Microbiology of the GU tract Flashcards
gonococci affecting the male urethra produce a strong __ response
neutrophilic
“dripping tap of pus”
gonococcus
“watery discharge”
chlamydia
what STI can be contracted from an inianimate source?
trichomonas vaginalis
vagina is an acid/alkali environment with a pH of _ to _
acid
4 to 4.5
predominate bacteria in the vagina?
lactobacillus
less predominate microorganisms in the vagina?
GABHS
candida
strep viridans
when can GABHS on a vaginal swab be a problem
pregnant women who are symptomatic
which is more resistant to treatment: candida albicans or non-albicans candida?
non-albicans
predisposing factors for candida infection?
recent ab therapy
high oestrogen levels
poorly controlled diabetes
immunocompromised patients
what can increase your oestrogen levels
pregnancy
contraceptives
presentation of candida infection?
intensely itchy white vaginal discharge
“spotty rash on penis that is itchy”
candida balanitis
is bacterial vaginosis an infection?
no, not sexually transmitted
what is discharge like in bacterial vaginosis?
creamy, white, fishy discharge
pathology in bacterial vaginosis?
normal flora is replaced with anaerobes
what is the most common anaerobe present in BV?
gardnerella vaginalis
what substance is used to test for BV and what does it shiw?
potassium hydroxide
amplifies the smell
what happens to lactobacilli in BV?
decrease in number and are replaced
pH paper result of BV?
will show up alkaline
“epithelial clue cells on gram stain”
BV
Tx of BV?
metronidazole ONLY if symptomatic for 7 days
causes of BV?
ASCENDING INFECTION endometritis salpingitis preterm delivery ruptured membranes
male sexual partners should be treated if a female has BV T or F
F, shows no benefit
name 3 bacteria responsible for STIs
chlamydia trachomatis
neisseria gonnorhoeae
treponema pallidum
mycoplasma genitalium
what bacteria causes syphilis?
treponema pallidum
mycoplasma genitalium causes what infection?
non-gonococcal urethritis
what bacteria cause urethritis
mycoplasma genitalium
chlamydia
gonorrhoea
what viruses can cause STIs?
HPV
HSV
hepatitis
HIV
what parasites can cause HIV
trichomonas vaginalis
phthirus pubic (crabs)
scabies
what serovars of chlamydia cause genetic infection
serovars D to K
why are gram stains not routinely done for chlamydia?
it cant be easily grown
chlamydia will infect the area it is exposed to T or F
T, eg if it was the vagina it will be in the vagina
Tx of chlamydia
doxycycline 100mg bd for 7 days
what infection is caused by chlamydia serovars A to C
trachoma
Ix of chlamydia
PCR test
combined nucleic acid amplification tests
how is a sample for chlamydia test collected in men?
first past urine sample
how is a sample for chlamydia test collected in women
vulval vaginal swab (self taken)
how long should you wait before a chlamydia retest
5 weeks
Ix of gonorrhoea
same as chlamydia:
PCR test
combined nucleic acid amplification tests
swab for culture
pathogenesis of gonorrhoea
endocytoses into host epithelial cells
gram -eve intracellular diplococcus on gram stain…
gonorrhoea (looks like 2 kidney beans facing each other)
what is discharge like in gonorrhoea?
purulent tap of discharge
where in the body can gonorrhoea grow?
urethra
rectum
throat
eyes
“pus cells” on gram stain
gonorrhoea
pharyngeal gonorrhoea is primarily asymptomatic T or F
T
who gets routine screening of rectal gonorrhoea?
MSM
Tx for gonorrhoea
ceftriaxone IM (secondary care only)
common cause of prostatitis in older men?
UTI
what sexually transmitted organisms can cause prostatitis in younger men?
chlamydia
gonorrhoea
Tx of prostatitis
ciprofloxacin
trimethoprim if high risk of c diff
syphilis does/does not stain with gram stain
does not
Ix for syphilis
- PCR
serological tests- IgM, IgG - non-treponemal tests
what are the secondary symptoms of syphilis?
snail track mouth ulcers
generalised rash
flu like symptoms
what is chancre in syphilis?
organism multiplies at inoculation site to form a chancre and gets into the bloodstream
late stage complications of syphilis
paralysis
cardiac complications
neurovascular disease
name the 3 specific serology tests for syphilis
enzyme immunoassay (EIA) haemagglutination assay (TPHA) particle agglutination assay (TPPA)
what antibodies are raised in syphilis?
IgG
IgM
a rapid plasma reagin test indicates…
indicates tissue inflammation/activity
Tx of syphilis
penicillin
topical treatment for genital herpes
lignocaine
location of dormant genital herpes?
sacral root ganglion
where can genital herpes also present and why?
thigh
buttock
low back
follows the sacral roots from the ganglion
Tx of genital herpes
aciclovir
Ix of genital herpes
PCR
Ix for trichomonas vaginalis
high vaginal swab for microscopy
Tx of trichomonas vaginalis
oral metronidozole
Tx of pubic lice
malathion lotion