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Reproduction SB > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what organisms make up normal vaginal flora

A

Lactobacillus spp. [predominate]

Strep Viridans
Group B beta-haemolytic Strep
Candida spp

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2
Q

why is Lactobacillus spp. important for the vagina flora

A

produced lactic acid +/- hydrogen peroxide

which suppress growth of other bacteria

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3
Q

what does it mean by beta-haemolytic

A

complete clear zone around it

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4
Q

what are the non-sexually transmitted genital tract infections

A 
Candida infection (“vaginal thrush”)
Bacterial vaginosis

Prostatitis

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5
Q

what are predisposing factors for a candida infection

A

Recent antibiotic therapy

High oestrogen levels (pregnancy, certain types of contraceptives)

Poorly controlled diabetes

Immunocompromised patients (severely immunocompromised)

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6
Q

what is the Sx of candida infection

A

intensely itch white vaginal discharge
- “cottage cheese”

spotty rash - just in C. balanitis

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7
Q

diagnosis of candida infection

A

Clinical diagnosis

High Vaginal Swab [HVS] for culture

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8
Q

Tx for candida infection

A

1st line - Topical Clotrimazole 500mg 2-3 times daily

2nd line - Oral Fluconazole 150mg as a single dose + Topical Clotrimazole

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9
Q

what is the appearance of c. albicans

A

yeasts structure with budding

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10
Q

what is the Sx of bacterial vaginosis

A

thin, watery, fishy-smelling vaginal discharge

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11
Q

Ix of bacterial vaginosis

A

clinical diagnosis
raised vaginal pH (pH > 4.5)
HVS = looking for presence of clue cells

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12
Q

Tx of bacterial vaginosis

A

Metronidazole 500mg twice daily

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13
Q

what is the classification of prostatitis

A
  1. Acute bacterial prostatitis
  2. Chronic bacterial prostatitis
  3. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
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14
Q

Sx of acute bacterial prostatitis

A

Sx of UTI [dysuria, frequency, nocturia, haematuria]

lower abdomen pain, back/perineal/penile pain,

tender prostate O/E

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15
Q

what organism is responsible for acute bacterial prostatitis

A

E.Coli

- same as UTI

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16
Q

if a patient has acute bacterial prostatitis, what else should they be tested for

A

STI in patients < 35y/o: Gonorrhoea, chlamydia

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17
Q

Ix for acute bacterial prostatitis

A

Clinical signs + MSSU for C&S

First pass urine for STI tests

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18
Q

Tx for acute bacterial prostatitis

A

1st line = Ciprofloxacin for 28 days

2nd line = Trimethoprim for 28 days if high C. Diff risk

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19
Q

what is the commonest bacterial STI in the UK

A

Chlamydia trachomatis

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20
Q

what can chlamydia affect

A

urethra, rectum, throat and eyes

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21
Q

how does chlamydia strain with gram stain

A

NO stain

- no peptidoglycan in the cell wall

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22
Q

what are the 3 serological groupings of chlamydia

A

Serovars A-C = Trachoma (eye infection) (NOT an STI)
Serovars D-K = Genital infection
Serovars L1-L3 = Lymphogranuloma venereum

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23
Q

Tx of chlamydia

A

Azithomycin (1g oral dose) for uncomplicated chlamidia

Doxycycline 100mg bd x 7 days

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24
Q

what is Lymphogranuloma venereum

A

inflammation of the rectum

- can mimic crohns disease as people think they need to go to the toilet

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25
Q

what does neisseria gonorrhoea affect

A

urethra, rectum, throat, eyes, endocervix

26
Q

how does neisseria gonorrhoea appear on gram staining

A

Gram negative diplococcus

- Look like “2 kidney beans facing each other”

27
Q

Ix of chylamydia and gonorrhoea

A

NAAT or PCR - tests for both

For males, need first pass urine sample

For females, HVS or vulvo-vaginal swab (VVS)

