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Microbiology Flashcards

1
Q

Produced by the commensal bacteria in the vagina to suppress the growth of other bacteria

A

Lactobacillus spp. produces lactic acid (+/- hydrogen peroxide)

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2
Q

Organism that is the cause of meningitis in neonates and can also be a commensal organism in the vagina

A

Group B beta-haemolytic streptococcus

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3
Q

Main organism that makes up the normal vaginal flora

A

Lactobacillus spp.

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4
Q

Name the predisposing factors for candida infection

A

Recent antibiotic therapy
High oestrogen levels (pregnancy, contraception)
Poorly controlled diabetes
Immunocompromised patients

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5
Q

Why does poorly controlled blood sugar within diabetes cause thrush?

A

High sugar levels encourage bacterial growth

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6
Q

Intensely itchy thick, white vaginal discharge - diagnosis?

A

Candid infection (vaginal thrush)

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7
Q

Treatment for candid infection (vaginal thrush)

A

Topical clotrimazole pessary or cream - put inside the vagina
Oral fluconazole

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8
Q

What is the typical appearance of candida infection on the male?

A

Spotty appearance

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9
Q

Thin, watery, fishy-smelling vaginal discharge (sometimes brown in colour) and a raised vaginal pH - diagnosis?

A

Bacterial vaginosis (BV)

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10
Q

Bacterial vaginosis is commonly caused by which organisms?

A

Anaerobes - Gardnerella vaginalis/Mobiluncus sp.

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11
Q

Treatment for Bacterial vaginosis?

A

Oral metronidazole (5 day course)

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12
Q

Laboratory testing that can be done for BV?

A

High vaginal swab (HVS) to look for the presence of clue cells

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13
Q

How may acute bacterial prostatitis present?

A

Symptoms of UTI; lower abdominal/back/perineal/penile pain; tender prostate on examination

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14
Q

Treatment for acute bacterial prostatitis?

A

Ciprofloxacin for 28 days (altered depending on culture result)
Trimethoprim if high C.diff risk (elderly)

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15
Q

Bacteria that causes Chlamydia?

A

Chlamydia tracahomatis

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16
Q

Sites where the chlamydia can infect

A

Urethra, rectum, throat and eyes

Endocervix (females)

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17
Q

Treatment for Chlamydia?

A

Azithomycin (1g oral dose)

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18
Q

How long after unprotected sex will chlamydia be detectable?

A

48hrs

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19
Q

Which is more common - chlamydia or gonorrhoea?

A

Chlamydia

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20
Q

Sites where gonorrhoea can infect

A

Urethra, rectum, throat and eyes

Endocervix (females)

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21
Q

Describe the morphology of Neisseria gonorrhoeae

A

Gram negative diplococcus: looks like two kidney beans facing each other

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22
Q

Which tests are used to diagnose chlamydia AND gonorrhoea?

A

Nucleic acid amplification tests (NAATs) or polymerase chain reaction test (PCR)

23
Q

Which samples are taken for gonorrhoea and chlamydia testing?

A

Male patients - first pass urine sample
Female patients - HVS or VVS
Rectal and throat swabs
Eye swabs

24
Q

What are the advantages of NAATs/PCR tests over culture?

A

Much less invasive
Much more sensitive
Will be positive even if organisms have died in transit
Takes hours not days

25
Q

What are the disadvantages of PCR/NAATs tests?

A

Cannot test antibiotic sensitivities

Will detect dead organisms - not a test of cure

26
Q

Recommended treatment for gonorrhoea in the UK?

A

IM ceftriaxone and oral azithromycin

27
Q

Which STI should be tested for cure due to high numbers of resistant strains?

A

Gonorrhoea

28
Q

Name the organism that causes syphilis

A

Treponema Pallidum

29
Q

What testing cannot be done on syphilis?

A

Cannot be grown in culture medium - diagnosis relies on PCR test or serological tests

30
Q

Describe the first stage of the syphilis illness

A

Organism multiplies at the inoculation site and get into bloodstream. Chancre will heal without treatment.

31
Q

Describe the second stage of syphilis illness

A

Large numbers of bacteria circulate in the blood with multiple manifestations at different sites (snail-track mouth ulcers, generalised rash (palms of hands and soles of feet - copper colour), flu-like symptoms)

32
Q

Describe the latent stage of syphilis

A

Patient will be asymptomatic. Low level of multiplication of the spirochaete in the small blood vessels

33
Q

Describe late stage syphilis

A 
Cardiovascular or neurovascular complications
Aortic aneurysm (commonly in the ascending or the arch)
Proprioception difficulty, difficulty focusing eyes, grandiose delusions)
34
Q

What is the treatment for syphilis?

A

Injectable long-acting preparations of penicillin

35
Q

Name the organism that causes genital warts

A

Human Papilloma Virus, types 6 &11

36
Q

Which type of HPV is associated with an increased risk of cervical cancer?

A

Types 16 & 18

37
Q

What is the treatment for genital warts?

A

Cryotherapy

Podophyllotoxin cream/lotion

38
Q

What types of HPV does the vaccination immunise against?

A

6, 11, 16 and 18

39
Q

Which type of herpes simplex virus causes both genital herpes and cold sores?

A

Type 1

40
Q

How are genital herpes spread?

A

Via genital/genital or oropharyngeal/genital contact

41
Q

How are genital warts spread?

A

Via genital-genital contact

42
Q

Describe the appearance of genital warts

A

They are often whiter than the surrounding skin and the surrounding skin is rough

43
Q

How is genital herpes diagnosed?

A

Deroof blisters and swab for PCR testing

44
Q

What is the treatment for genital herpes?

A

Aciclovir if early enough, can also give pain relief

45
Q

How is Trichomona Vaginalis diagnosed?

A

High vaginal swab

PCR can be done but not in Tayside - no good test for males.

46
Q

Likely diagnosis in a women with multiple small painful ulcers on her genitalia and a flu-like illness. She is unable to urinate due to the discomfort.

A

Herpes Simplex

47
Q

Likely diagnosis in a non-sexually active woman who presents with a frothy brownish vaginal discharge which has an offensive smell.

A

Bacterial vaginosis

48
Q

Likely diagnosis in a women who presents with vulval irritation and a white discharge

A

Candida albicans

49
Q

What is the most commonly reported STI in sexual health clinics?

A

Chlamydia

50
Q

Which form of HSV has a higher rate of viral shedding?

A

HSV 2

51
Q

How is a pregnant mother who is infected with a primary infection of HSV during the third trimester managed?

A

Mother will have no antibodies developed already and so no protection for foetus. Give IV acyclovir before delivery and then give dose to baby after birth.

52
Q

What is the incubation period of HPV?

A

Ranges from 3 weeks to 9 months - average about 3 months

53
Q

Which STI is known as the “great imitator” because its symptoms resemble those of other infections?

A

Syphilis

Reproduction (12 decks)

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