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Microbiology IV > Other genitourinary tract infections > Flashcards

Other genitourinary tract infections Flashcards

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1
Q

What is the primary vaginal bacteria genus during childbearing years?

A

Lactobacillus

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2
Q

What is the gram stain for lactobacillus?

A

Gram positive

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3
Q

What is the oxygen requirement for lactobacillus?

A

Microaerophilic or anaerobic rods

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4
Q

What is the shape of lactobacillus?

A

Rods

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5
Q

Why doesn’t lactobacillus cause UTIs?

A

Cannot grow in presence of urine

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6
Q

How does lactobacillus create an intravaginal environment of pH 4-5?

A

Metabolizes glycogen to lactic acid

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7
Q

Which bacteria are found in women who develop pelvic infections following a hysterectomy?

A
  1. Bacteroides fragilis
  2. E. coli
  3. Enterococcus spp.
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8
Q

Overgrowth of what type of bacteria is seen in bacterial vaginosis?

A

Anaerobic

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9
Q

Reduction in what bacteria is seen in bacterial vaginosis?

A

Lactobacillus

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10
Q

What are the symptoms of BV?

A
  1. Discharge, odor, pain, itching, burning

2. Can by asymptomatic

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11
Q

What are the Amsel criteria for BV diagnosis?

A
  1. Discharge - white or gray
  2. Clue cells in microscopy
  3. Positive whiff test - fishy amines upon KOH prep
  4. pH > 4.5
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12
Q

What are complications of BV?

A
  1. HIV infection and transmission risk increase
  2. Post-op infection
  3. Preterm delivery, miscarriage, post-partum infection
  4. Susceptibility to other STIs
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13
Q

What is the treatment for BV?

A
  1. Oral metronidazole (anaerobes, parasites)

2. Clindamycin (gram+ cocci, anaerobes)

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14
Q

What is the discharge for vulvovaginal candidiasis?

A

Thick, odorless, white (cottage cheese)

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15
Q

What is the identification of candida species in VVC?

A

Yeast form producing buds, pseudohyphae, and phyphae (gram stain or KOH)

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16
Q

VVC is generally seen in what populations?

A
  1. Local or generalized immunosuppression, or favorable overgrowth conditions
  2. Oral contraceptives, pregnancy, diabetes, systemic corticosteroids, HIV infection, antibiotic use
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17
Q

What is the diagnosis for VVC?

A
  1. Microscopy with KOH - visualization of hyphae and budding yeast
  2. Cultures with Nickerson medium if candida is suspected but not demonstrated
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18
Q

What is the treatment for VVC?

A
  1. UNCOMPLICATED: 1-3 day regimen of topical azole

2. COMPLICATED: 7-14 day topical regimen or 2 doses of oral fluconazole 3 days apart

19
Q

What is the discharge for trichomoniasis?

A
  1. Symptomatic - yellow-green, frothy, foul smelling

2. Asymptomatic / mild - scant, watery discharge

20
Q

What are the symptoms of trichomoniasis?

A

Mild to severe vaginitis, itching, burning, dysuria

21
Q

Are men typically symptomatic or asymptomatic for trichomoniasis?

A

Asymptomatic

22
Q

What is the shape / appearance of trichomonas vaginalis?

A

Small pear-shaped protozoa with 4 anterior flagella and an undulating membrane for motility

23
Q

What is the oxygen requirement for trichomonas vaginalis?

A

Anaerobic

24
Q

In what form(s) does trichomonas vaginalis exist?

A

Only trophozoite

25
Q

What is the pathogenesis for trichomonas vaginalis?

A
  1. Contact with epithelium of GU tract then destruction of epithelial cells
  2. Neutrophil influx and petecchial hemorrhages
26
Q

What is the appearance of the cervix during a trichomonas vaginalis infection?

A

“Strawberry cervix”

27
Q

Which infection presents with a “strawberry cervix”?

A

Trichomonas vaginalis

28
Q

Does trichomonas vaginalis infection confer immunity?

A

No

29
Q

What is the diagnosis for trichomonas vaginalis?

A
  1. Detection of swimming T. vaginalis in exudate

2. Pap smear for asymptomatic individuals

30
Q

What is the treatment for trichomonas vaginalis?

A

Metronidazole for BOTH partners

31
Q

What is the cause of toxic shock syndrome?

A

S. aureus

32
Q

What is the gram staining for S. aureus?

A

Gram positive

33
Q

What is the catalase rating for S. aureus?

A

Positive

34
Q

What is the coagulase rating for S. aureus?

A

Positive

35
Q

What is the shape of S. aureus?

A

Cocci in clusters

36
Q

What is responsible for the systemic effects of toxic shock syndrome?

A

TSST-1

37
Q

What is the virulence of TSST-1 in toxic shock syndrome?

A
  1. Heat- and proteolysis-resistant exotoxin

2. Superantigen

38
Q

What is responsible for the hypotension and shock associated with toxic shock syndrome?

A

TNFa and TNFb release

39
Q

What is released by macrophages in response to TSST-1?

A

IL-1B and TNFa

40
Q

What is released by T cells in response to TSST-1?

A

IL-2, IFNy, TNFb

41
Q

What is responsible for the fever associated with toxic shock syndrome?

A

IL-1B

42
Q

What are the main /common symptoms associated with toxic shock sydrome?

A

Diarrhea, general ill-feeling, high fever / occasional chills, nausea, vomiting

43
Q

What are the major criteria for toxic shock syndrome diagnosis?

A

Hypotension, orthostatic syncope, systolic BP < 90mmHg, temperature > 38.8C, late skin desquamation on hands, and feet, very high creatine phosphokinase levels

44
Q

What is the treatment for toxic shock syndrome?

A
  1. B-lactamase-resistant penicillin or vancomycin

2. Supportive - fluids

Microbiology IV (6 decks)

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