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152 LE4 > Bacteria in the Genitourinary Tract > Flashcards

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

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2
Q

What is the most severe UTI?

A

pyelonephritis or urosepsis

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3
Q

58% of UPEC belongs to which serotypes?

A

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

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4
Q

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

A

P fimbriae and other virulence factors

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5
Q

Why are women more susceptible to UPEC?

A

proximity of urethra

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6
Q
A
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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
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8
Q

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

A

TRUE

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9
Q

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

A

O Ag

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10
Q

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

A

O Ag

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11
Q

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

A

lipopolysaccharide, epithelial cells

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12
Q

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

A

Flagellar (H ag)

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13
Q

The flagella may be denatured or removed by ______

A

heat or alcohol

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14
Q

Enumerate fimbriae types of UPEC

A
  • Type 1
  • P fimbriae
  • F1C
  • S Fimbriae
  • Ygi and Yad
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15
Q

FimA: Main structural subunit; FimH: ____

A

Adhesin, at the tip

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16
Q

What is the function of Type 1 fimbriae?

A

invade bladder cells by binding mannose moietis and increase inflammation

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17
Q

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

A

pap: pyelonephritis-associated pili

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18
Q

What is the function of P fimbriae?

A

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

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19
Q

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

A

mannose-resistant, specific to O blood

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20
Q

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

A

FALSE, papA

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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

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22
Q

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

A

S fimbriae

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23
Q

SfaS (tip adhesin) binds _______ on kidney epithelial cells

A

sialic acid

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24
Q

What is the function of S fimbriae?

A

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

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25
Q

What is the function of Ygi & Yad fimbriae?

A

biofilm formation

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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

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27
Q

______ are proteins that undergo type V secretion

A

Autotransporters

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28
Q

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

A

extracellular matrix

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29
Q

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

A

FALSE: uropathogenesis

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30
Q

UPEC pathogenesis is ____ and _____

A

ascending and hematogenous

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31
Q

Signs and Symptoms of UPEC

A
  • Urinary frequency
  • Dysuria
  • hematuria
  • pyuria
  • flank pain
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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)

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33
Q

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

sulfonamides
ampicillin
penicillin
cephalosporins
fluoroquinolones
aminoglycosides

A

penicillin

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34
Q

Individually, Neisseriae appears _____-shaped

A

Kidney

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35
Q

In pairs, Neisseriae the _____ sides are adjacent

A

flat or concave

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36
Q

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

A

convex, glistening, elevated, mucoid colonies

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37
Q

TRUE OR FALSE: Neisseriae appears pigmented, hemolytic in media

A

FALSE: transparent/opaque,
nonpigmented, nonhemolytic

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38
Q

Neisseriae grows best under _______ conditions

A

aerobic

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39
Q

What test is key in identifying Neisseriae species?

A

Oxidase Test

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40
Q

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

A

Neisseriae

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41
Q

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

A

autolytic

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42
Q

Neisseriae grows best in __% CO2

A

5%

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43
Q

Neisseriae is rapidly killed by:

A

drying
sunlight
moist heat
disinfectants

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44
Q

TRUE OR FALSE: Neisseria has bigger colonies than neisseriae

A

False

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45
Q

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

A

arginine, hypoxanthine, uracil

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46
Q

N. gonorrhoeae can grow in which of the following carbohydrates

Maltose
Lactose
Sucrose
Glucose
Fructose

A

Glucose

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47
Q

Enumerate N. gonorrhoeae surface structures

A
  • Pili (fimbriae)
  • POR (fimbriae)
  • OPA Proteins
  • RMO (Protein III)
  • LIPOOLIGOSACCHARIDE
  • H8
  • Fbp
  • IgA1 Protease
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48
Q

This protein associates with Por in formation of pores

A

RMP (protein III)

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49
Q

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

A

POR

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50
Q

Which terminal of pili is most prominent in immune response?

Amino terminal
Mid portion
C Terminal

A

C terminal

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51
Q

What is the function of OPA proteins?

A

adhesion w/in colonies
attachment to host cells

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52
Q

LOS resemble what human structure?

A

cell membrane glycosphingolipids

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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

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

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

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

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

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

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 ____

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

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

118
Q

Congenital syphilis happens ______ after gestation, before treatment of mother

119
Q

Congenital syphilis is similar to _______ syphilis in adults

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

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

152 LE4 (6 decks)

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