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MBBS - Year 1 > Microbiology - Gender, Family & Culture > Flashcards

Microbiology - Gender, Family & Culture Flashcards

1
Q

Why are STIs difficult to control

A

Increasing density and mobility of human population
The difficulty of engineering changes in human sexual behaviour
The absence of vaccines for almost all STIs, expect for the HPV vaccine

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2
Q

Common STI causing organisms

A 
Papillomaviruses (6, 11, 16 and 18)
Chlamydia trachomatis
Candida albicans 
Trichomonas vaginalis 
HSV-1, 2 
Neisseria gonnorhrea 
HIV 
Trepenoma pallidum 
Hep B virus 
Haemophilus ducreyi 
Phthirus pubis
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3
Q

Disease cased by papillomaviruses

A

Genetic warts

Dysplasia

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4
Q

Disease caused by Phthirus pubis

A

Pubic lice

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5
Q

Treatment of pubic lice

A

Permethrin cream

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6
Q

How does the urogenital tract being a continuum affect the spread of microorganisms

A

Micro-organisms can spread easily from one part to another

The distinction between vaginitis and urethritis or urethritis and cystitis is not always easy or necesary

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7
Q

Microbrial strategies against urine flow (for urethral infection)

A

Infection of urethral epithelial or sub epithelial cells e.g. HSV or chlamidyia

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8
Q

Microbial strategy against cell-mediated immune response

A

Antigenic variation - allows re-infection

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9
Q

Why do most microbes require close contact or spread through vectors

A

Unstable on drying

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10
Q

Vaginal defences against microbes

A

Vaginal pH of 5.0 inhibits colonization by all except the lactobacilli and certain other streptococci and diphtheroids

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11
Q

How can intestinal bacteria cause cystitis

A

Common invaders of urinary tract and can adhere to GU tract e.g. E.coli

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12
Q

Whoa re STIs more common in

A

Uncircumcised males

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13
Q

Effect of female urogenital tract being shorter than male

A

More vulnerable to infection

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14
Q

Semen as source of infection

A

CMV shed from oropharynx, HIV and hep B found in semen

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15
Q

What organism causes syphilis

A

Trepenoma pallidum (spirochete)

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16
Q

How does T. palladium enter the body

A

Through minute abrasions or mucous membranes

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17
Q

Transmission of syphilis

A

Requires close personal contact; horizontal spread occurs through sexual contact and vertical spread via transplacental infection of the foetus

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18
Q

When is congenital syphilis acquired

A

After 3 months of pregnancy

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19
Q

How can congenital syphilis manifest

A

Serious infection resulting in intrauterine death
Congenital abnormalities, which may be obvious at birth
Silent infection, which may not be apparent until ~2 yrs (facial and tooth deformities)

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20
Q

Initial contact of syphilis

A

2-10 weeks

Primary chancre at site of infection

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21
Q

Primary syphilis

A

1-3 months

Enlarged inguinal nodes

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22
Q

Secondary syphilis

A

2-6 weeks

Flu-like illness, mucocutanoeus rash, spontaneous resolution

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23
Q

When do you experience latent syphilis

A

Last 3-30 years

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24
Q

Tertiary syphilis

A

Neurosyphilis

Cardiovascular syphilis

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25
Q

Serological dx of syphilis

A

Non-spp tests are VDRL and RPR
ELISA - IgM and IgG

Confirmation of a dx requires several serological tests

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26
Q

VDRL

A

Venereal Disease Research Lab

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27
Q

RPR

A

Rapid Plasma Reagin

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28
Q

Treatment of syphilis

A

Penicillin

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29
Q

Organism causing gonorrhoea

A

Gram-ve coccus Neisseria gonorrhoeae (the gonococcus)

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30
Q

Virulence factors of gonorrhoea

A

Pili
Opa Protein
Capsule

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31
Q

Pili as a virulence factor

A

Aids attachment to epithelium

Contains constant and hyper variable regions - contribute to antigenic diversity

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32
Q

Opa proteins

A

Assist binding to epthelial cells

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33
Q

Gonorrhoea capsule

A

Resists phagocytosis unless antibody present

34
Q

What can persistent untreated gonorrhoea infection result in

A

Chronic infl and fibrosis

35
Q

Is gonorrhoea infection localised or unlocalised

A

Usually localised, but in some cases bacteria isolates can invade the bloodstream and so spread to other parts of the body

36
Q

How does gonorrhoea present in women

A

Initially asymptomatic but can cause infertility

37
Q

When do gonorrhoea symptoms develop

A

Within 2-7 days

38
Q

Gonorrhoea symptoms in males

A

Urethral discharge and dysuria

39
Q

Gonorrhea symptoms in females (if not asymptomatic)

A

Vaginal discharge

40
Q

Dx of gonorrhea

A

Made from microscopy and culture of appropriate specimens

41
Q

Treatment of gonorrhoea

A

Dual therapy - ceftriaxone and azithromycin
Treats chlamydia
Resistance of penicillin and fluroquinones seen

