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Microbiology Exam 7 > STD/STI > Flashcards

STD/STI Flashcards

1
Q

Dark Field

A

Treponema Pallidum

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2
Q

Non-culturable Organisms

A

Treponema Pallidum

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3
Q

Treponema Pallidum bacterial characteristics

A

GN, spirochete, motile, slow growing, sensitive to desiccation and temperature

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4
Q

Endarteritis

A

T. pallidum; inflammation causing proliferation of endothelial and fibroblast cells - > blocking lumen

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5
Q

Periarteritis

A

T. pallidum; inflammation causing proliferation of adventitial cells/pericytes & cuffing of vessel by monocytes, lymphocytes, & plasma cells

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6
Q

Treponema Pallidum Virulence Factors

A

No LPS (few OMPs), Lipoprotein (act spike endotoxin, immunomodulator), antigenic variation (Tpr)

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7
Q

Transmission of Treponema Pallidum

A

No fomites (unstable), rare during latency, direct contact, transplacentally, blood transfusions

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8
Q

Treponema Pallidum incubation period

A

~21d (3-90d)

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9
Q

IgM w/ Treponema Pallidum

A

Peaks in 2nd Syphilis, but rapidly declines and goes away

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10
Q

IgG w/ Treponema Pallidum

A

Peaks at the end of 2nd Syphilis, but never goes away

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11
Q

Immune response to Treponema Pallidum

A

Th1 during Primary Syphilis, agent drives conversion to Th2 during Secondary Syphilis

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12
Q

Treponema Pallidum Reservoir

A

Humans

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13
Q

Endarteritis and Periarteritis are results of

A

Inflammatory reaction to Treponema Pallidum

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14
Q

Primary Syphilis Manifestations

A

Chancre/Genital Ulcer: indurated, sharply demarcated, eroded center, serous discharge, painless, highly infectious + regional LAD 7-10d after chancre appearance

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15
Q

Primary Syphilis chancre is d/t

A

immune response to local replication

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16
Q

Primary Syphilis often occurs _______ on the male penis

A

in the sulcus

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17
Q

Regional LAD may appear when during Syphilis

A

7-10d after primary chancre appearance, & during Secondary Syphilis

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18
Q

Secondary Syphilis appears

A

6 weeks after exposure

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19
Q

Manifestations of Secondary Syphilis

A

VARY, but include: non-pruritic rash on palms/soles,mouth/anus & spreads, condylomata lata, alopecia, fever, HA, malaise, arthralgia, LAD

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20
Q

Primary Syphilis chancre lasts

A

2-6wks

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21
Q

Infectious periods during Syphilis

A

Primary Syphilis & all bouts of Secondary Syphilis; Early Latent Stage (w/in year 1)

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22
Q

Condylomata lata

A

occurs during Secondary Syphilis; highly infectious, raised, painless, central erosion & covered w/ a thin membrane – found on genital, oral, &/or rectal mucosa

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23
Q

Rash of Secondary Syphilis

A

b/l symmetrical, non-pruritic, infectious skin rash, starting on palms/soles/mouth/anus and spreads, fever, LAD

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24
Q

In utero Syphilis infection can occur

A

anytime during latent syphilis or active syphiis

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25
Q

Alopecia

A

Secondary Syphilis

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26
Q

Why is Syphilis a disease of 1/3

A

1/3 untreated secondary syphilis pts will spontaneously cure, 1/3 secondary syphilis pts remain infected, but asymptomatic, 1/3 will progress to tertiary syphilis

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27
Q

What additional Manifestations may be present during secondary syphilis

A

hepatitis, IC-glomerulonephritis, meningitis/encephalitis, arthritis, GI and eye problems

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28
Q

secondary syphilis resolves

A

w/ or w/o treatment

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29
Q

Latent Syphilis

A

Asymptomatic phase but w/ (+) serology

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30
Q

Early Syphilis

A

1st year after exposure, considered Infectious, Most secondary syphilis relapses occur in early phase of latent syphilis

