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Medical Microbiology > Lecture 7: Diseases Affecting Urinary and Reproductive System > Flashcards

Lecture 7: Diseases Affecting Urinary and Reproductive System Flashcards

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Biology 101 flashcards USMLE® Step 1 flashcards
1
Q

Urinary system

A
  1. removes waste from blood, helps maintain homeostasis
  2. infections influenced by system’s anatomy
  3. 50% UTIs are sexually transmitted
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2
Q

Females most at rx for infections

A

opening of urethra close to anus

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3
Q

Known colonizers of urethra in males and females

common (4)
lesser (3)

A

Main

  1. corynobacterium
  2. streptococcus
  3. staphylococcus
  4. bacteroides

Lesser

  1. peptostreptococcus
  2. prevotella
  3. porphyromonas
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4
Q

female susceptibility to kidney infection

A

urethra shorter, bacteria does not have to travel as far to reach kidneys

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5
Q

Kidneys and ureter microbiota?

A

usually sterile

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6
Q

Antimicrobial defenses of urinary system (7)

A
  1. shedding outermost cells of mucosa
  2. mucous secretion
  3. flushing action of urine
  4. pH (acidic)
  5. urea content
  6. antimicrobial proteins
  7. zinc secretion- inhibits E..coli
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7
Q

UTIs characterization

A

characterized by presence of significant number of bacteria in urinary tract

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8
Q

UTI sx (4)

A
  1. persistent urinary urgency
  2. persisten dysuria
  3. hematuria
  4. cloudy and strong smelling urine
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9
Q

Most common cause of UTI (pathogen)

A

e. coli

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10
Q

Infections of lower urinary tract

involve what 3 organs (3)
most common infections (3)

A

Involve

  1. urethra
  2. bladder
  3. prostate

Most common lower infections

  1. urethritis
  2. cystisis (inflam. bladder)
  3. prostitis
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11
Q

Infections of upper urinary tract

A

involve kidneys and pyelonephritis

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12
Q

Urethritis

def.
2 pathogen
sx (2)

A
  1. bacteria from lower intestine and anus reach the vagina
  2. neisseria gonorrhaea and chalmydia
  3. can be asymptomatic
  4. sx: dysuria and purulent discharge
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13
Q

Cysitis

def
pathogen
high rx population
sx (4 rsh)

A
  1. infection of bladder
  2. e coli most common
  3. higher rx during pregnancy
  4. urinary catheter can cause hospital-acquired cystitis
  5. sx similar to urethritis; clinically distinguished by acute onset, more severe symptoms, bacterial cells in urine, hematuria
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14
Q

prostitis

special pop.
2 types

A

inflammation and infection of protstate

  1. develops in young and older men following placement of indwelling catheter
  2. acute: sudden onset fever chills, increased urinary urgency and frequency
  3. chronic: signs and sx develop gradually and are less severe
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15
Q

Pyelonephritis

definition
commonly caused by

A

UTI involving one or both kidneys

  1. more common in women
  2. 90% of cases caused by e. coli
  3. can lead to permanent damage of kidneys and can spread systemically
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16
Q

Leptospirosis

A
  1. zoonotic disease affecting kidneys and other tissues
  2. hook at one end, resembles question mark
  3. spread by direct or indirect contact with urine of infected animal
    - spirochetes found in contaminated waters, soil etc.
    - bacteria enter via mucous membranes od eyes, nose, mouth
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17
Q

Leptospitosis pathogen

A

thin, aerobic, gram-negatie mossige spirochete

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18
Q

Clinical presentation leptospirosis

  1. incubation
  2. transmission
  3. sx (5)
  4. compilation
A
  1. rapid onset after 10 day incubation
  2. enters host through membranes od eyes, nose, mouth, and abrasions on feet
  3. 90% patients present with flu-like sx (chills, myalgia, HA, conjuctivitis), nausea/vomiting/diarrhea
  4. weil Syndrome: severe form leptospirosis: meningitis, liver, lung, and kidney damage
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19
Q

Weil syndrome

complications (3)

A

severe form leptospirosis

meningitis
liver
and kidney damage

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20
Q

tx leptospirosis/weil syndrom

A

DCN, PROMPT

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21
Q

Vaginal mirobiota

A

lactobacillus thrive in acidic pH of vagina, and convert lactic acid which further contributes to low pH

-susceptible to significant alterations (dysbiosis) that lead to common infections

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22
Q

Non-sexually transmitted infections of female reproductive system (2)

A
  1. bacterial vaginosis

2. vaginal candidiases

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23
Q

Bacterial vaginosis

caused by what pathogens (3)
tx

A

non-sexually transmitted infection of female reproductive system

garnerella vaginalis rods, prevotella, mobiluncus

tx: metronidazole or clindamysin (oral or vaginal, less rx c. diff)

most common vaginal infection in women of child-bearing age
-40-50% all gynecologic conditions

