Chapter 23

Question 1

urinary bladder

Answer 1

Triangle-shaped muscular organ
Can collect and store 400‒600 ml of urine
Lined with transitional epithelium that can easily accommodate the changes in bladder volume required
Uropathogenic E. coli can invade epithelium and form a biofilm and serve as a source for recurrent bladder infections.

Question 2

cystitis

Answer 2

bladder infections

Question 3

pyelonephritis

Answer 3

kidney infections

Question 4

infections from the urethra to the bladder

Answer 4

Urogenital membranes ascend into the bladder.
More common in women

Question 5

ascending infection to the kidney

Answer 5

Organisms from an established infection in the bladder
Ascend along the ureter to infect the kidney

Question 6

descending infection from the kidney

Answer 6

Infected kidney sheds bacteria that descend into the bladder.
Kidney infections may arise when microbes are deposited in the kidneys from the blood.

Question 7

urethritis

Answer 7

Signified by pain or burning upon urination
Urethral discharge
Typically contract the disease as a result of sexual intercourse

Question 8

asymptomatic bacteriuria

Answer 8

Bacteria in the urine (bacteriuria)
No signs or symptoms
Concern for pregnant women and the elderly
Lack of symptoms may be due to
Changes in the pathogens (less virulent)
Less-responsive immune system
Combination of these factors

Question 9

cystitis

Answer 9

Diagnosis when the number of bacteria sample is greater than 105/ml
Symptoms include
Sudden onset of dysuria (painful or difficult urination)
Increased frequency of urination
Nocturia (waking up at night to urinate)
Less common symptoms
Fever
Lower abdominal pain

Question 10

urinary tract infections in children

Answer 10

Risk factors in children are
Incomplete emptying of the bladder
Postponing emptying of the bladder
Childhood urinary tract infections can lead to damage of the kidney if not treated.
Prevalence of UTI in children decreases with age.

Question 11

recurrent urinary tract infections

Answer 11

Some women suffer from recurrent UTIs.
Two or more UTIs in 6 months
Three or more UTIs in 12 months
Causes
Incomplete emptying of the bladder
Sexual activity
Use of spermicides
Prophylactic (preventative) continuous antibiotic therapy
Postcoital antibiotic prophylaxis is an alternative to continuous therapy for some.

Question 12

pyelonephritis

Answer 12

More prevalent in women
Symptoms
High fever (38°C or 104°F, or higher)
Chills
Oliguria (producing less than normal urine)
Flank pain
Costovertebral tenderness
Nausea
Bacterial flagella and pili allow bacteria to access ureters.
Can be treated with antibiotics

Question 13

sexually transmitted infections (STIs)

Answer 13

infections transmitted through sexual activity
Genital, oral-genital, or anal-genital contact
Some infections of the reproductive tract are not exclusively sexually transmitted.
Some STIs cause symptoms but others are asymptomatic.

Question 14

genital warts

Answer 14

Condylomata acuminata
Most common sexually transmitted viral infection
Appearance
Cauliflower-shaped, soft, flesh-colored lesions on an infected patient’s genitals or rectum
Symptoms can include itching, pain, or tenderness

Question 15

genital herpes

Answer 15

Herpes simplex viruses 1 and 2
Primary infection: may be asymptomatic
Erythematous papules, progress to vesicles and pustules, burning pain, muscle ache, fever
Latent period: no symptoms (lesions resolve)
Inactive period
Virus moves to nerves at base of spine
Recurrent episode
Milder than primary infection
Herpes encephalitis

Question 16

neonatal herpes

Answer 16

Pregnant mothers with genital herpes can transmit the virus to their baby before (transplacental), during, or after delivery.
May only appear as a skin infection but can also spread through the infant and affect many parts of the infant’s body, including the brain, liver, lungs, and kidneys.

Question 17

syphilis

Answer 17

Treponema pallidum
Spirochete
“Great imitator”-symptoms in second stage mimic those of other diseases
Primary syphilis
Chancre: painless inflammatory reaction-contains spirochetes
Latency-lesion goes away, early latent stage can last five years

Question 18

gonorrhea

Answer 18

Neisseria gonorrhoeae
Gram-negative diplococcus

Men (85–90%) exhibit symptoms such as painful urination, yellowish white discharge from the penis, and swelling of the testicles and penis.
Women (80%) do not exhibit symptoms.
When symptoms are present, they are usually mild, such as painful, burning sensation when urinating, and vaginal discharge that is yellowish-white and sometimes bloody.

Question 19

chlamydia trachomatis

Answer 19

Gram-negative-like
Obligate intracellular pathogen
Most frequently reported sexually transmitted infectious disease
75% of infected women have no symptoms. Most men are also asymptomatic.
Chlamydia is the major cause of nongonococcal urethritis in the United States.

Question 20

lymphogranum venereum (LGV)

Answer 20

Chlamydial disease involving the L1, L2, and L3 serotypes (more virulent than other serotypes)

Question 21

trichomoniasis

Answer 21

Trichomonas vaginalis
Flagellated protozoan
Trichomonas can infect both sexes.
Male reproductive organs
Painful urination
Urethral or testicular pain
Female reproductive organs
Vaginal pH to rise (4.5)
Vaginal itching/burning
Strawberry cervix
Vaginal odor
Frothy/green discharge

Question 22

vaginosis

Answer 22

vaginal infection

Question 23

vaginitis

Answer 23

inflammation

Question 24

epididymitis

Answer 24

infection of the epididymis

Question 25

orchitis

Answer 25

inflammation of the testes

Question 26

prostatitis

Answer 26

inflammation of the prostate gland

Question 27

fournier’s gangrene

Answer 27

Necrotizing fasciitis infection
Involves soft tissues of the male genitals
Infection involves mixed population of aerobic and anaerobic organisms.
Streptococci, clostridia, staphylococci, Klebsiella, and other enteric bacteria-source is usually skin and urogenital areas
Have an underlying immune dysfunction
Diabetes, IV drug use, trauma, recent surgery, immune suppression, peripheral vascular disease, and morbid obesity
Treatment includes broad-spectrum antibiotics (imipenem or meropenem) and surgical debridement.

Question 28

vulvovaginal candidiasis (yeast infection)

Answer 28

Candida is part of the normal vaginal microbiota.
Overgrowth problem
Candida albicans: most common species
Risk factors
Diabetes
Hormone replacement therapy
Birth control pills
Corticosteroids
Short-term antibiotic treatment