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Microbiology > Exam #6: Review > Flashcards

Exam #6: Review Flashcards

1
Q

List the important characteristics of the Chlamydiaceae family.

A

Lack peptidoglycan
Stain weakly Gram (-)
Contain LPS with weak endotoxin activity

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2
Q

What does C. trachomatis have a tropism for?

A

Nonciliated, columnar, cuboidal, & transitional epithelial cells of the:

  • Urethra
  • Endocervix
  • Endometrium
  • Fallopian tubes
  • Anorectum
  • Respiratory tree
  • Conjunctiva
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3
Q

What is trachoma?

A

Chronic inflammatory/ granulomatous process of the eye leading to:

  • Corneal ulceration
  • Scarring
  • Pannus formation (abnormal layer of granulation tissue)
  • Blindness
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4
Q

What is adult inclusion conjunctivitis?

A

Acute conjunctivitis seen in sexually active adults that is characterized by:

  • Mucopurulent discharge
  • Dermatitis
  • Corneal infiltrates
  • Corneal vascularization (chronic disease)
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5
Q

What are the symptoms of C. trachomatis infections in men & women? What is the important difference?

A

Men=

  • Dysuria
  • Mucopurulent discharge

Women= MOST ASYMPTOMATIC carriers
- PID

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6
Q

What are the complications of C. trachomatis infection in men?

A

1) Epididymidis
2) Prostatitis
3) Reiter Syndrome

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7
Q

What is Reiter Syndrome?

A

1) Urethritis
2) Conjunctivitis
3) Polyarthritis
4) Mucocutaneous lesions

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8
Q

What are the symptoms of LGV?

A

Small, painless ulcers that swell

Painful inguinal lymph nodes that ulcerate

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9
Q

How is C. trachomatis diagnosed?

A

*After obtaining a SCRAPING of the location:

1) Giemsa stain
2) Iodine for reticulate bodies
3) Immunoflourescence of elementary bodies

and

4) NAAT, which is the gold standard

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10
Q

List six virulence factors associated with N. gonorrhoeae. What is unique about some of these virulence factors?

A

1) Pilin= attachment
2) Por protein= promotes intracellular survival
3) Opa protein= attachment
4) LOS= endotoxin (stimulates TNF-alpha & chemokine response)

*These undergo antigenic variation

5) IgA protease
6) B-Lactamase

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11
Q

What complications can be seen in N. gonorrhoeae infection in men & women? (Note disseminated gonorrhoeae)

A

Men=

  • Epididymidis
  • Prostatitis
  • Periuretheral abscess

Women=

  • Salpingitis
  • Tubovarian abscess
  • PID
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12
Q

What are the symptoms of disseminated N. gonorrhoeae?

A

Septicemia
Gonococcal arthritis
Pustular rash

*Leading cause of purulent arthritis in adults

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13
Q

How is N. gonorrhoeae diagnosed?

A

1) Direct smear= Gram negative bean-shaped diplococcus in neutrophils
2) Culture and growth from uretheral or cervical scrapings
3) NAAT

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14
Q

How is N. gonorrhoeae treated?

A

Ceftriaxone + prophylactic Chlamydia treatment i.e. azithromycin or doxycycline

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15
Q

What are the characteristics of Treponema pallidum?

A

Thin Gram (-) spirochete
Motile
Microaerophilic

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16
Q

How is sphyilis diagnosed?

A

Dark field microscopy
Direct fluorescence
Serology
(Treponemal & Non-teponemal- cardiolipin)

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17
Q

What are the symptoms of secondary syphilis?

A

Secondary syphilis= systemic syphilis

  • Flu-like syndrome
  • Prominent desquamating lesion on palms of hands & soles of the feet
  • Condylomata lata
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18
Q

What are symptoms of tertiary syphilis?

A
  • Gummas
  • Diffuse chronic inflammation
  • Can affect any tissue/ organ
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19
Q

What are the symptoms of congenital syphilis?

A 
Chronic rhinitis lead to saddle nose 
Hutchinson malformation (teeth) 
Bone malformation
Blind & Dead 
Cardiovascular syphilis
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20
Q

What are the most common causes of NGU? List the characteristics of these organisms.

A 
Mcoplasma genitalium ("fried-egg" morphology)- No doxy
Ureaplasma urealyticum
  • NO cell wall
  • Not stained
  • Pleomorphic
  • Membrane contains sterols
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21
Q

How is Chancroid treated?

A

Macrolides

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22
Q

What causes Donovanosis?

A

Klebsiella granulomatis

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23
Q

What are the symptoms of Donovanosis?

A

Hard, ulcerated, and painless lesion that bleeds easily & has a tendency to cause significant genital damage

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24
Q

How is Donovanosis diagnosed?

