Bacteria in the Genitourinary Tract Flashcards by Joram Manio

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

A. Indole
D. Methyl Red

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What is the most severe UTI?

pyelonephritis or urosepsis

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58% of UPEC belongs to which serotypes?

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

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

P fimbriae and other virulence factors

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Why are women more susceptible to UPEC?

proximity of urethra

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Enumerate all 7 UPEC Components

LPS
Capsular (K protein)
toxins
iron acquisition systems
flagellar (H) Ag (O:K:H serotype)
fimbrial and afimbrial adhesins
haemolysin

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

TRUE

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

O Ag

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

O Ag

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

lipopolysaccharide, epithelial cells

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

Flagellar (H ag)

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The flagella may be denatured or removed by ______

heat or alcohol

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Enumerate fimbriae types of UPEC

Type 1
P fimbriae
F1C
S Fimbriae
Ygi and Yad

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FimA: Main structural subunit; FimH: ____

Adhesin, at the tip

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What is the function of Type 1 fimbriae?

invade bladder cells by binding mannose moietis and increase inflammation

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

pap: pyelonephritis-associated pili

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What is the function of P fimbriae?

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

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

mannose-resistant, specific to O blood

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

FALSE, papA

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What is the function of F1C fimbriae?

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

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

S fimbriae

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SfaS (tip adhesin) binds _______ on kidney epithelial cells

sialic acid

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What is the function of S fimbriae?

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

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What is the function of Ygi & Yad fimbriae?

biofilm formation

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. Yad is for bladder epith. cells

______ are proteins that undergo type V secretion

Autotransporters

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

extracellular matrix

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

FALSE: uropathogenesis

UPEC pathogenesis is ____ and _____

ascending and hematogenous

Signs and Symptoms of UPEC

- Urinary frequency - Dysuria - hematuria - pyuria - flank pain

Dysuria is characterized by ____

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

Which of the the following are NOT treatment drugs for UPEC? sulfonamides ampicillin penicillin cephalosporins fluoroquinolones aminoglycosides

penicillin

Individually, Neisseriae appears _____-shaped

Kidney

In pairs, Neisseriae the _____ sides are adjacent

flat or concave

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

convex, glistening, elevated, mucoid colonies

TRUE OR FALSE: Neisseriae appears pigmented, hemolytic in media

FALSE: transparent/opaque, nonpigmented, nonhemolytic

Neisseriae grows best under _______ conditions

aerobic

What test is key in identifying Neisseriae species?

Oxidase Test

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

Neisseriae

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

autolytic

Neisseriae grows best in __% CO2

Neisseriae is rapidly killed by:

drying sunlight moist heat disinfectants

TRUE OR FALSE: Neisseria has bigger colonies than neisseriae

False

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

arginine, hypoxanthine, uracil

N. gonorrhoeae can grow in which of the following carbohydrates Maltose Lactose Sucrose Glucose Fructose

Glucose

Enumerate N. gonorrhoeae surface structures

- Pili (fimbriae) - POR (fimbriae) - OPA Proteins - RMO (Protein III) - LIPOOLIGOSACCHARIDE - H8 - Fbp - IgA1 Protease

This protein associates with Por in formation of pores

RMP (protein III)

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

POR

Which terminal of pili is most prominent in immune response? Amino terminal Mid portion C Terminal

C terminal

What is the function of OPA proteins?

adhesion w/in colonies attachment to host cells

LOS resemble what human structure?

cell membrane glycosphingolipids

Function of LOS

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

What is the function of IgA1 Protease

splits and inactivates IgA1 (a mucosal IG of humans

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

TRUE

Which has a higher attack rate for N. gonorrhoaea, F to M? M to F?

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

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

95%

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

III -> I -> II

What are the symptoms of N. gonorrhoeae for men?

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

What are the symptoms of N. gonorrhoeae for women?

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

In babies, the manifestations of N. gonorrhoeae are ___

- discharge - bleeding - itchiness - soreness - painful bowel - movements

TRUE OR FALSE: Gonococcal endocarditis may lead to blindness

False, genococcal opthalmis neonatorum

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

G- diplococci

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

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

What is selective mediium for N. gonorrhoeae?

