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Reproduction and Sexual Health > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what bacteria is present as part of the normal vaginal flora

A

lactobacillus

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2
Q

what does lactobacillus produce

A

lactic acid +/- hydrogen peroxide

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3
Q

what does the lactic acid +/- hydrogen peroxide do

A

suppress growth of other bacteria

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4
Q

what other organisms are present as part of normal vaginal flora

A

strep viridans, group B streptococcus, candida (small numbers)

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5
Q

give examples of non-sexually transmitted genital tract infections

A

candida (vaginal thrush)
bacterial vaginosis
prostatitis

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6
Q

approx. what percentage of females are colonished with candida and have no symptoms

A

30%

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7
Q

what are predisposing factors for candida infection

A

recent antibiotic therapy
high oestrogen levels (pregnancy, certain contraceptives)
poorly controlled diabetes
immunocompromised patients

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8
Q

what does candida infection present with

A

intensely itcy white vaginal discharge

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9
Q

what is the treatment for candida

A

topical clotrimazole pessary or cream, can also give oral fluconazole

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10
Q

what does candida look like on gram film

A

budding and hyphae

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11
Q

how is bacterial vaginosis diagnosed

A

clinical diagnosis

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12
Q

what causes bacterial vaginosis

A

role of gardnerella vaginalis/mobiluncus and other organisms including anaerobes

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13
Q

what are they symptoms of bacterial vaginosis

A

thin watery, fishy smelling vaginal discharge

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14
Q

what helps a diagnosis of bacterial vaginosis

A

raised vaginal ph >4.5

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15
Q

in lab testing what types of cells are associated with bacterial vaginosis

A

clue cells

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16
Q

what is the treatment of bacterial vaginosis

A

metronidazole orally

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17
Q

how does acute bacterial prostatitis present

A

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

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18
Q

how is acute bacterial prostatitis diagnosed

A

clinical signs + MSSU for C&S

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19
Q

what is the treatment for bacterial prostatitis

A

ciprofloxacin for 28 days , trimethoprim for 28 days if high C diff risk

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20
Q

what is the commonest bacterial STI in UK

A

chlamydia

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21
Q

what does chlamydia infect

A

urethra, rectum, throat and eyes and endocervix

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22
Q

how does the bacteria reproduce

A

it is an obligate intracellular bacteria with biphasic life cycle-energy parasite-it does not reproduce outside a host cell

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23
Q

how does chlamydia stain on gram

A

IT DOESNT STAIN-no peptidoglygan in the cell wall

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24
Q

which serological grouping of chlamydia causes trachoma

A

serovars A-C

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25
Q

which serological grouping of chlamydia causes genital infection

A

serovars D-K

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26
Q

what does serovars L1-L3 cause

A

lymphogranuloma venereum

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27
Q

what is the treatment for chlamydia trachomatis

A

azithromycin

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28
Q

where does Neisseria gonorrhoeae infect

A

infects the urethra, rectum, throat and eyes and endocervix

29
Q

what does gonorrhoeaea bacteria look like

A

gram negative diplococcus

looks like 2 kidney beans facing each other

30
Q

what does gonorrhoeaea look like on a gram film

A

easily phagocytosed by polymorphs so often appear intracellularly on a gram film

31
Q

what type of organism is gonorrhoeaea in relation to growth

A

fastidious

does not survive well outside the body

32
Q

how is chlaymdia and gonorrhoea diagnosed

A

combined nucleic acid amplification tests (NAATs) or PCR which tests for both organisms in 1 test

33
Q

how is data for NAATs or PCR obtained

A

in male patients from FIRST PASS URINE SAMPLE
in female patients HVS or VVS or endocervical swab
rectal and throat swabs

34
Q

how else can you test for gonorrhoeae

A

microscopy of urethral/endocervical swabs or culture
cant do culture of high vaginal swabs nb it is now only done on swabs from patients attending SHS clinic in Tayside as swabs from GP patients were often falsely culture negative as organism would die during transit to lab

35
Q

what are the disadvantages of PCR/NAAT over culture

A

cannot test antibiotic sensitivities without culture so cant track antibiotic resistance
and it will detect dead orgnaisms (have to wait 5 weeks to do ‘‘test of cure’’ tests)

