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1. Reproduction > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is the normal pH of the vagina?

A

acidic - 4.5

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2
Q

What organism predominates in the vagina and is protective?

A

lactobacillis - gram +ve bacilli

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3
Q

What do lactobacillis produce?

A

lactic acid and hydrogen peroxide

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4
Q

What exist in small numbers in the vagina?

A

candida
group B haemolytic strep
strep viridens

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5
Q

What organism commonly causes candida infection?

A

Candida albicans

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6
Q

What predisposes to a candida infection?

A

recent antibiotic therapy
high oestrogen levels
poorly controlled diet
immunocomprimised patients

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7
Q

How does candida present?

A

“cottage cheese”

intensely itchy white vaginal discharge

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8
Q

What swab is done for candida?

A

high vaginal for culture

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9
Q

What is the treatment of candida?

A

AZOLE
topical clotrimazole pessentery or cream
oral fluconazole

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10
Q

What is candida balantis?

A

spotty rash on the tip of a males penis

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11
Q

Is candida balantis sexually transmitted?

A

NO

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12
Q

What organism causes gonorrhoea?

A

nisseria gonnorhea

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13
Q

What does nisseria gonnorhea look like on microscopy?

A

gram negative intracellular diplococcus

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14
Q

What is the action of nisseria gonnorhea?

A

attaches to host epithelial cells and is endocytosed into the cell to then replicate within the host cell and be released into the subepithelial space

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15
Q

How is gonnorhoea diagnosed?

A

1st line - NAATS

2nd line - swab of pus + culture

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16
Q

How does gonnorhea present?

A

purulent discharge
can infect the urethra, rectum, throat, and eyes
endocervix in females

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17
Q

Is gonnorhea always symptomatic?

A

NO - 50% of women with it have no symptoms

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18
Q

What happens to a baby if the pregnant mother has gonnorhea?

A

sticky eyes

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19
Q

What is the benefit of doing NAATs over culture?

A

the organism dies quickly so better to look for DNA remnants

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20
Q

How is gonnorhea treated?

A

IM Ceftriaxone 1G

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21
Q

What are possible gonorrhea complications for males?

A

tysonitis
rectal and periurethral abscesses
epididymis
prostatitis

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22
Q

What are possible gonorrhea complications for females?

A 
bartholinitis
rectal and periurethral abscesses 
PID
endometritis
ectopic pregnancy
hydrosalphinix 
infertility
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23
Q

What is the most common bacterial STI?

A

chlamidya

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24
Q

What serovar corresponds to the genital infection?

A

D-K

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25
Q

What does serovars A-C correspond to?

A

trachoma - eye infection

NOT AN STI

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26
Q

What does serovars L1-L3 correspond to?

A

lymphogranuloma venerum (LGV)

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27
Q

What is LGV?

A

occurs in those who are from tropical places and MSM

histologically identical to crohns disease

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28
Q

How does LGV present?

A

rectal pain
discharge
bleeding

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29
Q

What organism causes chlamidya?

A

chlamidya trachomatis

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30
Q

How is chlamidya tachomatis seen on histology?

A

intracellular bacteria
surrounding inflammatory cells
no peptidoglycan so doesnt stain on gram staining - gram negative

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31
Q

What type of female swab is done for both chlamidya and gonorrhea?

A

vulvo-vaginal swab - can be self taken

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32
Q

What is done to diagnose chlamidya?

A

NAATS - 1st line done after 14 days

PCR

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33
Q

What male swab is done for chlamidya?

A

first pass urine

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34
Q

What is the treatment for chlamidya?

A

Doxycycline 100mg for 7 days

35
Q

How does chlamidya present for women?

A

post coital or intermenstrual bleeding
pain during sex - dyspareunia
lower abdo pain
micropurulent cervicitis

36
Q

How does chlamidya present for men?

A

urethral discharge
dysuria
urethritis
epididymio-orchitis

37
Q

What disease do 9% of women with chlamidya develop?

A

pelvic inflammatory disease (PID)

38
Q

What does PID increase?

A

risk of ectopic pregnancy x10

infertility 15-20%

39
Q

Apart from PID, what are other chlamidya complications?

A

reactive arthritis

Fitz-hugh-curtis syndrome (perihepatitis - piano string adhesions)

40
Q

What pathogen causes bacterial vaginosis?

A

trichomonas vaginalis - single celled protozoal parasite

41
Q

What causes bacterial vaginosis?

