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Reproduction > Microbiology of Genital Tract Infections > Flashcards

Microbiology of Genital Tract Infections Flashcards

1
Q

What are the bacterial causes of STIs?

A

chlamydia trachomatis; neisseria gonorrhoeae and treponema pallidum

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2
Q

What is the difference between gonococci and chlamydia in terms of discharge?

A

gonococci- intense neurtrophil response with lots of pus whereas chlamydia produces a mild, watery discharge

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3
Q

What is the only method for transmission of STIs?

A

human-human, eg no fomites

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4
Q

How common is candida infection?

A

30% females are colonised with Candida and haven o symptoms

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5
Q

What ar ethe predisposing factors for candida infection?

A

recent antibiotic therapy; high oestrogen levels (pregnancy, contraceptives); poorly controlled DM; immunocompromise

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6
Q

How does candida present?

A

intensely itchy white vaginal discharge

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7
Q

What is the treatment for candida?

A

tropical clotrimazole pessary or cream; oral fluconazole

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8
Q

What is the most common form of candida?

A

candida albicans

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9
Q

What is the appearnace of C.albicans on gram film?

A

buds and hyphae

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10
Q

Who gets candida balanitis?

A

males

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11
Q

What is the presentation of candida balanitis?

A

red spotty rash over penis

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12
Q

What are the three types of prostatits?

A

acute bacterial; chronic bacterial prostatitis; chronic prostatitis/chronic pelvic pain syndrome

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13
Q

What are the symptoms of acute bacterial prostatits?

A

UTI symptoms; lower abdo/back/perineal/penile pain and tender prostate

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14
Q

What causes acute bacterial prostatitis?

A

complication of UTI

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15
Q

What causes acute bacterial prostatitis?

A

e.coli and other ocliforms; enterococcus sp.

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16
Q

What bugs should you check for in patients <35 with acute bacterial prostatitis?

A

gonorrhea and chlamydia

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17
Q

How is a test for chlamydia and gonorrhea done?

A

first pass urine

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18
Q

What is the treatment for acute bacterial prostattis?

A

trimethoprim for 28 days

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19
Q

What infection does the presence of genital ulcers increase the risk of getting?

A

HIV

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20
Q

What is the main bug in the normal vaginal flora?

A

lactobacillus spp.

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21
Q

What do lactobacilli produce?

A

lactic acid and hydrogen peroxide

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22
Q

What type of lactobacillus is found in yoghurt and why is it not effective as a remedy?

A

lactobacillus acidophilus which is rarely found in the normal vagina so yoghurt is not effective

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23
Q

What is the change in pH with bacterial vaginosis?

A

becomes more alkaline

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24
Q

What organism predominates in bacterial vaginosis?

A

gardnerella vaginalis and other anaerobic bacteria

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25
Q

What is the discharge in bacterial vaginosis like?

A

homogenous and may contain bubbles

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26
Q

What is a positive whiff test?

A

adding potassium hydroxide to the discharge on the slide elicits an amine-like, fishy odour

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27
Q

What is seen on a wet mount with bacterial vaginosis?

A

absence of bacilli and their replacement with clumps of coccobacilli which can obscure the cell edges (clue cells)

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28
Q

What does high numbers of leukocytes in the wet mount of a woman with BV suggest?

A

coincident infection eg trichomoniasis or bacterial cervicitis

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29
Q

What are the risks associated with bacterial vaginosis?

A

incrased rate of upper tract infection eg endometritis; salpingitis; preterm delivery if pregnant; increased HIV risk

30
Q

What is the treatment of bacterial vaginsosi?

A

metronidazole for 7 days

31
Q

What is the most common bacterial STI in the UK?

A

chlamydia trachomatis

32
Q

What areas of the body does chlamydia infect?

A

urethra; rectum; throat and eyes; endocervix

33
Q

Why does chlamydia not stain with gram stain?

A

no peptidoglycan in the cell wall

34
Q

How does chlamydia live?

A

obligate intracellular bacteria

35
Q

What does lymphogranuloma venereum cause?

