Genitourinary Tract and STD Infections Flashcards
General Info on Genitourinary Tract and STD Infections
Urine and urinary tract above urethra are usually free of microorganisms in both women and men
Lower Urethra has normal resident microbiota, includes species like lactobacillus, staph, corynebactrium
Microbiota of genital tract of women affected by hormones: so glycogen is created on vagina when estrogen is present, and that is used by lactobacillus to create lactic acid, which is great because that keeps the pH of the vagina low and acidic to kill off invaders
Bacterial Cystitis (Bladder Infection)
S/S: starts suddenly, include burning pain during urination, urgent need to pee, and frequent release of small amounts of urine (feels like you can’t fully empty your bladder); urine is CLOUDY from leukocytes and may be pale red from blood –> often smells horrible and area above pubic bone can be painful
can progress to pyelonephritis!!
CA: most cases are from specific Uropathogenic strains of E.Coli (UPEC), but other diseases can cause it too like Klebsiella, Proteus, Staph, Serratia, or Pseudomonas
Pathogenesis: UPEC plays a huge role, essentially once they get into the bladder they just float around, but they can detect sheer forces (the force of people trying to pee out bad shit) and they can stick to the inner lining of the bladder, and so drinking tons of fluids to try and flush out bacteria isn’t always a good idea, depends on what type of E.Coli strand you have; also think IBCs (intracellular bacterial communities) and they essentially are why people have recurrent bladder infections because they colonize underneath the lining of the bladder and are occasionally dispersed to caused infection again
Epidemiology: cystitis is most common UTI and women are predisposed to it because of a short urethra (space between ass and vagina is shorter), sexual intercourse (wrap it before u tap it!), and birth control devices (IUDs are a foreign device that is inserted in you that could potentially bring invaders!), other factors are like an enlarged prostate but thats for men lol
Pyelonephritis
usually the result of having bacterial cystitis (bladder infection) and it’s S/S are: bladder pain, chills, vomiting, back pain, tenderness overlying kidneys; “Bear Paw” Morphology because the kidneys are filled with pus
easy to misdiagnose because people will complain of a lot of back pain, and the worry is the infection spreading to the blood
protein + other shit gets in urine because the kidneys are being hindered from working properly
repeated episodes lead to scarring, shrinkage of kidneys, and can lead to kidney failure
Gonorrhea
CA: Gonococcus (GC) Neisseria gonorrhoeae, it’s a Gra NEGative diplococcus; has pili (allows sticking and twitching motility) and lactoferrin (grabs onto iron in environment)
S/S: incubation period of 2-5 days, frequently asymptomatic
-in MEN: may have pain during urination of thick, pus-containing discharge from penis
-in WOMEN: may also have painful urination, unusual vaginal discharge; wherever it grows it creates inflammation and pain, especially when it grows in the cervix and on the fallopian tubes
Associated Conditions:
-Men: inflammation can produce scar tissue that obstructs urethra, and this can cause infertility because abscesses can block sperm from being able to shoot out, infection may also spread to prostate gland and testes
-Women: infection can spread to fallopian tubes and cause Pelvic Inflammatory Disease (PID), sometimes infertility because scarring of fallopian tube can lead to Ectopic Pregnancy (egg gets stuck in fallopian tube and can’t grow properly so it dies): Ophthalmia Neonatorum infection in newborns (Mom might have gonorrhea or chlamydia and babies rub up against vaginal canal on the way out); Disseminated Gonococcal Infection (DGI): systemic infection causing fever, rash (it can get in blood so it goes everywhere so WBCs leave a trail trying to kill it), arthritis
Pathogenesis: attachment by fimbriae/pili to receptors on non-ciliated epithelial cells, so it can occur wherever it is first deposited (urethra, uterus, pharynx, anus…etc); entry via Endocytosis (they induce movement into host cell via pili) mediated by porin protein in LOS!
–> LOS (Lipo Oligo Saccharide), basically the LPS but SOO much worse in regards to inflammation and scarring, it’s the LPS of Gonorrhea that’s essentially on steroids
–> LOS and peptidoglycan released by autolysis of cells is in response to complement activation, and so Neisseria breaks up so the LOS is released, and they signal to other bacteria or they die via antibiotic