A

acidic environment becomes more alkaline and anaerobes take over

42
Q

How is bacterial vaginosis transmitted?

A

sexual contact

but can be just by using same towels etc

43
Q

How does bacterial vaginosis present?

A

vaginal discharge and irritation in females

44
Q

What are the complications of bacterial vaginosis?

A

increased rate of upper GU infections - endometritis and salpingitis
can cause premature rupture of membranes and preterm delivery
increased risk of HIV

45
Q

How is bacterial vaginosis diagnosed?

A

high vaginal swab for microscopy

46
Q

How is bacterial vaginosis treated?

A

oral metronidazole for 7 days

47
Q

Should you offer treatment to the male sexual partners of those with bacterial vaginosis?

A

no - no benefit

48
Q

What is the pathogen causing syphilis?

A

treponema pallidum

49
Q

How is treponema pallidum seen on microscopy?

A

spirochaete

50
Q

What is the primary lesion seen in syphilis?

A

chancre

51
Q

Will the chancre heal without treatment?

A

YES

52
Q

What is the incubation period for the chancre?

A

9-90 days

53
Q

What is the pathogenesis of treponema pallidum?

A

organism multiples at innoculation site and gets into blood stream then it multiplies in the blood and there are manifestations at different sites

54
Q

What is the secondary stage of syphilis?

A

large number of bacteria circulating in the blood stream

55
Q

What is the incubation period for the second stage of syphilis?

A

6 weeks - 6 months

56
Q

What is the latent stage of syphilis?

A

no symptoms

low level of multiplication of spirochete in intima of small blood vessels

57
Q

What is the primary testing for syphilis?

A

dark ground microscopy

PCR

58
Q

What is the secondary testing for syphilis?

A

serology - ELISA

VDRL and RPR

59
Q

What serology is specific for syphilis?

A

ELISA

60
Q

What serology is non specific for syphilis?

A

VDRL and RPR

61
Q

What happens to serology after sucessful treatment?

A

becomes negative

decrease by 4 fold in 3-6 months

62
Q

What is the treatment for syphilis?

A

penicillin - benzylpenicillin

63
Q

What causes herpes?

A

HSV 1 and HSV 2

64
Q

What most commonly causes herpes - HSV 1 or HSV 2?

A

HSV 2 - 4-5 attacks per year

65
Q

How does HSV appear on microscopy?

A

enveloped virus containing double stranded DNA

66
Q

How is herpes transmitted?

A

close contact with someone shedding the virus

genital/oropharyngeal

67
Q

What is the pathogenesis of herpes?

A

virus replicates in the dermis and epidermis then gets into nerve endings of sensory and autonomic nerves
inflammation of the nerve endings cause exquisitively painful small vesicles when are easily reroofed
virus migrates to the sacral root ganglion and hides from the immune system there
the virus can reactivate

68
Q

How is herpes diagnosed?

A

swab deroofed blister then PCR

69
Q

How is herpes treated?

A

aciclovir if caught early enough

saline bathing or topical lidocaine if verysore

70
Q

How does herpes present?

A 
blistering and ulceration of external genitalia
pain
external dysuria
discharge
local lymphadenopathy
71
Q

What pathogen causes pubic lice?

A

pthirus pubis

72
Q

How is pubic lice treated?

A

malathion lotion

73
Q

What is the most common viral STI?

A

HPV

74
Q

What HPV types are covered by the vaccine?

A

6
11
16
18

75
Q

What are the low risk HPV types? What do they cause?

A

6 + 11

anogenital warts

76
Q

What are the high risk HPV types? What do they cause?

A

16 + 18

neoplasia

77
Q

What do HPV 1 and 2 cause?

A

palmar and plantar warts

78
Q

What is the incubation period of HPV?

A

3 weeks - 9 months

79
Q

What is the lifetime risk of aquiring an HPV infection?

A

80%

80
Q

How does HPV present?

A

cauliflower lesions around areas of friction

can also get them perianally

81
Q

How is HPV treated?

A

Podophyllotoxin - warticon (cytotoxic so not for extragenital warts)
Imiquimod - 1st line for anogenital warts
Cryrotherapy
Electrocautery

82
Q

When is the HPV vaccination given?

A

females aged 11-13

MSM

83
Q

What is mycoplasma genitalium?

A

emerging sexually transmitted pathogen
associated with non gonococcal urethritis and PID
diagnosed by NAAT tests
40% levels of macrolide

1. Reproduction (50 decks)

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