L20: Urinary Tract and Genital Infections Flashcards by Katlyn Heneghan

UTI’s or pyelonephritis refer to infections of the kidneys and ureters, which make up the…
A. Lower Urinary Tract
B. Upper Urinary Tract

B. Upper Urinary Tract

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True or False: Urethritis may be due to either NF or STI, whereas BV is usually due to displaced flora

False -
while Urethritis may be due to either NF or STI, BV is usually due to OVERGROWTH of NF at a site that it’s normally found

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Which four gram (-) bacilli commonly cause cystitis and pyelonephritis?
(hint: PEP K)

Which four gram (+) cocci commonly cause cystitis and pyelonephritis
(hint: SOS E)

Gram (-) Bacilli
1) P. mirabilis
2) E. coli
3) P. aeuroginoas
4) Klebsiella

Gram (+) Cocci
1) S. aureus
2) Other coag-negative staph
3) S. saprophyticus
4) Enterococcus

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Which is the number one agent of UTI’s?

E. coli

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Which of the following gram (-) bacilli secretes urease (urea to ammonia) leading to:
1) Alkaline urine
2) Urine crystals/stones made of struvite

A. P. mirabilis
B. E. coli
C. P. aeuroginoas
D. Klebsiella

A. Proteus mirabilis

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What is the most common route for UTI’s?

Ascending Route

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What path does a pathogen take to cause a UTI?

Urethra - colonization
Bladder - penetration
Ureter - ascension
Kidney

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Once pathogen colonized urethra, it migrates to the bladder. As result, there is immune response induced by ___, leading to ___ accumulation on catheter, provides environment for attache of uropathogens that express __ ___ proteins

catheterization; fibrinogen; fibrinogen-binding proteins

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___ is important for establishing a UTI while ___ can assist in tissue invasion
A. Biofilm; Hemolysins
B. Urease; Capsule
C. Adhesions; Hemolysins
D. Capsule; Biofilm

C. Adhesions; Hemolysins

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Which of the following is NOT a symptoms of Cystitis (bladder infection)?
A. Hematuria
B. Increased urinary frequency or urgency
C. Fever
D. Suprapubic pain

C. Fever

Fever is associated with Pyelonephritis

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What is the most common mechanism of transmission of urogenital infections?
A. Hand-Genital
B. Vertical
C. Fomites
D. Sexual

D. Sexual

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Which of the following is NOT part of normal vaginal flora?
A. Lactobacillus
B. Anaerobes
C. Klebsiella
D. Staphylococci
E. Streptococci

C. Klebsiella

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A patient has pus or exudate. Tests show they have co-infection with Chlamydia and Gonorrhea. Which complication should you warn them about?
A. Cervical Cancer
B. HIV
C. Pelvic Inflammatory Disease

C. Pelvic Inflammatory Disease

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A patient has HPV (genital warts). Which complication should you warn them about?
A. Cervical Cancer
B. HIV
C. Pelvic Inflammatory Disease

A. Cervical Cancer

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Which of the following pathogens is a gram (-) diplococci that should be grown on selective media, such as: Thayer Martin
A. N. gonorrhoeae
B. C. trachomatis

A. N. gonorrhoeae

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What are 2 ways that N. gonorrhoeae can infect mucosal surfaces and survive within a neutrophil?

How does N. gonorrhoeae establish an infection?

1) Attach to mucosal cell
2) Penetrate cell

Est. infection by passing into sub-epithelial space

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What three features allow N. gonorrhoeae to adhere and invade?

1) Opa protein - firm attachment
2) OM proteins - prevents phagolysome fusion
3) Type IV Pili - attach, neutrophil killing

Which of the following is NOT a strategy used by N. gonorrhoeae to evade immune system
A. LOS - endotoxin activity
B. IgA Protease
C. OM Proteins
D. Pili

C. OM Proteins
- used for invasion and adherence

True or False: Cervicitis, Urethritis, or Vaginal/Urethra discharge may result due to infection by N. gonorrhoeae

True

True or False: Chlamydia can cause non-gonococcal urethritis (NGU) while N. gonorrhoeae can cause gonococcal urethritis (GU)

True

Which of the following is NOT associated with Chlamydia?
A. LPS - weak endotoxin activity
B. MOMP’s
C. Obligate Intracellular Pathogen
D. Light microscopy

D. Light microscopy

What’s the difference between the two different forms of Chlamydia: Elementary Body (EB) and Reticulate Body (RB)?

EB = Infectious, non-replication, resistant to harsh environment

RB = Non-Infectious, replicating, met. activity

Which of the following replicates using binary fission, remains in cytoplasmic phagosome, and is seen as inclusion with antibody staining?
A. Elementary Body
B. Reticulate Body

B. Reticulate Body

Although ___ is commonly asymptomatic, mucopurulent discharge can be seen as a result of infection
A. Gonorrhea
B. Chlamydia

B. Chlamydia

What can occur if a neonate gets Chlamydia?

Inclusion or neonatal conjunctivitis

True or False: Both men and women can develop urethritis due to infection by C. trach or N. gonorrhoeae

True

T. pallidum causes ____

Syphilis

When is syphilis most contagious?

Primary and secondary stage

True or False: C. trach enters the skin and mucous membranes, then disseminates via: circulatory system

False - this is the case with T. pallidum

True or False: Early infection by T. pallidum infect skin and mucosal surfaces while late infection can affect any organ system

True

Which stage of syphilis is characterized by a papule that has progressed to an infectious -- yet, painless-- ulcer/chancre? A. Secondary B. Primary C. Latent

B. Primary

If primary syphilis is not treated, it will progress to secondary syphilis, which is characterized by ___ and other lesions (e.g condylomata lata)

rash

True or False: Condylomata lata lesions--which characterize secondary syphilis--are highly infectious

True

True or False: Gumma, CV Syphilis, and Neurosyphilis are features of tertiary (late stage) syphilis

True

When is the risk of Congenital Syphilis (transmission of T. pallidum to fetus) greatest?

Primary or Secondary Syphilis

True or False: T. pallidum requires darkfield microscopy and is fastidious (meaning: cannot be cultured in vitro)

True

_____ a condition in which H2O2-producing Lactobacilli are replaced by other pathogens. There is NO inflammation.

BV (bacterial vaginosis)

What two etiologic agents are responsible for BV?

1) Garnerella* - Facultative anerobe - Non motile - Rod 2) Mobiluncus - Obligate anaerobe - Vibrio

Which gram negative rod is responsible for causing failures/recurrence after metronidazole treatment of BV? A. Prevotella B. Fusobacterium C. Atopobium D. Bacteroides

C. Atopobium

True or False: Having BV is a risk factor for HIV

True

Why is there no inflammation seen in BV?

Production of succinate (inhibits infiltration of PMN's)

True or False: (+) Clue cells and (+) Whiff or Sniff Test , as well as pH that is greater than 6 suggests BV

True