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Obs & Gynae > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What are the characteristics of the chlamydia bacteria?

A

Obligate intracellular bacteria with biphasic life cycle

Does not reproduce outside a host cell

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2
Q

What are the causal bacteria of prostatitis?

A

E. coli & other coliforms, Enterococcus sp (same as UTIs)

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3
Q

What is Lymphogranuloma venereum?

A

Acute onset of tender, enlarged lymph nodes in the groin

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4
Q

What is the treatment for gonorrhoea?

A

Intramuscular ceftriaxone and oral azithromycin

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5
Q

What are the four viral STIs?

A

Human papilloma virus (genital warts)
Herpes simplex (genital herpes)
Hepatitis
HIV

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6
Q

What is used as a screening test for syphilis?

A

Combined IgG & IgM ELISA

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7
Q

What is the treatment for uncomplicated chlamydia?

A

Azithromycin

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8
Q

What further tests can be done for Neisseria gonorrhoea?

A

Microscopy of urethral/endocervical swabs

Culture on selective agar plates

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9
Q

What is a chancre?

A

A primary sore or ulcer at the site of entry of a pathogen, usually syphilis

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10
Q

What is the normal vagina flora?

A

Mainly Lactobacillus spp

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11
Q

What is the commonest viral STI?

A

Genital warts - human papilloma virus

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12
Q

How does bacterial vaginosis present?

A

Thin, watery, fishy smelling discharge

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13
Q

What parasites are considered STIs?

A

Trichomonas vaginalis
Phthirus pubis (pubic lice or “crabs”)
Scabies

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14
Q

What is the most common bacterial STI in the UK?

A

Chlamydia

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15
Q

What is the first stage of syphilis infection?

A 
1y lesion (chancre) - organism multiplies at inoculation site and gets into bloodstream
Chancre will heal without treatment
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16
Q

What are the characteristics of Neisseria gonorrhoeae?

A

Gram negative diplococcus
Look like “2 kidney beans facing each other”
Easily phagocytosed by polymorphs, so often appear intracellularly on a Gram film

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17
Q

What is the purpose of testing for non-specific antibodies in syphilis?

A

Indicates how active the disease is and is useful to monitor the response to treatment

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18
Q

What advantages do PCR/NAATs have for testing for chlamydia or gonorrhoea over culture?

A

Less invasive specimens required
More sensitive
Takes hours, not days

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19
Q

How is the diagnosis of bacterial vaginosis made?

A

Mainly clinical diagnosis

Assess vaginal pH - will be raised

20
Q

What are the causal bacteria for bacterial vaginosis?

A

Gardnerella vaginalis

Mobiluncus sp

21
Q

What disadvantages do PCR/NAATs have for testing for chlamydia or gonorrhoea instead of culture?

A

Cannot test antibiotic sensitivities without culture, so difficult to track antibiotic resistance
Will detect dead organisms (have to wait 5 weeks to do “test of cure” tests)

22
Q

Which serovars of chlamydia cause eye infection?

A

A-C

23
Q

What is the treatment of syphilis?

A

Injectable long-acting preparations of penicillin used for treatment (provided patient is not penicillin hypersensitive)

24
Q

How does prostatitis present?

A

Symptoms of UTI, but may have lower abdominal pain/back/perineal/penile pain and tender prostate on examination

25
Q

What is prostatitis?

A

Swelling of the prostate gland - a rare complication of UTIs in men

26
Q

How can the diagnosis of chlamydia or gonorrhoea be made?

A

Combined nucleic acid amplification tests (NAATs) or polymerase chain reaction test (PCR) – tests for both organisms in 1 test

27
Q

What structures does the gonorrhoea bacteria infect?

A 
Urethra
Rectum
Throat 
Eyes 
Endocervix
28
Q

What is the final stage of syphilis infection?

A

Late stage - cardiovascular or neurovascular complications many years later

29
Q

What is the purpose of testing for specific antibodies in syphilis?

A

Confirm the diagnosis, but antibody levels decrease very slowly even after successful treatment, and often remain positive for life

30
Q

What predisposing factors are there for vaginal thrush?

A

Recent antibiotic therapy
High oestrogen levels (pregnancy, certain types of contraceptives)
Poorly controlled diabetes
Immunocompromised patients

31
Q

What is the treatment for prostatitis?

A

Ciprofloxacin for 28 days

Trimethoprim for 28 days if high risk of C.diff

32
Q

What is the treatment for vaginal thrush?

A

Topical clotrimazole pessary or cream

Oral fluconazole

33
Q

How does vaginal thrush present?

A

Intensely itchy

White discharge - ‘cottage cheese’

34
Q

What does lactobacillus produce in the vaginal flora that helps deter other bacteria?

A

Lactic acid

Hydrogen peroxide

35
Q

How is the diagnosis of thrush made?

A

Mainly clinical diagnosis

Can do high vaginal swab

36
Q

What type of infection do chlamydia serovars D-K cause?

A

Genital infection

37
Q

What kind of infection do chlamydia serovars L1-L3 cause?

A

Lymphogranuloma venereum

38
Q

If combined IgG & IgM ELISA test is positive, what is the next stage for investigation of syphilis?

A

Further blood tests:
IgM ELISA
VDRL test
TPPA test

39
Q

How is syphilis diagnosed?

A

Dark ground microscopy to look for spirochaetes in exudate from 1y and 2y lesions
Swab of 1y or 2y lesions for PCR
Serology – tests for non-specific and specific antibodies to T. pallidum in blood

40
Q

What is the name of the bacteria that causes syphilis?

A

Treponema pallidum

41
Q

What is the treatment for bacterial vaginosis?

A

Oral metronidazole

42
Q

What are the three bacterial STIs?

A 
Chlamydia trachomatis (chlamydia)
Neisseria gonorrhoeae (gonorrhoea)
Treponema pallidum (syphilis)
43
Q

In which infection are clue cells found?

A

Bacterial vaginosis

44
Q

What is the third stage of syphilis infection?

A

Latent stage – no symptoms, but low-level multiplication of spirochaete in intima of small blood vessels
Can be divided into early latent and late latent period

45
Q

What structures does the chlamydia bacteria affect?

A 
Urethra
Rectum
Throat
Eyes
Endocervix
46
Q

What is the second stage of syphilis infection?

A

2y stage – large numbers of bacteria circulating in blood with multiple manifestations at different sites (“snail-track” mouth ulcers, generalised rash, flu-like symptoms etc.)

47
Q

What non-sexually transmitted genital tract infections are there?

A

Candida infection
Bacterial vaginosis
Prostatitis

Obs & Gynae (20 decks)

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