medical micro - UT/STI Flashcards by ahmad elmowag

what do lower UTI’s involve

bladder - cystitis
urethra - urethritis

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what do upper UTI’s affect

kidneys - pyelonephritis
ureters - ureteritis

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difference between symptomatic and asymptomatic infection

symptomatic - display symptoms of disease
asymptomatic - significant number of bacteria but no symptoms

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give anatomical reasons why women are more susceptible to UTI

shorter urethra
closer to the bladder

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how does birth control contribute to female UTI

spermicidal agents and diaphragms in the birth control can increase risk of infection

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how does menopause increase risk of UTI

decline in circulating oestrogen, causes changes to urinary tract, more vulnerable to infection.

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different between single or reccurant UTI

single - only happens ones
reccurant - relapse with same/ different organism

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difference between un/complicated UTI

uncomplicated - no additional UT problems
complicated - other factors associated with the infection

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outline how a lower UTI can progress to an upper UTI

1 - colonisation
2 - uroepithelium penetration
3 - ascension
4 - pyelonephritis
5 - acute kidney injury

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what do UTI tests generally depend on

chemical tests - dipstick
bacterial culture

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difference between polyuria/haematuria and dysuria

polyuria - excessive urine output
haematuria - blood in urine
dysuria - pain when pissing

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what is the definition to area above the pubis

suprapubic

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what is pyruia

presence of pus/WBC in urine

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what do leukocytes in the urine indicate and how to detect it

body is fighting an infection
test detects leukocyte esterase

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what is the primary cause of UTI’s

uropathogenic E. coli

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what are the virulence factors of uropathogenic E. coli

adhesion - prevents removal in urine flow
survival - acquires iron and evades host defences
toxicity - leads to infalmmation

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what are the primary adherance factors of UPEC and common adhesive organelles

adherence factors:
pili
fimbriae
adhesion organelles:
type 1
P
S
FIC pili

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features of type 1

required for colonisation, invasion and persistence
occurs mainly in the bladder
possess FimH - adhesin

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what does FimH target

Mannosylated uroplakins
Α1β3 integrins

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what happens after UPEC attaches

invasion into umbrella cells

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what happens once E. coli invades umbrella cells

activation of Rho GTPase
causes actin rearrangement and internalisation
E. coli gets engulfed by the cell

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where is the P pili more active

upper UTI infections

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once UPEC is engulfed, what does the host cell membrane cause

leads to exocytosis of UPEC inside of a vesicle into the plasma membrane
this leads to transient biofilm-like intracellular UPEC communities in the host membrane

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vesicular UPEC also form quiescent intracellular reservoirs (QIR), what is that

in membrane bound compartments of 4-10 bacteria covered in F-actin
long term viability

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what does PapG on P pili bind

globosides present on kidneys TLR4 to reduce their expression - modulating the immune system

what antibody is effected by PapG binding to globosides

IgA through cells to the kidney lumen

what are other virulence factors of UPEC

siderophores α-haemolysin (HylA) cytotoxic necrotising factor 1 (CNF1)

why would siderophores be a useful virulence factor for lower UTI infections

the bladder is an iron-limited environment

function of α-haemolysin (HylA)

causes pore formation in umbrella cells promotes lysis and release of nutrients and iron trigger exfoliation - highly expressed in IBC's

function of CNF1

affects actin modelling causes membrane ruffling - aids in internalisation

when does initial attachment of proteus occur

after urease causes pH to increase

if proteus is in contact with host tissue, what toxins does it release

α-haemolysin proteus toxin

function of proteus toxin

punctures host cell membrane causes cytosol to leak - causing osmotic stress causes actin depolymerisation

features of lactobicilli

adhere to vaginal cells - prevents colonisation produce hydrogen peroxide to inhibit pathogenic growth produces lactic acid to maintain low pH releases bacteriocins - antimicrobials can deactivate HIV-1

what does sperm contain for antimicrobial purposes

lysozyme lactoferrin phospholipase A2 secretory leukocyte inhibitor semenogelin 1 derived peptides

what does uncomplicated gonorrhoeae affect

mucus membrane of: urethra endocervix rectum pharynx conjuctiva

what can disseminated gonorrhoeae present as

septic arthritis dermatitis

what are the complications associated with gonorrhoeae in men

acute epididymitis penile lymphangitis per-urethral abscess acute prostatitis seminal vesiculitis

what are the complications associated with gonorrhoeae in women

Bartholin's abscess spontaneous abortion premature labour rupture of fetal membrane

what are NAATS used to detect

gonorrhoeae and chlamydia

features of Neisseria gonorrhoeae

gram-negative diplococci fastidious facultative intracellular

what are the virulence factors of gonorrhoeae

capsule to resist phagocytosis Opa proteins to aid in attachment Pilus protein to attach to epithelium LOS - liposaccharide with endotoxic activity release IgA protease Rmp proteins - inhibits cidal action of semen Por - created pores in membrane

what is the difference in wo/men in contraction of chlamydia

men - infects urethra women - infects urethra and/or endocervix

what is the difference between un/complicated chlamydia

uncomplicated - doesn't ascend to upper genital tract complicated - ascends to upper genital tract

what does complicated chlamydia cause in wo/men

men - epididymo-orchitis women - pelvic inflammatory disease (PID)

what does epididymo-orhitis cause

pain/swelling/inflammation in the epididymous/testicles

what is adult conjuctivitis caused by

autoinoculation

what is LGV caused by

infection of lymphatic system

what does SARA cause

polyarthritis of weight-bearing joints

what are the virulence factors of chlamydia

binds to sialic acid on mucus membrane to give it access to immuno-privileged areas LPS is cysteine-rich to prevent phagocytosis Type III secretion system antigenic variation infested vacuole to divert lipids to itself

what is syphilis caused by

spirochete bacterium - Treponema palladium

how is syphilis transmitted

direct contact with the infectious lesions

what is primary syphilis

painless ulcer affects genitals localised lymphadenopathy

what is secondary syphilis

multisystem and one or many regions

what is the progression of syphilis

early latent late syphilis late latent stage tertiary

what is tertiary syphilis divided into

neruosyphilis gummatous syphilis

features of Treponema palladium

obligate intracellular parasite fastidious - gram-negative cork-screw shaped

how does T. palladium reproduce

transverse fission

what is the outer sheath of T. palladium composed of

glycosaminoglycan

what is the function of the axial filament (endoflagella) of T. palladium

provides osmotic stability covers the protoplasmic cylinder

what are the virulence factors of T. pallidium

adherence proteins hyaluronidase - allows perivascular infiltration coats host cells with fibronectin to prevent phagocytosis