24
Q

Vaginal candidasis

pathogen
sx (2)
tx (3)

A

“yeast infection”

c. albicans responsible agent for non-sexually transmitted infection of reproductive system
- decreased lactobacilli allow c.albicans to grow

sx: itching, white discharge
tx: nystatin, clotrimazole, fluconazole

25
Q

3 key changes leading to bacterial vaginosis

A
  1. dysbiosis
  2. production volatile amines
  3. pH > 4.5
26
Q

chlamydial urethritis

pathogen
transmission

A
  1. most frequently reported STD
  2. chlamydia trachoma’s
  3. one of several non-gonococcal urethritis
  4. sexually transmitted by contact with mucous membrane secretion of semen of infected person
    * more common in men t
27
Q

chlamydia lifecyle

characteristics pathogen
2 phases

A

c. trachomatis: small, round/ovoid-shaped organism, obligate, intracellular parasite
1. two phases
a. elementary body (EB): non-replicating, extracellular, infectious
b. reticulate body (RB): replicating, intracellular, non-infectious

28
Q

chlamydia disease

transmission
sx (male/female)
complication

A

t: vaginal, anal, oral sex
- silent disease, 85-90% have no symptoms

sx: slight vaginal discharge and inflammation of the cervix
- burning pain during urination possible if urethra is infected
- males: painful urination and water/milky discharge
- can cause infertility in males

can cause pelvic inflammatory disease

29
Q

Salpingitis

A

spreading of disease to the fallopian tubes

-blockage and inflammation of fallopian tubes can cause infertility

30
Q

chalmydia other facts

dx test
tx

A
  1. can occur in parynx or anus
  2. newborns can contract chlamydial ophthalmia during delivery
  3. lab text=sample of urethra in men or cerix in women and using PCR ro detect chalmydial DNA
    4: tx: tetracyclines (DCN), or macrocodes (azithromycin)
31
Q

Gonorrhea

pathogen
shape
susceptibility
transmission

A
  1. can be an infection in any sexually active person
  2. caused by Neisseria Gornorrheae “the clap”
  3. double bean shape
  4. susceptible to most antiseptics and disinfectants, sensitive to dehydration
    - survives only a brief period outside the body
  5. transmission: sexual contact, newborn during birth
32
Q

Neisseria gonorrhoeae

5 characteristicns

A
  1. small
  2. nonencapsulated
  3. nonmotile
  4. gram (-)
  5. diplococcus
33
Q

Gonorrhea

incubation
affects what organs
special population

A
  1. incubation: 2-6 days
  2. affects: reproductive organs, female: cervix/urethra/fallopian tubes, male: infects urethra, pharynx, rectum, eyes
  3. rarely can disseminate and cause arthritis or dermatitis
  4. infant can contract gonoccal ophthalmia while passing through birth canal
34
Q

Gonorrhea females

Major complication
Other complications (3)
tx

A

many infected females are asymptomatic and contribute to the spread of the disease, may present with PID

  1. can spread to fallopian tubes/salpingitis
  2. can lead to sterility
  3. can lead to ectopic pregnancy

tx: high dose ceftriaxone IM x1 dose

35
Q

Gonorrhea Males

sx/complications (6)
tx

A
  1. tingling penis
  2. pain when urinating
  3. penile dischrge
  4. swollen lymph nodes
  5. painful testicles
  6. infertility

tx: high dose ceftriaxone IM x1 dose

36
Q

PID

pathogens (3)
complications
sx

A

pelvic inflammatory disease

  1. polymicrobail infection
    - neisseria gonorrhoeae
    - chlamydia trachomatis
    - anaerobes
  2. salpingitis- infection fallopian tube
    - scarring blocks passage of ova from ovary to uterus, causing sterility
    - blocked uterine tube may cause fertilized ovum to be implanted in the tube rather than uterus (ectopic pregnancy)
  3. sx: chronic abdominal pain; pain during or after menses particularly suggestive
  4. preventing PID is main reason for treating STD
37
Q

Syphilis

caused by what patogen

A
  1. chronic, infectious disease
  2. top 5 most reported microbial disease in US
  3. treponema palladium, spirochete for which humans are only host
38
Q

Syphilis

incubation period
sx

A
  1. I: 3 weeks avg, can vary
  2. chancre where bacteria entered body
    - painless circular small raised edges
    - persists 3-6 weeks, healthcares spontaneously
39
Q

secondly syphilis

def
sx
A
  1. occurs when spirochete spreads through blood and lymph to other organs
  2. sx: fever, skin rash, swollen nodes, transmission can occur through lesions
    - chornic latent stage of 3-30 years follows in which relapses of secondary syphilis can occur, will be infectious at this point
40
Q

tertiary syphillis

complications

A
  1. formation of non-infectious gammas
    - weakenig or bursting of blood vessels
    - degeneration spinal chord tissues
    - brain damage leading to personality and judgement changes
41
Q

congenital syphillis

complications
tx
prevention
dx

A

can occur in fetus of pregnant women

  • still birth
  • birth defects: hutchinson’s triad: deafness, impaired vision, noted peg shaped teeth
  • tx: penicillin G 2.4 million units IM x 1 dose
  • P: safe sex partners
  • d: observation spirochetes by microscopy, antibody tests
42
Q

