protein III)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

This N. gonorrhoeae structure allows nutrient entry as wells as prevention of phagosome-lysosome fusion

A

POR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Which terminal of pili is most prominent in immune response?

Amino terminal
Mid portion
C Terminal

A

C terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the function of OPA proteins?

A

adhesion w/in colonies
attachment to host cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

LOS resemble what human structure?

A

cell membrane glycosphingolipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Function of LOS

A

evasion of immune recognition
Interferes with gonococcal binding to receptors on phagocytic cells

54
Q

What is the function of IgA1 Protease

A

splits and inactivates IgA1 (a mucosal IG of humans

55
Q

TRUE OR FALSE: LPS has no O-Ag side chains

A

TRUE

56
Q

Which has a higher attack rate for N. gonorrhoaea,

F to M?
M to F?

A

F to M: ~20%
Answer: M to F: >50%

57
Q

____% of men present with acute symptoms
with infection of N. gonorrhoeae

A

95%

58
Q

What is the correct order in the pathogenesis of N. gonorrhoeae?

I. acute suppuration -> tissue invasion
II. chronic inflammation and fibrosis
III. attach via adherence ligands (pili, Opa) to
mucous membranes -> entry into host cell

A

III -> I -> II

59
Q

What are the symptoms of N. gonorrhoeae for men?

A
  • penile discharge (white, yellow, greenish)
  • pain/burning when peeing
  • painful/swollen testes
    may extend to epididymis
60
Q

What are the symptoms of N. gonorrhoeae for women?

A
  • mostly asymptomatic
  • vaginal discharge (mucopurulent discharge)
  • pain/burning when peeing
  • vaginal bleeding between periods or during sexual intercourse
  • chronic cervicitis/proctitis: often asymptomatic
61
Q

In babies, the manifestations of N. gonorrhoeae are ___

A
  • discharge
  • bleeding
  • itchiness
  • soreness
  • painful bowel
  • movements
62
Q

TRUE OR FALSE: Gonococcal endocarditis may lead to blindness

A

False, genococcal opthalmis neonatorum

63
Q

In diagnostic tests of N. gonorrhoeae, what do you expect to see in the neutrophil of smears?

A

G- diplococci

64
Q

Smears are more sensitive in Male/Female for N. gonorrhoeae diagnosis

A

M: >95% sensitive
F: 50-70% sensitive

65
Q

What is selective mediium for N. gonorrhoeae?

A

Martin-Lewis agar (chocolate agar w/ antibiotics against G-, G+, and fungi)

66
Q

A patient treated for N. gonorrhoeae wanted to attend a Grindr Hookup 8 days after their treatment. Is he allowed to have sexual intercourse?

A

Yes. He has passed the 7D post-treatment period

67
Q

Retesting for N. gonorrhoeae should happen _____ months after treatement

A

3 months

68
Q

Untreated N. gonorrhoeae may lead to the ff. complications:

A
  • blockage of fallopian
  • tubes (due to scarring)
  • ectopic pregnancy
  • infertility
  • long-term
  • pelvic/abdominal pain
69
Q

Identify three species of Chlamydiae

A

C. trachomatis, C. pneumoniae, C. psittaci

70
Q

Chlamydiae is a Gram-_____ ______(shape)

A

Gram-negative cocci

71
Q

Which of the following are present in Chlamydiae

Peptidogolycan
Mechanism for energy production
All of the above
None of the above

A

None of the above

72
Q

The major outer membrane protein (MOMP) of Chlamydiae is ______

A

immunogenic

73
Q

The replicative cycle of Chlamydiae involves how many forms? Enumerate

A

2 forms: Elementary and reticulate

74
Q
A
75
Q

In elementary form of the replicative cycle of Chlamydiae, provide the characteristics of the bacteria

A

smaller, have rigid cell walls, can
survive outside cells, infectious

76
Q

Reticulate form of Chlamydiae happens after ____

A

cell entry (endocytosis)

77
Q

Give the chronological order of the replicative cycle of Chlamydiae

I. Exocytosis
II. Endocytosis
III. Infectious stage characterized by smaller rigid cell walls
IV. Binary Fission

A

III -> II -> IV -> I

78
Q

Enumerate Biovars of Chlamydia trachomatis

A

A, B, C
D-K
L

79
Q

The biovars for A,B,C of Chlamydia trachomatis manifests by which syndrome?

