Micro of Vagina and Penis

Question 1

How does estrogen promote the normal vaginal flora proliferation

Answer 1

estrogen increases epithelial proliferation
glycogen is in these cells
consumed by lactobacilli (normal flora in 80% of women)

Question 2

Lactobacilli are the normal flora in what % of women

Answer 2

80%

Question 3

How does the production of lactic acid by lactobacilli promote a normal vaginal flora
2 answers

Answer 3

• makes acid, keeps other spp. out

- lactate taken up by immune cells via MCTs, used for energy (like reverse Warburg)

Question 4

Hydrogen peroxide is made by this enzyme in lactobacilli

Answer 4

glucose oxidase

Question 5

Mechanism of bacteriocins

Answer 5

pore-forming

made by bacteria against other bacteria

Question 6

Is D- or L-lactate taken up by MCTs of immune cell

Answer 6

L

L –> D via racemase

Question 7

5-10% of asymptomatic women have this bug in their vaginal flora

Answer 7

S. aureus

Question 8

Bacterial vaginosis

pathology

Answer 8

not 1 organism causing infection
disruption of normal vaginal microflora
esp Gardnerella

Question 9

Untreated bacterial vaginosis

complications

Answer 9

ascending infection

Question 10

Amsel criteria

Answer 10

diagnosis of bacterial vaginosis based on Sx

Question 11

Nugent score

Answer 11

diagnosis of bacterial vaginosis based on microflora composition

Question 12

Metronidazole

MOA in bacterial vaginosis

Answer 12

reduced by pyruvate:feredoxin oxidoreductase
interferes with metabolism of bacteria
free radicals in nitrogen species –> nucleic acid damage

Question 13

PID complication in fallopian tubes

Answer 13

loss of cilia

increased risk of ectopic

Question 14

Tx of PID

Answer 14

ceftriaxone +
doxycycline ±
metronidazole

Question 15

Toxic shock syndrome organism

Answer 15

S. aureus

Question 16

Toxin in toxic shock syndrome

Answer 16

TSST-1

toxic shock syndrome toxin-1

Question 17

TSST-1 is located on which pathogenicity island in S. aureus

Answer 17

SaPI1

Question 18

TSST-1 is transferred from bacterium to bacterium via

Answer 18

phage transduction

Question 19

Toxic shock syndrome often associated with

Answer 19

tampon use

Question 20

Toxic shock syndrome and S. aureus bacteremia

Answer 20

they are mutually exclusive almost always

Question 21

Most common bacteria in penis/urethra

Answer 21

lactobacilli

*numbers decreased in STIs

Question 22

Circumcision and HIV

Answer 22

circumcision decreases risk of infection and transmission

because inner foreskin and urethra are most important sites of viral entry/exit

Question 23

Why does circumcision decrease risk of HIV transmission via decreasing inflammation

Answer 23

promotes aerobic bacterial colonization
these are less inflammatory overall
keeps macrophages in deep tissue
if they are deeper in penile tissue, they are less likely to be infected by viruses on surface