L20: Urinary Tract and Genital Infections Flashcards

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1
Q

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

A

B. Upper Urinary Tract

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2
Q

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

A

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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3
Q

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

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

A

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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4
Q

Which is the number one agent of UTI’s?

A

E. coli

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5
Q

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

A. Proteus mirabilis

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6
Q

What is the most common route for UTI’s?

A

Ascending Route

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7
Q

What path does a pathogen take to cause a UTI?

A

Urethra - colonization
Bladder - penetration
Ureter - ascension
Kidney

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8
Q

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

A

catheterization; fibrinogen; fibrinogen-binding proteins

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9
Q

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

A

C. Adhesions; Hemolysins

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10
Q

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

A

C. Fever

  • Fever is associated with Pyelonephritis
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11
Q

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

A

D. Sexual

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12
Q

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

A

C. Klebsiella

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13
Q

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

A

C. Pelvic Inflammatory Disease

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14
Q

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

A

A. Cervical Cancer

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15
Q

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

A. N. gonorrhoeae

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16
Q

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

How does N. gonorrhoeae establish an infection?

A

1) Attach to mucosal cell
2) Penetrate cell

  • Est. infection by passing into sub-epithelial space
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17
Q

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

A

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

18
Q

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

A

C. OM Proteins
- used for invasion and adherence

19
Q

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

A

True

20
Q

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

A

True

21
Q

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

A

D. Light microscopy

22
Q

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

A

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

RB = Non-Infectious, replicating, met. activity

23
Q

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

A

B. Reticulate Body

24
Q

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

A

B. Chlamydia

25
Q

What can occur if a neonate gets Chlamydia?

A

Inclusion or neonatal conjunctivitis

26
Q

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

A

True

27
Q

T. pallidum causes ____

A

Syphilis

28
Q

When is syphilis most contagious?

A

Primary and secondary stage

29
Q

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

A

False - this is the case with T. pallidum

30
Q

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

A

True

31
Q

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

A

B. Primary

32
Q

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

A

rash

33
Q

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

A

True

34
Q

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

A

True

35
Q

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

A

Primary or Secondary Syphilis

36
Q

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

A

True

37
Q

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

A

BV (bacterial vaginosis)

38
Q

What two etiologic agents are responsible for BV?

A

1) Garnerella*
- Facultative anerobe
- Non motile
- Rod

2) Mobiluncus
- Obligate anaerobe
- Vibrio

39
Q

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

A

C. Atopobium

40
Q

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

A

True

41
Q

Why is there no inflammation seen in BV?

A

Production of succinate (inhibits infiltration of PMN’s)

42
Q

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

A

True