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Urogenital Microbiology > Genital > Flashcards

Genital Flashcards

1
Q

Mention STDs with systemic effects

A

HIV, HLTV, HBV, CMV

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2
Q

Some STDs if left untreated cause….

A

PID & infertility in women

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3
Q

…..&……cause urethral discharge & PID

A

N.gonorrhea & C.trachomatis D-K

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4
Q

Vaginal discharge is caused by……..

A

Candida albicans & Gardnella vaginalis

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5
Q

Genital herpes is mostly caused by………

A

HSV-2

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6
Q

List complications of genital herpes

A

Recurrence, aseptic meningitis, neonatal infection if genital herpes affects pregnant women

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7
Q

The duagnostic specimen for genital herpes is……

A

Vesicular fluid, scraping of ulcer base

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8
Q

Treatment of genital herpes is…..

A

Acyclovir

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9
Q

Treponema pallidum is inactivated by……

A

mild heat 60deg, cold, most disinfectants

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10
Q

Describe MOT of syphilis

A

Mainly by sexual contact but also direct contact but no through fomites. Also transplacentally. Rarely by blood transfusion

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11
Q

GR:
1-Evasion of immune response by treponema pallidum
2-Immunity to syphilis is incomplete

A
  1. Due to unique stucture of treponemal outer membrane
  2. Since specific Abs do not stop progression of disease
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12
Q

Mention Abs produced in response to syphilis

A
  1. Reagin (heterophil or non-specific) antibodies: a mixture of IgM & IgG against widely distributed antigens in normal tissues as cardiolipid, appear 2-3 wks after infection
  2. Specific antitreponemal Abs
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13
Q

Describe mainfestations of 1ry syphilis

A

Multiply at inoculation site & form local painless hard chancre on genitalia in 2-10 wks. Bilateral Regional lymphadenopathy. 1ry lesions disappear heal spontaneously within 3-6 wks. It is communicable.

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14
Q

Describe mainfestations of 2ry syphilis

A
  1. Most commonly affect skin & mucus membranes in the form of warty or macular lesions. Moist leisons on genitalia are called condyloma containing organism (highly infectious)
  2. Constitutional symptoms
  3. Pharyngitis, menintis, nephritis, hepatitis.
  4. Serology is highly +ve
  5. 1/3 heal without treatment, 1/3 have latent syphilis, 1/3 disease progress to tertiary
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15
Q

Describe mainfestations of 3ry syphilis

A

It is slowly progressive, destructive inflammatory disease that may affect any organ may occur after decades in untreated individuals. Tertiary syphilis is chct by appearance of chronic granulomas (gumma) in skin, skeleton, CNS, CVS). Few spirochaetes are found in lesions

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16
Q

Mention diagnostic specimen for direct methods in syphilis
List methods of examination

A

Freshly collected exudates from chancre in 1ry stage or condyloma in 2ry stage
Methods: Fontana-stained preparation, unstained preparation examined by dark field microscope, direct immunofluorescence

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17
Q

T.pallidum can be propagated by inoculation on……

A

Rabit testis

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18
Q

Mention uses of standart tests fir syphilis

A
  1. Screening as they are cheap & simple (in 1ry & 2ry)
  2. Monitor efficacy if therapy as their titer dec with specific ttt
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19
Q

Mention flocculation tests for syphilis diagnosis & explain each

A

A) Venereal disease research lab test: Ag added to patient heat inactivated serum, +ve cases are visualized microscpoically
B) Rapid plasma reagin test: Ag contains carbon to enable reaction to be visuallized by nakes eye. Doesn’t require heat inactivation

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20
Q

GR:
1. False +ve
2. False -ve
In non-specifuc tests for syphilis

A
  1. Non treponemal infectious diseases, collagen & vascular diseases
  2. Prozone phenomenon & tertiary syphilis
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21
Q

Specific Abs for syphilis apear…….& remain for…..

A

2-3 wks after infection
Life

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22
Q

The test used as confirmation after screening is……., while……..is replacing flocculation for screening purposed.

A

Fluorescent treponemal Ab test
EIA

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23
Q

…….is used for ttt of syphilis while……is used in penicillin-allergic, non-pregnant patient

A

Penicillin G
Doxycycline

24
Q

……..can follow ttt of 2ry syphilis

A

Jarisch-Herxheimer reaction

25
Q

Chancroid is caused by……which requires…..for growth

A

H.ducreyi
X factor

26
Q

Describe manifestations of chancroid

A

Chct by soft painful genital ulcers called soft chancre. Tender unilateral lymphadenopathy is also found. A chancroid ulcer may block the opening of urethra, causing pain during urination. Most common symptom in women

27
Q

Ttt of chancroid is…….

A

Azithromycin or IM ceftriaxone

28
Q

Mention causative agent & C/P of lymphgranukoma venereum

A

C. trachomatis L1-L3
The disease is chct by painless genital papule or ulcer followed by enlarged painful inguinal LNs which ulcerate & discharge pus into sinuses

29
Q

Lymphgranuloma venereum is ttt by…..

A

Doxycycline (erythromycin in pregnant women & children)

30
Q

Chlamydia grow on…..

