Skildum: Microbiology of the Penis and Vagina

Question 1

what can cause oxygen concentrations to increase in the normally AEROBIC vagina

Answer 1

tampon use
sexual activity
damage

Question 2

dominant microorganisms in the vagina

Answer 2

lactobacilli

Question 3

gram positive rods

facultative anaerobes that produce LACTIC ACID and HYDROGEN PEROXIDE and BACTERIOCINS

Answer 3

Lactobacilli

Question 4

lactic acid

Answer 4

decreases pH

Question 5

hydrogen peroxide

Answer 5

hydroxyl radicals

Question 6

bacteriocins

Answer 6

proteins that depolarize pathogenic bacteria

Question 7

what does the vaingal microbial community depend on

Answer 7

estrogen

Question 8

how is extracellular glucose produced in the vagina?

Answer 8

ovaries>
17 b estradiol>
vaginal epithelial expansion>
vaginal epithelial glycogen production>
epithelial cell sloughing>
extracellular glycogen

Question 9

MC lactobacilli

Answer 9

iners
gasseri
cripsatus
jensenii

Question 10

how is extracellular glucose used by L iners to decrease vaginal pH?

Answer 10

Glucose is converted to pyrufvate and 2H

2 H are responsible for decreasing vaginal pH to 3.5-4.5

Question 11

what is lactate a substrate for?

Answer 11

immune cells?

Question 12

act as symporters and transport one proton w/ each molecule of lactate

Answer 12

MCTs

Question 13

what happens when cells take up lactate?

Answer 13

they increase extracellular pH

Question 14

difference between L and D lactate

Answer 14

Lactobacillus can make both types

L can be taken up by HOST (immune) cell through MCTs and used to generate ATP

D is NOT transported into host cells

*require 2 different lactate dehydrogenases to syntehsize

Question 15

lactate racemase (LAR)

Answer 15

enzyme expressed by lactobacillus that is used to interconvert L and D lactate

Question 16

how do lactobacilli make hydrogen peroxide from pyruvate?

Answer 16

PO

or glucose oxidase

Question 17

what is the must abundant bacteria in healthy women and what does this say about hydrogen peroxide?

Answer 17

L. iners

does NOT produce hydrogen peroxide

Question 18

does hydrogen peroxide inhibit the growth of vaginal pathogens, like gardnerella vaginosis?

Answer 18

No

Question 19

proteins that are produced by bacteria and are lethal to other bacteria

Answer 19

bacteriocins

Question 20

form a PORE in the target cell’s membrane>

depolarization and outflow of cytoplasmic contents

Answer 20

bacteriocins

Question 21

what percent of health women do NOT have lactobacilli dominated microbial communities?

Answer 21

20%

Question 22

characteristics of vaginal flora in healthy women who do NOT have lactobacilli dominated microbial communities

Answer 22

higher pH 5.3-5.5
facultative or strict anaerobes
atopobium
cornyebacterium
anaerococcus
gardnerella

Question 23

s. aureus is present in what percent of healthy women

Answer 23

5-10%

Question 24

disruptions in vaginal microbiome lead to…

Answer 24

bacterial vaginosis
PID
TSS

Question 25

Bacterial vaginosis

Answer 25

NOT caused by SINGLE pathogen disruption of NORMAL vaginal microflora

Question 26

bacteria most abundant in pts w/ BV

Answer 26

gardneralla

Question 27

what happens to lactobacilli in BV

Answer 27

replaced w/ anaerobic microflora

Question 28

increased concentrations of the following are associated w/..... Gardnerella vaginalis (gram variable, facultative anaerobic bacilli) Mycoplasma hominis (tiny, lack a cell wall, require cholesterol in growth media) Mobiluncus sp. (gram negative, anaerobic, motile curved rod) Atopobium vaginae (gram positive, anaerobic, elliptical cocci or rod shaped)

Answer 28

BV

Question 29

an increased upward spread of a BV infection leads to...

Answer 29

decreased host defenses by mucolytic proteases *also provides an innoculum

Question 30

Amsel criteria | nugent score

Answer 30

used to dx BV amsel critera: by sxs nugent score: microflora composition

Question 31

Tx for BV

Answer 31

oral/intravaginal METRONIDAZOLE | BORIC ACID for sx relief

Question 32

interferes w/ bacterias fuel metabolism and generates reactive nitrogen damaging nucelic acids

Answer 32

metronidazole

Question 33

WHAT IS requires to reduce metronidazole to its active form?