36
Q

what is the treatment for gonorrhoeae and why

A

many strains are now resistant to penicillins. tetracyclines, quinolones and most oral cephalosporins
recommended treatment is now IM ceftriaxone and oral azithromycin

37
Q

how does syphilis stain with gram

A

it doesn’t

38
Q

how is syphilis diagnosed and why

A

cannot be grown in artiifical culture media so diagnosis relies on PCR test or on serological tests to detect antibodies

39
Q

how many stages of syphilis are there

A

4 stage illness

40
Q

what are the four stages of syphilis

A

1-lesion-chacre
2-large numbers of bacteira circulating in blood with multiple manifestations
3-latent stage, no symptoms but low-level multiplication of spirochaete in intima of small blood vessels
4-late stage cardiovascular or neurovascular complications many years later

41
Q

what happens in the 2ndry stage of syphilis

A

large numbers of bacteria circulating in blood with multiple manifestations at different sites (snail-track mouth), ulcers, generalised rash, flu-like symptoms

42
Q

how is syphilis diagnsosed

A

dark ground microscopy to look for spirochaetes in exudate from primary and secondary lesions (NOT DONE IN TAYSIDE)
swab of lesions and sent for PCR
serology=tests for specific and non-specific antibodies to T. pallidum in blood

43
Q

what does the serology for syphilis useful for

A

how active the disease is and monitor the response to treatment
nb antibody levels decrease very closely even after successful treatment and often remain positive for life

44
Q

what are non specific serological tests

A

VDRL

RPR

45
Q

what do VDRL and RPR measure

A

non specific tests that indicate tissue imflammation

46
Q

when could non specific serological tests such are VDRL and RPR be useful

A

when monitoring response to therapy

47
Q

what are some specific serological tests

A

TPPA
TPHA
NB these are not useful for monitoring response to therapy

48
Q

what is used as the screening test for syphilis

A

Combines IgG and IgM ELISA is used as the screening test for syphilis

49
Q

what is the syphilis testing protocol in Tayside

A

syphilis combine IgM and IgG screening test and if positive further tests performed on blood-IgM ELISA and VDRL test and TPPA test

50
Q

what is the treatment for syphilis

A

injectable long acting preparations of penicillin

51
Q

what is the commonest viral STI

A

genital warts

52
Q

what are genital warts caused by

A

HPV

53
Q

which types of HPV are associated with genital warts

A

6 and 11

54
Q

which HPV is most associated with cervical cancer

A

16 and 18

55
Q

how are genital warts diagnosed

A

clinically

56
Q

what is the treatment for genital warts

A

cryotherapy, podophyllotoxin cream/lotion

57
Q

what is genital herpes caused by

A

herpes simplex virus type 1 and 2

58
Q

what does the virus HSV look like

A

enveloped virus containing double standed DNA

59
Q

what does the DNA look like in genital warts

A

non-enveloped icosahedral virus containing double stranded DNA

60
Q

where does the genital herpes virus replicate

A

in dermis and epidermis
gets into nerve endings of sensory and autonomic nerves, inflammation at nerve endings-painful multiple small vesicles which are easily deroofed
virus migrates to sacral root ganglion and hides from the immune system

61
Q

how is genital herpes diagnosed

A

PCR of deroofed blister

62
Q

treatment

A

acyclovir may be helpful if taken early enough

63
Q

what is trichomonas vaginalis

A

single celled protozoal parasite

64
Q

how is trichomonas vaginalis transmitted

A

sexual contact

65
Q

how is trichomonas vaginalis diagnosed

A

high vaginal swab for microscopy (PCR available but not used in Tayside so no good test for males)

66
Q

treatment for trichomonas vaginalis

A

oral metronidazole

67
Q

how are pubic lice-phthrius pubis acquired

A

by close genital skin contact

68
Q

what is the treatment for pubic lice

A

malathion lotion

69
Q

strawberry cervix is usually indicative of what

A

trichomonas vaginalis

Reproduction and Sexual Health (24 decks)

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