A. Hematuria
B. Conjunctivitis
C. genitourinary & neonatal infections
D. lymphogranuloma venereum

A

B. Conjunctivitis

80
Q

Chlamydiae attaches to which cells?

A

columnar epithelial cells of endocervix and upper genital tract of women, urethra, rectum, conjunctiva of both sexes

81
Q

Initial attachment of Chlamydiae is mediated by _____ and other membrane proteins which leads to __________

A

MOP, Cellular Invasion

82
Q

Trachoma is also called as _______

A

chronic follicular conjunctivitis

83
Q

Trachoma is usually contracted from infancy or early childhood from the ___________

A

mother or close contact

84
Q

Severe corneal scarring from trachoma may lead to

A. Conjunctivitis
B. Cataracts
C. Blindness

A

C. Blindness

85
Q

TRUE OR FALSE: C. trachomatis is symptomatic and is communicable to sexual partners.

A

FALSE: May be asymptomatic but
COMMUNICABLE to sexual partners

86
Q

Symptoms of C. trachomatis among males include:

A

epididymitis
non-gonococcal urethritis

87
Q

Symptoms of C. trachomatis among females include:

A

urethritis
cervicitis
PID leading to: sterility, ectopic pregnancy

88
Q

C. trachomatis may infect up to _______ of newborns

A

20-50%

89
Q

Lymphogranuloma Venereum, characterized by suppurative inguinal adenitis, contains the serovar ______

A

one of 3 serovar Ag (L1-L3)

90
Q

Lymphogranuloma Venereum is commonly found in _____ climates

A. Cold
B. Hot
C. Temperate
D. Tropical

A

D. Tropical

91
Q

Chronic inflammation of Lymphogranuloma Venereum leads to:

A

fibrosis, lymphatic obstruction, rectal strictures

92
Q

What are the symptoms of RTI in newborns caused by C. trachomatis

A

striking tachypnea
paroxysmal cough
No fever
eosinophilia
x-ray: lung consolidation and hyperinflation

93
Q

TRUE OR FALSE: In diagnostic test of C. trachomatis, Smears from pus, buboes, biopsy are frequently recognized

A

False, rarely

94
Q

McCoy Cell cultures of C. trachomatis may be treated with aminoglycoside to avoid contamination. What aminoglycoside is the exception?

A

Penicillin

95
Q

In serology of C. trachomatis, what single titer is indicative of active infection?

A

single titer of 1:64

96
Q

In treatment of C. trachomatis, what drug is used for nongonococcal urethritis and nonpregnant infected females?

A. Tetracyclines
B. Azithromycin
C. Sulfonamides
D. Erythromycin

A

A.

97
Q

Azithromycin is the treatment of C. trachomatis for which group?

A. Pregnant
B. Nonpregnant

A

A. Pregnant

98
Q

Treponema pallidum is a highly motile __________

A

corkscrew-shaped spirochete

99
Q

What is the causative agent for syphilis?

A

Treponema pallidum

100
Q

TRUE OR FALSE: Treponema pallidum cannot be cultured, as is usually grow in animals (rabbit brain)

A

FALSE: rabbit testes

101
Q

Treponema pallidum may only been by the following EXCEPT:

A. immunofluorescence
B. darkfield microscopy
C. electron microscopy
D. silver impregnation

A

C. electron Microscopy

102
Q

Treponema pallidum is usually spread via

A

Direct Sexual Contact

103
Q

Other ways T. pallidum can be spread is through _____

A

nongenital contact
sharing of needles
transplacental

104
Q

What is the correct order for the pathogenesis of T. pallidum

I. Lesions
II. Tissue Reaction
III. Obstruction of local blood supply
IV. Possible necrosis and secondary destruction
V. Endarteritis
VI. Multiply in submucosa

A

VI. II. I. V. III. IV

105
Q

In primary infection of T. pallidum, papules may lead to ____

A

Ulcer

106
Q

What is chancre (T. pallidum symptom)

A

Ulcer with firm base and raised margins

107
Q

In secondary infection of syphilis, what are the symptoms present?