28
Q

what is the advantages of PCR/NAAT over culture

A

less invasive
more sensitive
takes hours for result [not days]

29
Q

what is the disadvantages of PCR/NAAT over culture

A

Cannot test antibiotic sensitivities without culture, so difficult to track antibiotic resistance
Will detect dead organisms

30
Q

how long do you have to wait to do a test of cure

A

5 weeks

31
Q

Tx of gonorrhoea

A

IM ceftriaxone + oral azithromycin

32
Q

what causes syphilis

A

Treponema pallidum

33
Q

how does Treponema pallidum stain

A

does not stain with gram stain

34
Q

what are the 4 stages of syphilis

A

1y lesion (chancre)
2y stage
Latent stage
Late stage

35
Q

what is 1y lesion stage

A

organism multiplies at inoculation site and gets into bloodstream.
Chancre will heal without treatment

36
Q

what is 2y lesion stage

A

large nos. bacteria circulating in blood with multiple manifestations at different sites

(“snail-track” mouth ulcers, generalised rash, flu-like symptoms etc.)

37
Q

what is the latent stage

A

no symptoms, but low-level multiplication of spirochaete in intima of small blood vessels.

Can be divided into early latent and late latent periods.

Not infectious in the latent stage.

38
Q

what is late stage syphilis

A

cardiovascular or neurovascular complications many years later

39
Q

Ix of syphilis

A

1 - Swab of 1y or 2y lesions for PCR

2 - Serology – tests for non-specific and specific antibodies to T. pallidum in blood

40
Q

what are the two type of tests done in serology of syphilis

A

non specific

  • indicates how active the disease is
  • useful to monitor the response to treatment

specific
- confirm diagnosis

41
Q

1st line test for syphilis

A

IgM & IgG ELISA

42
Q

2nd line test for syphilis if 1st line positive

A

IgM ELISA
VDRL test
TPPA test

43
Q

Tx for syphilis

A

2.4 IM Benzathine penicillin x1

if penicillin allergic
- Doxycyline 100mg oral + Prednisolone 40-60mg

44
Q

what is the commonest viral STI

A

genital warts

45
Q

what causes genital warts

A

HPV

46
Q

what types of HPV are associated with pathology

A

6 & 11 = genital warts

16 & 18 = risk of cervical cancer

47
Q

how is genital warts spread

A

by close genital skin contact

48
Q

diagnosis of genital warts

A

clinical

49
Q

Tx for genital warts

A

cryotherapy; podophyllotoxin cream/lotion

50
Q

what vaccine is given for HPV

A

quadrivalent vaccine give to 11-13 year old girls

immunises against types 6,11,16 & 18

51
Q

how do genital warts appear

A

whiter than the surrounding skin with a rough surface

52
Q

what causes genital herpes

A

HSV type 1 and type 2

HSV-1 and HSV-2

53
Q

what is HSV-1 also associated with

A

cold sores

54
Q

how are genital herpes spread

A

genital/genital or oropharyngeal/genital contact

55
Q

what is the pathogenesis of genital herpes

A

Primary infection may be asymptomatic (or very florid)

Virus replicates in dermis and epidermis

Gets into nerve endings of sensory and autonomic nerves

Inflammation at nerve endings

Virus migrates to sacral root ganglion and “hides” from the immune system there

Virus can reactivate from there causing recurrent genital herpes attacks

56
Q

presentation of genital herpes

A

exquisitely painful multiple small vesicles, which are easily deroofed

57
Q

Ix for genital herpes

A

Swab deroofed blister for PCR test

58
Q

Tx for genital herpes

A

pain relief

aciclovir may help if taken early enough

59
Q

what is Trichomonas vaginalis

A

single celled protozoal parasite

60
Q

Sx of Trichomonas vaginalis

A

vaginal discharge
irritation
urethritis in males

61
Q

Ix and Tx of Trichomonas vaginalis

A

HVS for microscopy

Oral metronidazole

62
Q

what is Tx for lice

A

malathion lotion

Reproduction SB (30 decks)

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