Chapter 23 Flashcards
urinary bladder
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.
cystitis
bladder infections
pyelonephritis
kidney infections
infections from the urethra to the bladder
Urogenital membranes ascend into the bladder.
More common in women
ascending infection to the kidney
Organisms from an established infection in the bladder
Ascend along the ureter to infect the kidney
descending infection from the kidney
Infected kidney sheds bacteria that descend into the bladder.
Kidney infections may arise when microbes are deposited in the kidneys from the blood.
urethritis
Signified by pain or burning upon urination
Urethral discharge
Typically contract the disease as a result of sexual intercourse
asymptomatic bacteriuria
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
cystitis
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
urinary tract infections in children
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.
recurrent urinary tract infections
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.
pyelonephritis
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
sexually transmitted infections (STIs)
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.
genital warts
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
genital herpes
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
neonatal herpes
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.
syphilis
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
gonorrhea
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.
chlamydia trachomatis
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.
lymphogranum venereum (LGV)
Chlamydial disease involving the L1, L2, and L3 serotypes (more virulent than other serotypes)
trichomoniasis
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
vaginosis
vaginal infection
vaginitis
inflammation
epididymitis
infection of the epididymis
orchitis
inflammation of the testes
prostatitis
inflammation of the prostate gland
fournier’s gangrene
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.
vulvovaginal candidiasis (yeast infection)
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
