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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
which serological grouping of chlamydia causes genital infection
serovars D-K
26
what does serovars L1-L3 cause
lymphogranuloma venereum
27
what is the treatment for chlamydia trachomatis
azithromycin
28
where does Neisseria gonorrhoeae infect
infects the urethra, rectum, throat and eyes and endocervix
29
what does gonorrhoeaea bacteria look like
gram negative diplococcus | looks like 2 kidney beans facing each other
30
what does gonorrhoeaea look like on a gram film
easily phagocytosed by polymorphs so often appear intracellularly on a gram film
31
what type of organism is gonorrhoeaea in relation to growth
fastidious | does not survive well outside the body
32
how is chlaymdia and gonorrhoea diagnosed
combined nucleic acid amplification tests (NAATs) or PCR which tests for both organisms in 1 test
33
how is data for NAATs or PCR obtained
in male patients from FIRST PASS URINE SAMPLE in female patients HVS or VVS or endocervical swab rectal and throat swabs
34
how else can you test for gonorrhoeae
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
what are the disadvantages of PCR/NAAT over culture
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
what is the treatment for gonorrhoeae and why
many strains are now resistant to penicillins. tetracyclines, quinolones and most oral cephalosporins recommended treatment is now IM ceftriaxone and oral azithromycin
37
how does syphilis stain with gram
it doesn't
38
how is syphilis diagnosed and why
cannot be grown in artiifical culture media so diagnosis relies on PCR test or on serological tests to detect antibodies
39
how many stages of syphilis are there
4 stage illness
40
what are the four stages of syphilis
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
what happens in the 2ndry stage of syphilis
large numbers of bacteria circulating in blood with multiple manifestations at different sites (snail-track mouth), ulcers, generalised rash, flu-like symptoms
42
how is syphilis diagnsosed
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
what does the serology for syphilis useful for
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
what are non specific serological tests
VDRL | RPR
45
what do VDRL and RPR measure
non specific tests that indicate tissue imflammation
46
when could non specific serological tests such are VDRL and RPR be useful
when monitoring response to therapy
47
what are some specific serological tests
TPPA TPHA NB these are not useful for monitoring response to therapy
48
what is used as the screening test for syphilis
Combines IgG and IgM ELISA is used as the screening test for syphilis
49
what is the syphilis testing protocol in Tayside
syphilis combine IgM and IgG screening test and if positive further tests performed on blood-IgM ELISA and VDRL test and TPPA test
50
what is the treatment for syphilis
injectable long acting preparations of penicillin
51
what is the commonest viral STI
genital warts
52
what are genital warts caused by
HPV
53
which types of HPV are associated with genital warts
6 and 11
54
which HPV is most associated with cervical cancer
16 and 18
55
how are genital warts diagnosed
clinically
56
what is the treatment for genital warts
cryotherapy, podophyllotoxin cream/lotion
57
what is genital herpes caused by
herpes simplex virus type 1 and 2
58
what does the virus HSV look like
enveloped virus containing double standed DNA
59
what does the DNA look like in genital warts
non-enveloped icosahedral virus containing double stranded DNA
60
where does the genital herpes virus replicate
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
how is genital herpes diagnosed
PCR of deroofed blister
62
treatment
acyclovir may be helpful if taken early enough
63
what is trichomonas vaginalis
single celled protozoal parasite
64
how is trichomonas vaginalis transmitted
sexual contact
65
how is trichomonas vaginalis diagnosed
high vaginal swab for microscopy (PCR available but not used in Tayside so no good test for males)
66
treatment for trichomonas vaginalis
oral metronidazole
67
how are pubic lice-phthrius pubis acquired
by close genital skin contact
68
what is the treatment for pubic lice
malathion lotion
69
strawberry cervix is usually indicative of what
trichomonas vaginalis

Reproduction and Sexual Health (24 decks)

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