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Repro > Micro > Flashcards

Micro Flashcards

1
Q

Normal vaginal flora

A

Lactobacillus spp. which produces lactic acid, hydrogen peroxide which suppress growth of other bacteria

strep viridian’s, group B beta haemolytic strep, candida sep

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2
Q

normal pH of vagina

A

acidic

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3
Q

non sexually transmitted genital tract infection

A

candida infection (thrush)
bacterial vaginosis - more common in sexually active people but not sexually transmitted
prostatitis - can also be associated with sexually transmitted infections

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4
Q

candida infection - is it normal to be have candida

predisposing factors

A

30% woman have candida and are fine

recent AB therapy, high oestrogen levels, poorly controlled DM, immunocompromised px

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5
Q

candida presentation
dx
rx

A

intensely itchy white vaginal discharge - discharge looks like cottage cheese
clinical diagnosis - high vaginal swabs for culture - was into the posterior of the cervix

topical clotrimazole pessary or cream, oral fluconazole

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6
Q

microscopy of candida albicans

A

fungus

yeast with hyphae (budding)

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7
Q

how does an infection of Candida look like in males

A

spotty rash of candida balanitis
settles with cream
common in males with poorly controlled DM

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8
Q

bacterial vaginosis organisms
symptoms
dx
why is it distressing

A

Gardnerella vaginalis/mobiluncus sp. /other organisms incl anaeorbes

thin watery fishy smelling discharge

clinical dx raised vagina pH >4.5

people will try wash the vagina out which will worsen the imbalance and the smell

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9
Q

lab testing for BV

treatment

A

HVS sent to lab and examined miscroscopically to look for clue cells - high subjective test. Hay - Son scoring system estimates proportions of clue cells to epithelial cells and lactobacillus

PO metro

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10
Q

prostatitis classification

A

acute bacterial
chronic bacterial
chronic/chronic pelvic pain syndrome

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11
Q 
acute bacterial syx
what can it be a cx of 
organisms 
dx
rx
A

symptoms of UTI but may have lower abd pain/back/perineal/penile pain and tender prostate on examination

rare cx of UTI in men

E.Coli and other coliforms, check for STI in <35s gonorrhoea, chlamydia

clinical signs and MSSU for C&S. STI suspected then first pass urine

cipro for 28 days, if high C Diff risk then Trimethoprim for 28 days

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12
Q

bacterial STIs
viral
parasites

A

chlamydia trachoma’s
neirssera gonorrhoea
treponema pallidum (syphilis)

HPV (genital warts)
herpes simplex (herpes)
hep and HIV

trichomonas vaginalis
phthirus pubis
scabies

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13
Q 
chlamydia 
what does it infect
who
how 
gram stain 
groupings
rx
A

commonest bacterial STI in the UK

urethra, rectum, throat and eyes and endocervix in females

biggest poor in males who have sex with other males

obligate intracellular bacteria with biphasic life cycle - does not reproduce outside a host cell

does not stain with a gram stain as there is no peptidoglycan in the cell wall

serovars A-C = trachoma eye infection (not an STI)
servers D-K - genital infection - commonest STI
Servers L1-L3 - lymphogranuloma vnerum - can mimic IB S

azithomycin 1g PO for uncx chlamydia

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14
Q 
gonorrhoea
more common that chlamydia?
infects what?
gram stain?
what about the organism
A

less common

urethra, rectum, throat and eyes and endocervix in females

gram neg diplococcus - looks like two kidney beans facing each other, easily phagocytksed by polymorphs so often appear intracellularly on a gram film

fastidious organism that does not survive well in less than ideal conditions so outside the body

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15
Q

discharge from a gonorrhoea infection

A

purulant discharge - dripping tap

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16
Q

dx of chlamydia and gonorrhoea

A

combined nucleic acid amplification tests or PCR-test for both organisms in one test