Diagnosis syphilis

A
  1. RPR: rapid plasma regain
    - antbodies to damaged cell components, not actual treponems
  2. t. palladium enzyme immunoassay (TP-EIA)
    - detects antibodies specific to t. pallidum
43
Q

Genital Herpes

serotype
tx

A
  1. HSV-2

tx: acyclovir, famciclovir

44
Q

signs of primary herpes infection

A
  1. itching or throbbing in genetical area
  2. reddening and appearance of blisters
  3. blisters crust over and disappear after 3 weeks
  4. 50% all infected individuals only experience one outbreak in lifetime
45
Q

Human Papilomaviruses

A
  1. some cause genital warts and can cause cancer

2. condylomata tranmitted through sexual conduct

46
Q

Condylomata

transmission
complications
prevention

A

genital warts

t: oral, vaginal, anal sex

  • often asymptomatic
  • can be transmitted to newborns during delivers
  • can cause cervical cancer
  • Gardisil vax
47
Q

HPV (5 points)

A
  1. DNA virus, 200+ serotypes
  2. t sexual contact or microscopic abrasions
  3. disease depends on types
  4. P: vaccination against HPV strains
  5. can cause caner of anus, vagina/vulva, penis, mouth, throat
48
Q

HPV types 16 & 18

A

cause 70% cervical cancer, assoc. with other cancers

49
Q

Garasil 9

A

targets HPV 6, 11, 16, 18, 31, 33, 45, 52, 58

  • only available in US
  • protects against cervical, vulvar, vaginal, anal, oropharyngeal, and other head and neck cancers
50
Q

Trichomoniasis

populations
transmission

A

parasitic protozoan, exists in only 1 morphological stage

  1. women > men
    - can lead to infertility
    - can lead to prostate cancer in meant
  2. adherence factors allow cervicovaginal epithelium colonization in women
  3. t: direct skin-skin contact with infected individual, most often vaginal intercourse
51
Q

Trichomoniasis

sx (3)
complication (6)
tx (3)

A
  1. common cause vaginitis in women
  2. intense itching and discomfort during urination and sexual intercourse, frothy, greenish vaginal discharge with musty malodorous smell
  3. complications: preterm delivers, low birth weight, increased mortality, predisposing HIV infection, AIDS, cervical cancer
  4. tx: metronidazole, tinidaole, secnidazole
52
Q

Mild- Moderate PID tx (3)

A
  1. single dose long acting cephalosporin (ceftriazone) 500-1000 mg IM
    • DCN 100 mg daily x14 days
  3. PLUS metronidazole 500 mg orally 2x daily for 14 days
53
Q

inpatient tx for PID

option 1

A

a. cefoxitin 2 g IV every 6 hours
b. cefotetan 2 g IV every 12 hours
c. PLUS DCN 100 mg orally or IV every 12 hours

54
Q

inpatient tx PID

option 2

A

clindamycin 900 mg IV Every 8 hours

PLUS gentamicin 3-5 mg/kg IV daily

55
Q

Tx neonatal eye infection of Neisseria Gonorrhoeae

complications
prevention
tx

A
  1. acquired via passage through cervix/vagina or within the uterus
  2. can cause blindness if left untreated
  3. Px: maternal screening during pregnancy so mother can be treated if infected
  • neonatal prophylaxis with erythromycin or tetracycline ointment applied up to 1 hour after birth
    • rec. for all newborns by CDC and American Academy of Pediatrics
  1. tx neonatal infection
    - ceftriaxone 25-50 mg/kg (MAX=125 mg) IV or IM x1 dose
    - Cefotaxime or ceftrazidine alternatives
56
Q

Neonatal eye infections: chlamydia trachomatis

A
  1. Aq. during birth in infants born vaginally to infected mothers
  2. causes neonatal conjunctivitis or pneumonia
  3. untreated conjunctivitis scan cause corneal and conjunctiontival scarring
  4. px: maternal screening during pregnancy for all women < 25 years old
    - neonatal prophylaxis is not effected for c. trachomatis
  5. tx: erythromycin 50 mg/kg orally in 4 divided doses per day for 14 days

OR azithromycin 20 mg/kg given orally once daily x3 days

**Topical therapy NOT effective for c. trachomatis

Medical Microbiology (11 decks)

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