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

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

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

Retesting for N. gonorrhoeae should happen _____ months after treatement

3 months

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

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

Identify three species of Chlamydiae

C. trachomatis, C. pneumoniae, C. psittaci

Chlamydiae is a Gram-_____ ______(shape)

Gram-negative cocci

Which of the following are present in Chlamydiae Peptidogolycan Mechanism for energy production All of the above None of the above

None of the above

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

immunogenic

The replicative cycle of Chlamydiae involves how many forms? Enumerate

2 forms: Elementary and reticulate

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

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

Reticulate form of Chlamydiae happens after ____

cell entry (endocytosis)

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

III -> II -> IV -> I

Enumerate Biovars of Chlamydia trachomatis

A, B, C D-K L

The biovars for A,B,C of Chlamydia trachomatis manifests by which syndrome? A. Hematuria B. Conjunctivitis C. genitourinary & neonatal infections D. lymphogranuloma venereum

B. Conjunctivitis

Chlamydiae attaches to which cells?

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

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

MOP, Cellular Invasion

Trachoma is also called as _______

chronic follicular conjunctivitis

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

mother or close contact

Severe corneal scarring from trachoma may lead to A. Conjunctivitis B. Cataracts C. Blindness

C. Blindness

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

FALSE: May be asymptomatic but COMMUNICABLE to sexual partners

Symptoms of C. trachomatis among males include:

epididymitis non-gonococcal urethritis

Symptoms of C. trachomatis among females include:

urethritis cervicitis PID leading to: sterility, ectopic pregnancy

C. trachomatis may infect up to _______ of newborns

20-50%

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

one of 3 serovar Ag (L1-L3)

Lymphogranuloma Venereum is commonly found in _____ climates A. Cold B. Hot C. Temperate D. Tropical

D. Tropical

Chronic inflammation of Lymphogranuloma Venereum leads to:

fibrosis, lymphatic obstruction, rectal strictures

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

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

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

False, rarely

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

Penicillin

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

single titer of 1:64

In treatment of C. trachomatis, what drug is used for nongonococcal urethritis and nonpregnant infected females? A. Tetracyclines B. Azithromycin C. Sulfonamides D. Erythromycin

Azithromycin is the treatment of C. trachomatis for which group? A. Pregnant B. Nonpregnant

A. Pregnant

Treponema pallidum is a highly motile __________

corkscrew-shaped spirochete

What is the causative agent for syphilis?

Treponema pallidum

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

FALSE: rabbit testes

Treponema pallidum may only been by the following EXCEPT: A. immunofluorescence B. darkfield microscopy C. electron microscopy D. silver impregnation

C. electron Microscopy

Treponema pallidum is usually spread via

Direct Sexual Contact

Other ways T. pallidum can be spread is through _____

nongenital contact sharing of needles transplacental

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

VI. II. I. V. III. IV

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

Ulcer

What is chancre (T. pallidum symptom)

Ulcer with firm base and raised margins

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

symmetric maculopapular rash, lymphadenitis, fever, malaise condylomata lata: painless mucosal warty erosions

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

relapsing secondary lesions or via blood fetal transmission

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

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

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

Neurosyphilis

In neurosyphilis, _________ and _____ are found in the CSF

Inctraser cells and proteins

Tabes dorsalis is the _________

demyelination of posterior columns

Cortical degeneration caused by neurosyphilis can lead to the following mental changes EXCEPT A. decreased memory B. ataxia C. hallucinations D. frank psychosis

B. ataxia

Cardiovascular syphilis may cause arteritis involving the _______

vasa vasorum of aorta

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

dilation of aorta and aortic valve ring

Gummatous syphilis is characterized by ___________

localized, granulomatous reaction

Which of the following are correctly matched A. Neurosyphilis: Paresis; Cardiovascular syphilis: gummatous syphilis B. Neurosyphilis: gummatous syphilis; Cardiovascular syphilis: Paresis

Congenital syphilis happens ______ after gestation, before treatment of mother

4 months

Congenital syphilis is similar to _______ syphilis in adults A. Primary B. Secondary C. Latent D. Tertiary

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

rhinitis and maculopapular rash

Bone involvement of congenital syphilis involves A. Saddle Shins B. Saber nose C. Sabre Saddle D. Saber shins

D. Saber Shins Saddle Nose

What are the symptoms of terminal congenital syphilis?

anemia, thrombocytopenia, liver failure

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

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

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

Cardiolipin

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

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

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

False positives

What are the advantages of nontreponemal tests?

low cost and relatively sensitive good for monitoring treatment

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

Treponemal Tests

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

penicillin

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?

Jarisch-Herxheimer reaction