A

Yold sac of chick embryo or tissue culture

31
Q

Describe pathogenesis of Chlamydia trachomatis (D-K) genital infection

A

Enters body through scrapes or cuts & infects cells lining mucus membranes. Typically, the lesion at a site of infection is small painless & heals rapidly. Clinical manifestations of chlamydial infection result from destruction of infected cells & inflammatory response this destruction stimulates. Reinfection in the same site or a similar strain triggers a vigorous immune response that can result in sexual dysfunction.

32
Q

List causative agents of genital warts & the features of each
Their MOT is….

A
  1. Human papilloma virus: small, non-enveloped icosahedral viruses containing circular dsDNA
  2. Molluscum contagiosum: brick-shaped, enveloped dsDNA belongs to Poxviridae
    Sexual or indirect contact
33
Q

HPVs induce…….., & some integrate into genome & produce…..that can trigger cancer

A

Epithelial cell proliferation
E6 & E7 proteins

34
Q

MCV lesions may heal spontaneously within…..

A

2-6 wks

35
Q

Describe prevention of HPV

A
  1. A recombinant vaccine having 4 types of HPV, 6&11 cause genital warts, 16&18 cause carcinoma
  2. A recombinant vaccine but contains only 16&18. Cervarix contains an adjuvant called AS04 that thereby enhances Ab production
36
Q

Describe manifestations of vaginal candidiasis

A

Irritation, pruritis & vaginal discharge is often curd like. This may be accompanied by urethritis & dysuria & may present as a UTI.

37
Q

Candida multiplication within vagina takes place when…….&…….

A

More alkaline than usual or if normal bacterial populations are reduced by Abx

38
Q

Bacterial vaginosis causative agent is……

A

Gardnerella vaginalis (it is polymicrobial)

39
Q

Describe manifestions of bacterial vaginosis

A
  1. The vaginal discharge is thin & greyish & has a pleasant odour often describes as “fishy”
  2. Some itching & irritation of the vaginal opening may also occur
  3. Up to 50% of women with bacteria vaginosis report no symptoms
40
Q

Diagnostic Specimen for bacterial vaginosis is……..

A

Vaginal exudates or swab (high vaginal or endocervical)

41
Q

Explain the following tests for bacterial vaginosis:
1. Amine or Whiff test
2. Saline wet film

A
  1. Addition of a drop of 10% KOH on vaginal secretion produces a fishy odor
  2. Examined by high power lens shows chct “clue cells”
42
Q

Ttt of bacterial vaginosis is……., & candidiasis is…..

A

Metronidazole
Oral fluconazole or vaginally adminstered miconazole or butoconazole

43
Q

Most common causative agents of cervicitis are……..

A

C.trachomatis & N.gonorrhea

44
Q

PID causes inc risk of…….

A

Ectopic pregnancy & sterility

45
Q

Mention causative agents of prostatitis

A
  1. Enterobacteriacae & pseudomonas
  2. N.gonorrhea & C.trachomatis
46
Q

Bacterial causeing urethritis include……while viral is caused by……

A

N.gonorrheae, C.trachomatis, Ureaplasma urealyticum
HSV & CMV

47
Q

List virulence factors of N.gonorrhea

A
  1. Lipoligosaccharides (endotoxin)
  2. Pili: undergo marked antigenic variation
  3. Outer membrane proteins (play a role in attachment)
  4. IgA1 proteases
  5. B-lactamases (plasmid mediated)
48
Q

Mention symptoms of disseminated gonococcal infection

A

Septic arthritis, fever, septic skin lesions on extermities & may end in septic shock

49
Q

Mention diseases caused by N.gonorrhea which are NOT sexually transmitted

A
  1. Ophthalmia neonatorum due to passage in infected birth canal. Routine prevention by topical erythromycin
  2. Vulvovaginitis due to poor hygeine in young girls
  3. Gonococcak conjunctivitis due to autoinfection
50
Q

Mention diagnostic specimen of gonococcal inefction

A
  1. In males: urethral exudates or morning drop in chonic cases
  2. In females: urethral & endocervical samples (a high vaginal swab is not suitable)
  3. Disseminated: blood, swab from skin lesion, pus aspirated from a joint
51
Q

Describe role of direct demonsatration in diagnosis of gonorrhea

A

In males with acute urethritis microscopic exam of gram-stained film is diagnostic
In females & chronic cases positive culture is needed

52
Q

Mention media for growth of Neisseria & suitable conditions

A

Thayer martin medium (for contaminated samples)
Heated blood agar (for sterile)
5-10% CO2, 37deg, 24-48 hrs

53
Q

Mention biochemical tests for Neisseria

A

Oxidase +ve & ferment glucose with production of acid only

54
Q

GR: Serology is not suitable for gonorrhea

A

Due to high variability of gonococcal antigens

55
Q

Describe treatment of gonorrhea

A

Third generation cephalosporins are 1st line therapy. Alternative is spectinomycin in allergic patients. Tetracyclines are indicated for eradication of associated C.trachomatis.

Urogenital Microbiology (3 decks)

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