17
Q

who are the tests for both done on

A

male - first pass urine sample
females - HVS or vulvo vaginal swab
rectal and swabs
eye swabs for babies and adults - babies for when the mothers have gonorrhoea as eyes can be full of pus

18
Q

what other tests can be for for gonorrhoea

A

microscopy of urethral/endocervical swabs

culture on selective agar plates - done on endocervical, rectal and throat swabs but not on vaginal swabs

19
Q

advantages of PCR/NAATs over culture

disadvantages

A

less invasive
more sensative
will be positive even if organisms die
takes hours not days

cannot test AB sensitivities without culture
will detect dead organisms - have to wait 5 weeks to do a test of cure tests

20
Q

AB resistance in N. gonorrhoea
what are they resistant to
recommended treatment
what is recommended for all px

A

resistant to pencillins, tetracyclines, quinolone and oral cephalosporins

IM ceftriaxone and oral azithromycin

test of cure

21
Q

syphilis caused by what
gram stain
tests

A

treponema pallidum
does not stain with gram stain
cannot be grown in artificial culture media so dx PCR or blood test to detect antibodies

22
Q

stages of syphilis

A

1 - organism multiplies at inoculation site and gets into the blog stream - chancre can heal without treatment
2 - large numbers of bacteria circulating in the blood with manifestations at different sites (snail track ulcers, rash, flu like)
Latent stage - no symptoms but low level multiplication of spirochete in intima of small blood vessels. can be early and late latent stages
late stage - cardiovascular or neurovascular cx years later

23
Q

syphilis dx

A

dark ground microscopy to look for spirochetes in exudate from 1 and 2 lesions
swab of 1 and 2 lesions for PCR
serology - test for antibodies non specific and specific

24
Q

non specific tests

A

VDRL
RPP

indicate tissue inflammation 
may be falsely positive 
how active the disease is
useful for monitoring response to therapy 
usually become negative after treatment
25
Q

specific serological tests

A

IgM and IgG ELISA used as the screening test for syphilis then the following tests can be done if +ve

TPPA
TPHA
specific for syphilis but remain positive for life
not useful for monitoring response in therapy

26
Q

syphilis treatment

A

injectable long acting preparations of penicillin provided px not penicillin allergic

27
Q 
genital warts
cause
organism 
tests 
types
A

commonest viral STI
HPV
non enveloped icocohedral virus containing double stranded DNA
cannot be grown in culture media or maintained in lab animals so difficult to study
>100 types 6 and 11 - genital warts
16 and 18 cervical cancer

28
Q 
genital warts 
spread
dx
recur
vaccine
A

spread by close genital skin contact
clinical dx
cryotherapy, podophyllotoxin cream/lotion
often re occur
11-13 yo girls that immunise against 6,11,16 and 18

29
Q

genital herpes cause
organism
transmission
spread

A

HSV 1 and 2
enveloped virus containing double stranded DNA
transmitted by close contact with someone shedding the virus
spread by either genital/genital or oropharyngeal/genital contact

30
Q

genital herpes pathogenesis
primary infection
virus replication

A

primary infection may be asymp
replicates in dermis and epidermis
gets into sensory nerve ending to sensory and autonomic nerves
inflammation at nerve endings - painful multiple small vesicles which are easily deroofed
virus migrates to sacral root ganglion and hides there
can be reactivated causing recurrent genital herpes attack
intermittent virus shedding can occur in the absence of symptoms

31
Q

GH dx and rx

what does it look like

A

swab in viral transport medium
acyclovir and pain relief

shallow ulcers - very painful

32
Q 
trichomonas vaginalis micro
transmission 
causes what
dx
rx
A

single cell protozoal parasite - divided by binary fission - human host only

transmitted by sexual contact

vaginal discharge and irritation in females (urethritis in males)

high vaginal swab for microscopy

oral metro

33
Q

pubic lice - phthirus pubis
how is it acquired
how long do they live for
treatment

A

close genital skin contact
males live for 22 days and females for 17
malathion lotion

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