Answer 33

pyruvate: feredoxin oxidoreductase | * only in ANAEROBIC ORGANIMS

Question 34

infection/inflammation of the upper inflammatory tract

Answer 34

PID (salpingitis endometritis

Question 35

abdominal pain | discharge

Answer 35

PID

Question 36

bacteria coated epithelial and inflammatory cells observed on wet mount of discharge are indicative of... CLUE CELLS!!

Answer 36

PID

Question 37

MCC of PID

Answer 37

G/C

Question 38

gram negative diplococci, non-motile, not acid fast, oxidase positive

Answer 38

n. gonorrhea

Question 39

gram negative, obligate intracellular parasite

Answer 39

c. trachomatis

Question 40

often accompanies G/C

Answer 40

H. influenza | s. pyogenes

Question 41

emerging cause of PID

Answer 41

mycoplasma genitalium

Question 42

tiny, lack a cell wall, require cholesterol in growth media

Answer 42

mycoplasma genitalium

Question 43

out pt tx for PID

Answer 43

Ceftriaxone (cefoxitin) + doxycycline +/- metronidazole (only for anaerobes)

Question 44

Binds to bacteria’s 30S ribosome and prevents tRNA binding, preventing protein synthesis.

Answer 44

doxycycline

Question 45

that binds penicillin binding proteins and inhibits bacterial cell wall synthesis, resulting in osmotic imbalance and death of dividing cells. It is effective against bacteria that produce b-lactamase

Answer 45

Ceftriaxone

Question 46

fever diffuse rash hypotn organ dysfunction

Answer 46

TSS

Question 47

90% of TSS cases are associated w/

Answer 47

s. aureus streptococcal TSS accounts for rest

Question 48

``` gram positive cocci grow in grape like clusters catalase positive non-motile aerobic / facultative anaerobic ```

Answer 48

staphylococci

Question 49

what is unique about s. aureus

Answer 49

coagulase positive *most others are negative

Question 50

what does coagulase do

Answer 50

coagulase> prothrombin> fibrin polymerization

Question 51

how do APCs display ag to T cell?

Answer 51

MHC II *activation requires Ag specific binding of TCR

Question 52

Superantigens

Answer 52

bind BOTH TCR and MHCII creating an immunological synapse w/out a specific antigen> activation of T cells regardless of specificity of their TCR

Question 53

Exotoxin produced by s. aureus that leads to TSS

Answer 53

SaPI1> | TSST1 (superantigen)

Question 54

cytokines released from activated Th1

Answer 54

IL-2 | IFNy

Question 55

cytokines released from activated mphage

Answer 55

IL-1 | TNF

Question 56

encoded on SapI1 pathogencity island

Answer 56

TSST-1

Question 57

regions that contain NON-essential genes (bacteria can live w/out them) that encode TOXINS or PROTEINS that enhance the VIRULENCE of bacteria

Answer 57

pathogenicity island

Question 58

how are SaPI1 pathogenicity islands spread

Answer 58

phage transduction **a community of s. aureus in BENIGN equilibirum can quickly become PATHOGENIC if PI spreads

Question 59

plays a central role in the genration and propagation of the inflammatory response

Answer 59

NFkB

Question 60

relationship between s. aureus in blood and TSS

Answer 60

NOPE

Question 61

sampling locations on penis for microbiological studies

Answer 61

the urethra (interior), coronal sulcus (exterior or interior), urine, prostatic secretions.

Question 62

dominates penis microbiome in healthy males

Answer 62

lactobacillus

Question 63

infection w/ an STI in a man is associated w/....

Answer 63

a DEPLETION in lactobacillus

Question 64

reduces HIV transmission | reduces BV in partners

Answer 64

circumcision--> increases protection from pathogens by altering microbial community towards AEROBIC bacteria

Question 65

why can an increased number of aerobic bacteria associated w/ circumcision be beneficial?

Answer 65

reduces inflammation | reduces number of CD4+/CCR5 mphages in urethra

Question 66

inflammation of the epididymis usually cuased by bacteria

Answer 66

epididymitis

Question 67

epididymitis in prepubertal boys

Answer 67

e. coli

Question 68

epididymitis in men < 35

Answer 68

G/C

Question 69

epididymitis in men >35

Answer 69

E. coli | Pseudomonas

Question 70

pain swelling fever dysuria

Answer 70

epididymitis

Question 71

tx for epididymitis caused by e. coli

Answer 71

quinalone (levofloxacin)

Question 72

tx for epididymitis caused by G/C

Answer 72

doxy+ ceftriaxone