A

symmetric maculopapular rash, lymphadenitis, fever, malaise

condylomata lata: painless mucosal warty erosions

108
Q

In latent infection of T. pallidum, transmission may happen via ______ or _______

A

relapsing secondary lesions or via blood fetal transmission

109
Q

In tertiary infection of T. pallidum, how many years usually pass since the first infection?

A

~5yrs after infection, but usually 15-20yrs
neurosyphilis and cardiovascular syphilis

110
Q

Meningovasculitis and degenerative parenchymal changes are symptoms of which kind of T. pallidum infection?

A

Neurosyphilis

111
Q

In neurosyphilis, _________ and _____ are found in the CSF

A

Inctraser cells and proteins

112
Q

Tabes dorsalis is the _________

A

demyelination of posterior columns

113
Q

Cortical degeneration caused by neurosyphilis can lead to the following mental changes EXCEPT

A. decreased memory
B. ataxia
C. hallucinations
D. frank psychosis

A

B. ataxia

114
Q

Cardiovascular syphilis may cause arteritis involving the _______

A

vasa vasorum of aorta

115
Q

Aneurysm of ascending ascending and transverse segments of aorta are caused by the ___________ due to cardiovascular syphilis

A

dilation of aorta and aortic valve ring

116
Q

Gummatous syphilis is characterized by ___________

A

localized, granulomatous reaction

117
Q

Which of the following are correctly matched

A. Neurosyphilis: Paresis; Cardiovascular syphilis: gummatous syphilis
B. Neurosyphilis: gummatous syphilis; Cardiovascular syphilis: Paresis

A

A

118
Q

Congenital syphilis happens ______ after gestation, before treatment of mother

A

4 months

119
Q

Congenital syphilis is similar to _______ syphilis in adults

A. Primary
B. Secondary
C. Latent
D. Tertiary

A

B

119
Q

Congenital syphilis has usually no physical findings but may show ____ and ________

A

rhinitis and maculopapular rash

120
Q

Bone involvement of congenital syphilis involves

A. Saddle Shins
B. Saber nose
C. Sabre Saddle
D. Saber shins

A

D. Saber Shins
Saddle Nose

121
Q

What are the symptoms of terminal congenital syphilis?

A

anemia, thrombocytopenia, liver failure

122
Q

TRUE OR FALSE: A negative darkfield microscopy rules out the possibility of syphilis due to the low count of T. pallidum

A

False, a negative result does not rule out syphilis since sample must contain thousands
of treponemes/mL to be detectable

123
Q

What is the lipid complex with a
component first extracted from beef heart

A

Cardiolipin

124
Q

What nontreponemal test is used for early stages only since it wanes in later stages?

A

Rapid Plasma Regin (RPR) & Venereal Disease
Research Laboratory (VRDL)

125
Q

Autoimmune diseases and liver destruction may cause _______ in nontreponemal tests/

A

False positives

126
Q

What are the advantages of nontreponemal tests?

A

low cost and relatively sensitive
good for monitoring treatment

127
Q

What are used to confirm RPR and VRDL results for T. pallidum?

A

Treponemal Tests

128
Q

T. pallidum infections are usually treated with ______ for all stages except in people with allergies to it

A

penicillin

129
Q

In T. pallidum treatment, the patient may experience a sepsis-like reaction in the first 8 hrs after administration of antibiotic. What is this reaction called?

A

Jarisch-Herxheimer reaction