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Obstetrics and Gynaecology > Microbiology of the GU Tract > Flashcards

Microbiology of the GU Tract Flashcards

1
Q

What is the most common flora found in the vagina?

A

Lactobacillius spp

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2
Q

What is the normal pH in the vagina and why?

A

4-1.5

- due to lactobacillius spp. producing lactic acid and hydrogen peroxide

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3
Q

What is the organism that causes thrush?

A

Candida Albicans

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4
Q

What are the 4 main causes which predispose you to candida?

A

recent abx treatment
increased oestrogen - pregnancy/contraceptives
poorly controlled diabetes
immunocompromised patients

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5
Q

How does candida infection present as?

A

intensely itchy

white discharge

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6
Q

How is candida typically diagnosed?

A

usually clinical
or
high vaginal swab for culture

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7
Q

What is the treatment for a candida infection?

A

topical clotrimazole pessary

oral fluconazole

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8
Q

What is the pathogenesis of a gonorrhoea infection?

A

gonococci cells attach onto host epithelial cells and is placed within the cell to replicate and released from within the sub-endothelial space.

  • thus, attracting neutrophilic leukocytes
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9
Q

What does gonorrhoea look like on gram stain?

A

gram negative dipploccus

- 2 kidney beans

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10
Q

What is the organism that causes chlamydia?

A

Chlamydia trochomatis

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11
Q

Where does Chlamydia trochomatis typically affect?

A

urethra
rectum
throat/eyes
endo-cervix

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12
Q

What is A-C Chlamydia trochomatis?

A

trachoma - affects the eye (NOT STI)

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13
Q

What is D-K Chlamydia trochomatis?

A

genital infection

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14
Q

Whta is L1-L3 Chlamydia trochomatis?

A

Lymphogranuloma venereum

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15
Q

How is Chlamydia trochomatis treated?

A

Doxycycline 100mg B.D for 7 days

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16
Q

How is Chlamydia trochomatis diagnosed in males?

A

first pass urine sample

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17
Q

How is Chlamydia trochomatis diagnosed in females?

A

high vaginal swabs

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18
Q

What organism causes bacterial vaginosis?

A

Trichomonal Vaginalis

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19
Q

What is Trichomonal Vaginalis?

A

single cell protozoal parasite

- divides by binary fusion + is anaerobic

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20
Q

How is Trichomonal Vaginalis transmitted?

A

sexual contact

21
Q

How does Trichomonal Vaginalis present?

A

vaginal discharge

irritation

22
Q

How is Trichomonal Vaginalis diagnosed?

A

high vaginal swabs for microscopy

23
Q

How is Trichomonal Vaginalis treated?

A

Oral Metronidazole

24
Q

What is seen on microscopy with Trichomonal Vaginalis?

A

discharge - homogeneous + bubbles

25
Q

What is a positive whiff test?

A

adding 10% potassium hydroxide = offensive amine fishy smell
- odour yields a positive test

26
Q

What is the pathogenesis of Trichomonal Vaginalis?

A

a wet mound reveals the absence of bacilli and their replacement with clumps of coccobacilli

27
Q

What can be seen on microscopy with Trichomonal Vaginalis?

A

loss of edges on bacilli = clue cells

28
Q

What is there an increased risk for with Trichomonal Vaginalis?

A

HIV

premature rupture of membranes/pre-term delivery

29
Q

What organism causes Syphillis?

A

Treponema Pallidum

30
Q

How is Treponema Pallidum cultured?

A

PCR

- does not stain with gram stain and cannot be grown in artificial culture media

31
Q

What is the first stage of Syphillis?

A

primary lesion

- chancre

32
Q

How does a chancre manifest?

A

organism multiplies at inoculation site and gets into blood stream

33
Q

How is a chancre treated?

A

heals without treatment

34
Q

What is the second stage of Syphillis?

A

snail-track mouth ulcers
generalised rash
flu-like symptoms

35
Q

How does the second stage of Syphillis manifest?

A

large numbers of bacteria circulating in blood stream causing multiple manifestations

36
Q

What is the latent stage of Syphillis?

A

no symptoms but–>

low level of spirochaete in intima of blood vessels

37
Q

How does late stage Syphillis present as?

A

CVS/Neuro complications many years later

38
Q

How is Syphillis diagnosed?

A
  1. Syphillis combined IgG and IgM test (ELISA)
  2. …if positive–>
    IgM ELISA
    TPPA Test
39
Q

How is Syphillis treated?

A

injectable long-acting Penicillin

- desensitisation may be necessary if allergic

40
Q

What organism causes genital herpes?

A

Herpes Simplex 1 + 2

41
Q

How can genital herpes be spread?

A

genital - genital

oropharyngeal - genital

42
Q

What is the pathogenesis of genital herpes?

A

1o infection may be asymptomatic
virus duplicates in demis/epidermis
gets into nerve endings of sensory/autonomic nerves
virus migrates to sacral root ganglion and hides from immune system

43
Q

How is genital herpes diagnosed?

A

swab (virus transport medium) of de-roofed blister for PCR

44
Q

How is genital herpes treated?

A

Aciclovir - helpful if early

analgesia

45
Q

What causes pubic lice?

A

Phthimus Pubis

46
Q

How is public lice transmitted?

A

acquired close genital contact

47
Q

How does pubic lice present as?

A

intensely itchy

48
Q

How is pubic lice treated?

A

Malathion lotion

Obstetrics and Gynaecology (7 decks)

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