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31
Q

Late Syphilis

A

Year 1-4, not considered infectious, low rate of relapse

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32
Q

Tertiary Syphilis

A

Slow, degenerative progressive inflammatory disease, refractory to Abx, ~10yrs after exposure

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33
Q

Tertiary Syphilis Manifestations

A

Cardiovascular/Aortitis, Neurosyphilis, Gumma

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34
Q

Syphilitic Aortitis

A

Endarteritis of vasa vasorum -> ischemia of aortic arch/ascending aorta -> aortic aneurysm, stenosis, regurgitation

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35
Q

Early Neurosyphilis

A

Asymptomatic (+ CSF), Meningitis, stroke w/ focal S/S

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36
Q

Late Neurosyphilis

A

General Paresis, Tabes Dorsalis, Argyll-Robertson Pupil

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37
Q

General Paresis

A

Dementing illness (personality, affect, reflexes, eyes, sensorum, intellect, speech)

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38
Q

Tabes Dorsalis

A

P.C. - loss of proprioception & sensation -> ataxia/wide-based gait
D.R. - loss of pain & temp sensation, areflexia

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39
Q

Argyll-Robertson Pupil

A

Constriction to accommodation, but not light

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40
Q

Gumma

A

chronic granulomas found in various tissues, benign unless affecting organ

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41
Q

Early Congenital Syphilis

A

most are born without clinical evidence of disease (but would be STORCH test positive) & develop Sx ~3-4mo old

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42
Q

Early Congenital Syphilis Sx typically begin

A

3-4mo of age

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43
Q

Early Congenital Syphilis Sx

A

persistent rhinitis -> maculopapular, desquamative rash, condylomata lata, diffuse rhinitis, lesions on any organ

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44
Q

Latency in Congenital Syphilis

A

occurs ~6-12mo of age and persists typically to 5-15y/o -> Late Syphilis

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45
Q

Late Syphilis/Stigmata Sx

A

Hutchinson’s Triad, frontal bossing, bulldog jaw, higoumenakia sign, saber shins, cluttons joints

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46
Q

Most common outcome w/ Congenital Syphilis

A

Stillbirth

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47
Q

Hutchinson’s Triad

A

saddle nose, skin rhagades (radial scars), corneal ulcers and opacities, Hutchinson’s teeth and mulberry molars

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48
Q

Microscopy for Treponema pallidum

A

Darkfield

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49
Q

Which Abs rise first in response to Treponema pallidum

A

Specific-Treponema Abs

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50
Q

What is the 1st diagnostic test that is (+) in syphilis?

A

Darkfield

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51
Q

What is the 1st serologic test that is (+) in syphilis?

A

Specific-Treponema Abs

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52
Q

Screening Test for Syphilis

A

Non-Specific Antibody Test

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53
Q

DFA-TP for Syphilis

A

Specific Fluorescent Ab test to T. pallidum

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54
Q

Non-Specific Treponema Antibody

A

anti-phospholipid Abs, used for screening tests, VDLR, RPR, monitor Tx

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55
Q

Diagnosis of Neurosyphilis

A

VDLR (non-specific)

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56
Q

Monitor Syphilis Tx

A

RPR (non-specific)

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57
Q

Confirmatory Tests for Syphilis

A

Specific-Treponema Abs, FTA-ABS, used to diagnose late syphilis or neurosyphilis

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58
Q

Treatment for Syphilis

A

Benzathine Penicillin G

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59
Q

Treatment for Syphilis in pregnant female

A

Benzathine Penicillin G; if HSN -> Azithromycin

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60
Q

Treatment for Syphilis in penicillin-hsn pt

A

Azithromycin, Doxycycline, Tetracycline

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61
Q

Syphilis resistance to Tx

A

rRNA mutation confers resistance to Azithromycin in strains spontaneously

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62
Q

Jarisch-Herxheimer Reaction

A

endotoxic shock-like response due to dying agents released into blood (fever, HA, myalgia, chills, tachycardia)