A

proctitis

36
Q

Who is at risk for lymphogranuloma venereum?

A

men who have sex with men

37
Q

What is the treatment for chlamydia?

A

azithromycin 1 g oral dose or doxy bd 7 day

38
Q

What serovars are genital infections usuall caused by?

A

D-K

39
Q

What tests are used to diagnose chlamydia and gonorrhoea?

A

combined nucleic acid amplification or PCR

40
Q

What samples are used for chlamydia and gonorrhea diagnosis?

A

male- first pass urine ; females- HVS or VVS; rectal and throat; eye

41
Q

What areas of the body does neisseria gonorrhoeae infect?

A

urethra; rectum; throat and eyes; endocervic

42
Q

How does gonorrhea appear on gram stain?

A

gram negative diplococcus - like two kidney beans facing each other

43
Q

Why do gonorrohea often appear intracellularly on gramfilm?

A

easily phagocytosed by polymorphed

44
Q

What is meant by gonorrhea being a fastidious organism?

A

doesnt survive well in less than ideal growth condition

45
Q

Why is PCR/ NAAT better than culture?

A

less invasive specimens required; more sensitive; quicker

46
Q

Why may culture be better than PCR/NAAT?

A

cannot track antibiotic resistance

47
Q

How is gonnorhoeal infection of the pharynx aquired?

A

orogenital exposure- fellatio more than cunnilingus

48
Q

How does pharyngeal gonorrhoea presnet?

A

mostly asymptomatic although can have exudative pharyngitis and cervical lymphadenopathy

49
Q

What is the treatment for n.gonorrhoeae?

A

IM ceftriaxone and oral azithromycin

50
Q

What should be done for all patients after treatment of gonorrhea?

A

test of cure

51
Q

What is the function of azithromycin in the treatment of gonorrhoea?

A

cotreatment of chlamydia and treat against resistance

52
Q

Why is routine screening for rectal gonorrhea done in MSM and not females?

A

> 50% of MSM with gonorrhea have only extragenital infections but this is rare in women

53
Q

What bug causes syphilis?

A

treponema pallidum

54
Q

How is syphilis diagnosed? wHy?

A

PCR or serological tests to detect antibodies as cannot be grown in artifical culture media

55
Q

What is the priamry lesion in syphilis?

A

chancre- painless ulcer at site of infection, will heal without treatment

56
Q

What is the secondary stage of syphilis?

A

snail track mouth ulcers, generalised rash, flu-like symptoms; larg numbers of bacteria in blood

57
Q

What are the 4 stages of syphilis?

A

primary lesion; secondary stage; latenet stage; late stage syphilis

58
Q

What are the non-specific serological tests that can be done for syhpilis?

A

VDRL ad RPR

59
Q

What are the non-speciic serological tests measuring and what are they measuring?

A

useful for monitroing response to therapy, meausre tissue inflammation

60
Q

What is the screnning specific serological test for syphilis?

A

IgM and IgG ELISA

61
Q

What is the treatment for syphilis?

A

injectable lon-acting penicillin

62
Q

what is the pathogenesis of genital herpes?

A

virus replicates in dermis and epidermis; gets into nerve endings of sensory and autonomic nerves- inflammation at nerve endings, virus migrates to root ganglion

63
Q

How is genital herpes diagnosed?

A

swab in virus transport medium of deroofed lister for PCR

64
Q

What is the treatment for genital herpes?

A

aciclovir and pain relief

65
Q

How does trichomonas vaginalis divide?

A

binary fission

66
Q

What is trichomonas vaginalis?

A

single celled protozoal parasite

67
Q

What does trichomonas vaginalis presnet with?

A

vaginal discharge and irritation

68
Q

How is trichomonas vaginalis diagnosed?

A

HVS for microscopy

69
Q

What is the treatment for trichomonas vaginalis?

A

oral metronidazole

70
Q

How is pubic lice acquired?

A

close genital skin contact

71
Q

What causes itching with phthirus pubis?

A

lice bite skin and feed on blood

72
Q

What is the treatment for phthirus pubis?

A

malathion lotion

Reproduction (52 decks)

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