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Reproduction & Sexual Health > Microbiology of GU Tract > Flashcards

Microbiology of GU Tract Flashcards

1
Q

What are bacterial causes of STI’s?

A
  • Treponema pallidum (syphilis)
  • Neisseria gonorrhoea (gonorrhoea)
  • Chlamydia trachomatis (chlamydia)
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2
Q

What are viral causes of STI’s?

A
  • Human papilloma virus (genital warts)
  • Herpes simplex virus (genital herpes)
  • HIV & hepatitis
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3
Q

What parasites cause STI’s?

A
  • Trichomonas vaginalis
  • pthirus pubis (pubic lice/”crabs”)
  • scabies
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4
Q

What are common non sexually transmitted genital infection?

A
  • candidiasis (vaginal thrush)
  • bacterial vaginosis
  • prostatitis
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5
Q

What are the normal vaginal flora?

A
  • lactobacillus species: gram + rods (predominate in healthy vagina)
  • streptococcus viridans
  • group b haemolytic streptococcus
  • candida species (small amount)-only problematic if symptomatic
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6
Q

What do lactobacillus produce?

A

-lactic acid & hydrogen peroxide (suppresses growth of microorganism)

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7
Q

What is candida infection?

A
  • non STI
  • responsive to treatment
  • most caused by candida albicans
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8
Q

What are the predisposing factors for candida infection?

A
  • recent antibiotic therapy
  • immunosuppression
  • poorly controlled DM
  • high oestrogen levels (pregnancy, certain contraceptives)
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9
Q

What is the presentation for candida infection?

A

-intensely itchy white vaginal discharge

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10
Q

How is candida diagnosed?

A
  • clinical diagnosis

- culture (high vaginal swab)

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11
Q

What is the management for candida infection?

A

-150mg fluconazole

avoid oral treatment in pregnancy, breastfeeding

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12
Q

What are the topical treatments available for candida? (suitable for pregnancy)

A
  • clotrimazole (pessary)-500mg

- clotrimazole (vaginal cream)-5g

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13
Q

Which parts of the body can be infected by chlamydia trachomatis?

A
  • urethra
  • eyes
  • throat
  • endocervix
  • *same as gonorrhoea
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14
Q

What are the characteristics of chlamydia trachomatis

A
  • obligate intracellular organism
  • biphasic life cycle
  • does not reproduce outside of host cell
  • does not stain with gram stain
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15
Q

Which serological group is responsible for genital infection?

A

serovars D-K (most common)

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16
Q

What is the treatment for chlamydia?

A

doxycycline 100mg bd for 7 days

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17
Q

What is the organism responsible for gonorrhoea what are their characteristics?

A

Neisseria gonorrhoeae

  • Gram negative diplococci (two kidney beans facing each other)
  • easily phagocytosed by polymorphs (so appear intracellularly)
  • cannot survive in less than ideal conditions (outside the body)
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18
Q

What symptom is typical of gonorrhoea

A

purulent discharge

19
Q

What is the treatment for gonorrhoea

A
  • IM ceftriaxone alone

- Test of cure is recommended

20
Q

How are chlamydia and gonorrhoea diagnosed?

A
  • combined nucleic acid amplification test (NAATs)/ polymerase chain reaction test (PCR)
  • tests for both organism in 1 test
  • highly sensitive and specific
21
Q

What other tests can be done for diagnosis for gonorrhea?

A
  • culture (for antibiotic sensitivity)

- microscopy

22
Q

What samples are taken?

A
  • first pass urine (male)
  • high vaginal swab/vulvovaginal swab (self taken)
  • endocervical swab (by clinician)
  • rectal & throat swabs
  • eye swabs (babies and adults)
23
Q

What are the advantages of NAATs/PCR?

A
  • less invasive specimen required (urine and VVS)
  • more sensitive than culture
  • will be positive even if organims die during transit
  • test takes hours instead of days
24
Q

What are the disadvantages of NAATs/PCR?

A
  • cannot test antibiotic sensitivity (unlike culture)

- will detect dead organism so 5 weeks required to perform test of cure

25
Q

What organism causes syphilis and what are their characteristics?

A

treponema pallidum

  • does not stain with gram stain
  • cannot be grown in culture so diagnosis based on PCR and serology to detect for antibody
26
Q

What are the 4 stages of illness of syphilis?

A
  • primary lesion (chancre-painless ulcers):heals naturally
  • secondary stage: bacteria in blood, “snail track ulcer”, generalised rash and flue like symptoms
  • latent stage: asymptomatic, multiplication of spirochate in intima of blood vessels
  • late stage: CVS/neurovascular complications
27
Q

How is syphilis diagnosed?

A
  • dark ground microscopy to look for spirochaetes in exudate of primary and secondary lesion
  • swab lesions PCR
  • serology: specific and non specific antibody
28
Q

What is the difference between specific and non specific antibodies to syphilis?

A
  • non specific antibodies are to monitor how active the disease and response to treatment
  • specific antibodies to confirm diagnosis. The antibodies often remain for life
29
Q

What is the non specific serological test for syphilis called ?

A

VDRL (venereal diseases research lab)

  • monitor response to therapy
  • usually negative after successful treatment
  • can be false positive (pregnancy, malaria, SLE)
30
Q

What are the specific serological tests for syphilis called?

A
  • TPPA (T. pallidum particle agglutination assay)

- IgM & IgG ELISA : screening for syphilis

31
Q

How is syphilis tested/screened in Tayside?

A 
1. IgM & IgG ELISA on clotted blood specimen 
If positive,
2.IgM ELISA 
3.VDRL (non specific)
4.TPPA (specific)
32
Q

What is the treatment for syphilis?

A

long acting penicillin (IM)

33
Q

What are genital warts?

A

-commonest viral STI due to human papilloma virus (HPV)

34
Q

What are the characteristics of HPV?

A
  • non-enveloped icosohedral virus containing double stranded DNA
  • HPV 6&11 commonly cause genital warts
  • HPV 16 & 18 high risk of cervical cancer
35
Q

What is treatment for genital warts?

A
  • cryotherapy
  • podophyllotoxin cream/lotion
  • vaccinations available for girls for HPV 6,11,16 & 18
36
Q

What causes genital herpes and what are their characteristics?

A
  • Herpes Simplex virus 1 & 2
  • enveloped virus containing double stranded DNA
  • spread by genital/oropharyngeal /genital contact
37
Q

How does HSV infect hosts?

A
  • replicates in dermis/epidermis
  • invades nerve endings and autonomic nerves
  • inflammation of nerve endings–>PAIN with multiple small vesicles that can be deroofed
  • virus migrates to sacral root ganglion and may remain there for life (reactivation is possible)
38
Q

How is herpes diagnosed?

A

-Swab of deroofed blisters for PCR

39
Q

What is the treatment for genital herpes

A
  • Aciclovir

- pain relief

40
Q

What is Trichomonas Vaginalis?

A
  • single cell protozoa which infect human hosts only

- divides by binary fission

41
Q

How does trichomonas vaginalis usually present?

A
  • vaginal discharge and irritation

- may cause urethritis in males

42
Q

How is trichomonas vaginalis diagnosed and treated?

A
  • High vaginal swab for microscopy (PCR may be done too but not in Tayside)
  • metronidazole
43
Q

What is pubic lice? (phthirus pubis)

A
  • lice bite skin and feed on blood
  • female lice lay eggs on hair next to skin
  • treatment: malathion lotion

Reproduction & Sexual Health (10 decks)

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