42
Q

Systemic spread of gonorrhoea

A

Skin lesions
Endocarditis
Arthritis
Opthalmia neonatorum

43
Q

Which C trachomatis serotypes cause STIs

A

D - K

44
Q

3 species of chlamydia

A

C trachomatis

C. psittaci and C.pneumoniae infect the respiratory tract

45
Q

Serotypes L1, L2, L3 of chlamydia

A

Usually associated with men who have sex with men

46
Q

How does chlamydia enter host

A

Through minute abrasions in the mucosal surface

Binds to spp receptors on the host cells and enter the cells by ‘parasite-induced’ endocytosis

47
Q

Clinical syndromes of chlamydia in men

A

Urethritis
Epididymitis
Proctitis
Conjuctivitis

48
Q

Complication of chlamydia in men

A

Systemic spread

Reiter’s syndrome

49
Q

Reiter’s syndrome

A

Urethritis
Conjunctivitis
Polyarthritis
Mucocutaneous lesion

50
Q

Clinical syndromes of chlamydia in women

A 
Urethritis 
Cervicitis 
Bartholinitis 
Salpinigitis 
Conjuctivitis
51
Q

Complications of chlamydia in women

A 
Ectopic pregnancy
Infertility 
Systemic spread 
Perihepattitis 
Arthritis dermatitis
52
Q

Clinical syndrome of chlamydia in neonates

A

Conjunctivitis

53
Q

Complications of chlamydia in neonates

A

Interstitial pneumonia

54
Q

Genital tract infections w/ serotypes D-K

A

Locally asymptomatic in most women but usually symptomatic in men

55
Q

Dx of chlamydia

A

Nucleic-acid based tests

56
Q

Treatment/ prevention of chlamydia

A

Doxycycline

Azithromycin

57
Q

Chancroid (soft chancre)

A

Caused by Haemophilus ducreyi (Gram-ve)

Characterised by painful genital ulcers and local lymphadenitis

58
Q

Other STIs

A

Mycoplasma hominis
M. genitalium
Ureaplasma urealyticum

59
Q

Most common cause of genital herpes

A

HSV 2

60
Q

What can HSV-2 infection result in

A

Twofold-increased risk for developing HIV; due to breaches in mucosal barrier because of the HSV ulcers

61
Q

Presentation of genital herpes

A

Characterized by ulcerating vesicles that can take up to 2 weeks to heal

62
Q

How is latent HSV infection established

A

The virus in the lesion travels up sensory nerve endings to establish latent infection in dorsal root ganglion neurones. From this site, it can reactivate, travel down nerves to the same area and cause recurrent lesions (‘genital cold sores’)

63
Q

Rare complications of HSV

A

Aseptic meningitis

Encephalitis

64
Q

What can spread of HSV from mother to infant at delivery cause

A

Neonatal disseminated herpes or encephalitis

65
Q

Dx of HSV

A

Genital herpes is generally diagnosed by clinical appearance
HSV DNA can be detected and typed in vesicle fluid or ulcer swabs

66
Q

Transmission of HIV

A

Involves mucosal surfaces e.g., cervicovaginal, penile and rectal
May be infected by IV or percutaneous routes

67
Q

Treatment for HSV

A

Aciclovir

68
Q

Window period for HIV detection

A

7-21 days as HIV multiplies in the mucosa and drain lymphoreticular tissues

69
Q

1st targets of HIV infection

A

CD4 receptor-bearing cells incl Th cells, monocytes, Langerhans cells and other dendritic cell, macrophages, and microglia

70
Q

What may primary HIV be accompanied by

A

A mild mononucleosis-type illness

71
Q

HIV progression to AIDS

A

Viral invasion of the CNS, with self-limiting aseptic meningoencephalitis

72
Q

Treatment for HIV

A

Anti-retroviral therapy

73
Q

Candida albicans

A

(Thrush)

Can cause vaginitis and urethritis which are treated with topical or oral antifungals

74
Q

Variation in Candida infections

A

Mild superficial, localised infection - healthy

Fatal - immunocompromised

75
Q

Candida as a normal inhabitant if vagina

A

Whilst Candida can be transmitted sexually, the presence of vulvovaginal candidiasis does not necessarily imply sexual transmission

76
Q

Trichomonas vaginalis

A

Protozoan parasite and causes vaginitis with copious discharge

77
Q

What does T. vaginalis inhabit

A

The vagina in women and the urethra (and sometimes the prostate) in men

78
Q

What is bacterial vaginosis associated with

A

Gardnerella vaginalis plus anaerobic infection and a fishy-smelling vaginal discharge

79
Q

What is BV characterised by

A 
At least 3 of:
Excessive malodorous vaginal discharge
Vaginal pH >4.5
Presence of clue cells (vaginal epithelial cells coated with bacteria)
A fishy amine-like odour
80
Q

Opportunist STIs

A 
Salmonellae
Shigellae
Hepatitis A 
Giardia intestinalis
Entamoeba histolytica infections
81
Q

Structure of C. trachomatis

A

Oblingate intracellular bacteria

82
Q

Virulence of C. trachomatis

A

Hemagglutinin facilitates attachment to cells
The cell-mediated immune response is responsible for tissue damage during inflammation
Endo-toxin like toxin is released

MBBS - Year 1 (93 decks)

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