A

Donovan bodies

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25
List the characteristics of Lactobacillus. What is unique about where it can grow?
Gram (+) rod Microaerophilic or anaerobic Cannot grow in urine; thus, it DOES NOT cause UTI
26
What are the risk factors for bacterial vaginosis?
- Oral sex - WSW - Sex during menses - New or multiple sex partners - Smoking - IUD
27
What are the four amsel criteria for bacterial vaginosis diagnosis?
1) Discharge (white-gray) 2) Clue cells 3) Whiff test 4) pH greater than 4.5 Remember, "I don't have a clue why I smell fish in the vagina garden"
28
What are the complications of bacterial vaginosis?
1) Increased STD & HIV risk 2) Increased STD & HIV transmission risk 3) Increased development of post-surgical infections 4) Increased risk of pregnancy complications
29
How is bacterial vaginosis treated?
Oral metronidazole | Clindamycin
30
What increased the risk for vulvovaginal candidiasis?
* ****Antibiotic administration***** - Systemic corticosteroids - Oral contraceptives - Pregnancy - DM - HIV infection
31
How is candidia albicans diagnosed?
- Microscopic examination with 10% KOH - Growth & culture on "Nickerson medium" - Germ tube test
32
What are the symptoms of Trichomoniasis?
Vaginitis Ictching Burning Dysuria "Yellow-green, frothy, foul-smelling discharge"
33
What is another hallmark finding of Trichomonas vaginalis?
Strawberry cervix This is due to epithelial cell descturction in the GU tract that leads to neutrophil influx & petechial hemorrhage
34
What are the presenting symptoms of TSS?
``` Malaise Fever Nausea Vomiting Diarrhea ``` *****Erythroderma*****
35
How is TSS treated?
1) Remove tampon 2) Supportive therapy (shock) 3) Beta-Lactamse resistance PCN or vancomycin
36
What are the symptoms of prostatitis?
Lower back pain Perirectal pain Testicular pain
37
What are some of the risk factors for developing a UTI?
``` Sexual intercourse Catheterization (CA-UTI) BPH DM Pregnancy ```
38
What bacteria most commonly cause community acquired UTI?
UPEC | S. saprophyticus
39
What bacteria are hospital acquired UTIs associated with?
Klebsiella Proteus mirabilis Pseudomonas aeruginosa
40
What are serologic makers of enterobacteriaceae?
O, H, & K antigens ``` O= LPS K= capsular H= flagella ```
41
What virulence factors are associated with enterobacteriaceae?
Endotoxin (LPS) | Antimicrobial resistance
42
What virulence factors are associated with UPEC?
Adhesin Hemolysin LPS/ Endotoxin Type I pili (mannose) P-pili ("sugar")
43
What virulence factor is associated with Proteus mirabilis? What is the clinical implication?
Urease Urease--> alkanization of the urine that can cause precipitation of organic & inorganic compounds i.e. leading to renal stones
44
How is a Proteus UTI treated?
TMP-SMX
45
How is pseudomonas aeruginosa diagnosed?
Blue-green cyan pigment
46
How is pseudomonas UTI treated?
Multiple antibiotics
47
What risk factors are associated with enterococsus UTI?
Hospitalization | Treatment with broad spectrum antibiotics
48
What infections are associated with enterococcus aside from UTI?
Peritonitis | Endocarditis
49
How is uncomplicated cystitis treated?
TMP-SMX
50
How is pyelonephritis treated?
Depends whether the causative organism if Gram positive or Gram negative. Gram positive= Amoxicillin Gram negative= Fluoroquinolones
51
What are the requirements for treating asymptomatic asymptomatic bacteriuria? How is it treated?
1) Pregnant women 2) Prior urologic surgery 3) Renal transplant - Amoxicillin - Cephalexin - Nitrofurantoin
52
What are the symptoms of acute HIV infection?
3-6 weeks post-infection there will be a mononucelosis-like syndrome with: ``` Fever Malaise Arthralgia Lymphadenopathy Sore throat Rash ```
53
What are common HIV associated infections & what causes them?
Oral Hairy Leukoplakia= EBV Pneumonia= Pneumocytis jevori & Mycobacterium Tuberculosis Trursh= candidia albicans CMV retinitis= CMV Neoplasm= kopasi's sacrcoma, B-cell lymphoma Diarrhea= cryptosporidium & isopsera belli
54
List the classes of antiretroviral drugs.
- Attachment inhibitors= chemokine receptor antagonists (gp120) - Fusion inhibitors= gp41 - Reverse transcriptase inhibitors Nuceloside Non-nucleoside - Integrase inhibitors - Protease inhibitors
55
What is the current standard of care for ARV therapy?
2x NTRIs + 1) NNRTI 2) II 3) PI
56
What are the symptoms of HSV genital infection?
Genital lesion Fever Inguinal lymadenopathy Malaise
57
How does the lesion seen with HSV appear?
The lesion progresses from macules to papules, vesicles, pustules, & ulcers
58
List the characteristics of HSV.
Herpesvirus family Enveloped dsDNA HSV-2 is most common
59
What are the three presentations of Neonatal Herpes Infection?
1) Localization to skin, eyes, & mouth 2) Encephalitis 3) Disseminated infection
60
How is HSV diagnosed?
Clinical appearance Tzanck smear PCR Immunohistochemistry to detect antigens
61
Generally, how is HSV infection treated based on different regions that can be infected?
``` Oral= NOT Eye= topical antiviral Neonatal= IV antiviral Genital= oral antiviral (long term if recurrent) ```
62
List the characteristics of HPV.
Papovirus family dsDNA non-enveloped
63
What is the medical term for genital warts?
Condyloma acumanitum
64
What are the descriptive features of genital warts?
Hyperkerototic Firm Expohilic papules
65
What serotypes of HPV cause Plantar Warts?
1 & 4
66
Which HPV serotypes have the highest association with cancer?
HPV 16 & 18
67
How is HPV diagnosed?
Main tool for diagnosis is the Pap smear; cells are removed during pelvic examination & placed directly onto glass slide with fixative - Mild dysplasia involving lower 1/3 of epithelial= cervical intraepithelial neoplasia I (CINI) - Dysplasia of the entire epithelium= carcinoma in situ (CIN3) - Dyplasia + breach of the basal membrane= invasive squamous cell carcinoma
68
How is HPV treated?
Low grade lesions= - Cauterization - Cryotherapy - CO2 laser therapy - Loop excision Advanced (carcinoma in situ +)= - Hysterectomy +/- radiation and/or chemotherapy

Microbiology (49 decks)

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