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Endo/Repro: Week 6 > Skildum: Microbiology of the Penis and Vagina > Flashcards

Skildum: Microbiology of the Penis and Vagina Flashcards

1
Q

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

A

tampon use
sexual activity
damage

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2
Q

dominant microorganisms in the vagina

A

lactobacilli

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3
Q

gram positive rods

facultative anaerobes that produce LACTIC ACID and HYDROGEN PEROXIDE and BACTERIOCINS

A

Lactobacilli

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4
Q

lactic acid

A

decreases pH

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5
Q

hydrogen peroxide

A

hydroxyl radicals

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6
Q

bacteriocins

A

proteins that depolarize pathogenic bacteria

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7
Q

what does the vaingal microbial community depend on

A

estrogen

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8
Q

how is extracellular glucose produced in the vagina?

A 
ovaries>
17 b estradiol>
vaginal epithelial expansion>
vaginal epithelial glycogen production>
epithelial cell sloughing>
extracellular glycogen
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9
Q

MC lactobacilli

A

iners
gasseri
cripsatus
jensenii

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10
Q

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

A

Glucose is converted to pyrufvate and 2H

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

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11
Q

what is lactate a substrate for?

A

immune cells?

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12
Q

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

A

MCTs

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13
Q

what happens when cells take up lactate?

A

they increase extracellular pH

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14
Q

difference between L and D lactate

A

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

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15
Q

lactate racemase (LAR)

A

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

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16
Q

how do lactobacilli make hydrogen peroxide from pyruvate?

A

PO

or glucose oxidase

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17
Q

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

A

L. iners

does NOT produce hydrogen peroxide

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18
Q

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

A

No

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19
Q

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

A

bacteriocins

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20
Q

form a PORE in the target cell’s membrane>

depolarization and outflow of cytoplasmic contents

A

bacteriocins

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21
Q

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

A

20%

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22
Q

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

A 
higher pH 5.3-5.5
facultative or strict anaerobes
atopobium
cornyebacterium
anaerococcus
gardnerella
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23
Q

s. aureus is present in what percent of healthy women

A

5-10%

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24
Q

disruptions in vaginal microbiome lead to…

A

bacterial vaginosis
PID
TSS

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25
Q

Bacterial vaginosis

A

NOT caused by SINGLE pathogen

disruption of NORMAL vaginal microflora

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26
Q

bacteria most abundant in pts w/ BV

A

gardneralla

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27
Q

what happens to lactobacilli in BV

A

replaced w/ anaerobic microflora

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28
Q

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)

A

BV

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29
Q

an increased upward spread of a BV infection leads to…

A

decreased host defenses by mucolytic proteases

*also provides an innoculum

30
Q

Amsel criteria

nugent score

A

used to dx BV

amsel critera: by sxs
nugent score: microflora composition

31
Q

Tx for BV

A

oral/intravaginal METRONIDAZOLE

BORIC ACID for sx relief

32
Q

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

A

metronidazole

33
Q

WHAT IS requires to reduce metronidazole to its active form?

A

pyruvate: feredoxin oxidoreductase

* only in ANAEROBIC ORGANIMS

34
Q

infection/inflammation of the upper inflammatory tract

A

PID

(salpingitis
endometritis

35
Q

abdominal pain

discharge

A

PID

36
Q

bacteria coated epithelial and inflammatory cells observed on wet mount of discharge are indicative of…

CLUE CELLS!!

A

PID

37
Q

MCC of PID

A

G/C

38
Q

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

A

n. gonorrhea

39
Q

gram negative, obligate intracellular parasite

A

c. trachomatis

40
Q

often accompanies G/C

A

H. influenza

s. pyogenes

41
Q

emerging cause of PID

A

mycoplasma genitalium

42
Q

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

A

mycoplasma genitalium

43
Q

out pt tx for PID

A

Ceftriaxone (cefoxitin)
+ doxycycline

+/- metronidazole (only for anaerobes)

44
Q

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

A

doxycycline

45
Q

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

A

Ceftriaxone

46
Q

fever
diffuse rash
hypotn
organ dysfunction

A

TSS

47
Q

90% of TSS cases are associated w/

A

s. aureus

streptococcal TSS accounts for rest

48
Q 
gram positive cocci
grow in grape like clusters
catalase positive
non-motile
aerobic / facultative anaerobic
A

staphylococci

49
Q

what is unique about s. aureus

A

coagulase positive

*most others are negative

50
Q

what does coagulase do

A

coagulase>
prothrombin>
fibrin polymerization

51
Q

how do APCs display ag to T cell?

A

MHC II

*activation requires Ag specific binding of TCR

52
Q

Superantigens

A

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

53
Q

Exotoxin produced by s. aureus that leads to TSS

A

SaPI1>

TSST1 (superantigen)

54
Q

cytokines released from activated Th1

A

IL-2

IFNy

55
Q

cytokines released from activated mphage

A

IL-1

TNF

56
Q

encoded on SapI1 pathogencity island

A

TSST-1

57
Q

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

A

pathogenicity island

58
Q

how are SaPI1 pathogenicity islands spread

A

phage transduction

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

59
Q

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

A

NFkB

60
Q

relationship between s. aureus in blood and TSS

A

NOPE

61
Q

sampling locations on penis for microbiological studies

A

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

62
Q

dominates penis microbiome in healthy males

A

lactobacillus

63
Q

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

A

a DEPLETION in lactobacillus

64
Q

reduces HIV transmission

reduces BV in partners

A

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

65
Q

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

A

reduces inflammation

reduces number of CD4+/CCR5 mphages in urethra

66
Q

inflammation of the epididymis usually cuased by bacteria

A

epididymitis

67
Q

epididymitis in prepubertal boys

A

e. coli

68
Q

epididymitis in men < 35

A

G/C

69
Q

epididymitis in men >35

A

E. coli

Pseudomonas

70
Q

pain
swelling
fever
dysuria

A

epididymitis

71
Q

tx for epididymitis caused by e. coli

A

quinalone (levofloxacin)

72
Q

tx for epididymitis caused by G/C

A

doxy+ ceftriaxone

Endo/Repro: Week 6 (8 decks)

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