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63
Q

Tx for Jarisch-Herxheimer Reaction

A

NSAID, prednisone

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64
Q

Reportable diseases

A

Syphilis

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65
Q

Haemophilus Ducreyi bacterial characteristics

A

GNR pleomorphic, highly fastidious

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66
Q

Culture of Haemophilus Ducreyi on

A

Chocolate agar

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67
Q

Chancroid is found primarily in

A

3rd world countries, and under diagnosed in the US

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68
Q

Most commonly associated w/ HIV transmission

A

Chancroid

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69
Q

Chancroid or Syphilis has a immune response during the primary stage

A

Syphilis

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70
Q

Why is Chancroid so highly associated w/ HIV transmission?

A

CD4+ Tcells & Monocytes are attracted to primary site

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71
Q

Chancroid Incubation period

A

7 days

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72
Q

Primary Chancroid Manifestation

A

genital ulcer: 1 or more painful, pustule, erodes & ulcerates w/ ragged edges +/- Bubo

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73
Q

Bubo

A

painful inguinal LAD, U/L, reddened skin, may suppurate & rupture

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74
Q

Bubo occurs

A

7-10days after chancre or during

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75
Q

Microscopy of Chancroid

A

GNR in chains in or outside of PMNs “school of fish” appearance

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76
Q

Treatment of Chancroid

A

Azithromycin, Erythromycin, Ceftriaxone

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77
Q

Chancroid may be resistant to what Tx

A

TMP-SMX; plasmid-mediated

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78
Q

Chlamydia trachomatis bacterial charcteristics

A

GN, obligate intracellular, biphasic (elementary & reticular bodies), cytoplasmic inclusions

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79
Q

Which strains of Chlamydia trachomatis cause LGV?

A

L1, L2, L3

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80
Q

Chlamydia trachomatis L1, L2, L3 preferentially infect

A

Macrophages

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81
Q

Immune response to Chlamydia trachomatis L1, L2, L3

A

CMI: Th1 -> IFN-gamma -> activate macrophages

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82
Q

LGV Incubation period

A

3-30days

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83
Q

Primary LGV Manifestations

A

small, inconspicuous genital papule or herpetiform ulcer of short duration and few symptoms (may go unnoticed)

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84
Q

Secondary LGV incubation

A

2-6 weeks after exposure

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85
Q

Secondary LGV Manifestations

A

fever, extensive inguinal LAD (acute inflammation) w/ bubo formation, groove’s Sign

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86
Q

Groove’s Sign

A

Secondary LGV; bubo formation and may bisect the inguinal mass by Poupart’s ligament

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87
Q

Tertiary LGV

A

genital ulcers, fistulas, & rectal strictures; genital elephantiasis due to lymphatic obstruction

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88
Q

Diagnosis of LGV

A

detection of chlamydial antigens by EIA, PCR

89
Q

Treatment of LGV

A

Macrolides

90
Q

Klebsiella granulomatis bacterial characteristics

A

encapsulated GNR, fastidious

91
Q

Klebsiella granulomatis can only be cultured with

A

human monocytes/macrophages

92
Q

Klebsiella granulomatis: Granuloma Inguinale is found

A

in the tropics

93
Q

Granuloma Inguinale is characterized by

A

Chronic ulcerative, degenerative and mutilating disease of the urogenital tissue and draining lymphatics

94
Q

Stain for Klebsiella granulomatis

A

Giemsa or Wright

95
Q

Microscopy for Klebsiella granulomatis would show

A 
Donovan bodies: clusters of organism in the cytoplasm of monocytes and macrophages
Bipolar staining (safety pin)
96
Q

Treatment of Granuloma Inguinale

A

Ciprofloxacin, TMP-SMX, Macrolides, Doxycycline

97
Q

Donovan Bodies

A

Klebsiella granulomatis

98
Q

HSV-2 viral characteristics

A

dsDNA, enveloped, latent in sacral ganglia

99
Q

Transmission of HSV-2

A

Asymptomatic sexual contact, in utero or parturition, autoinoculation

100
Q

HSV-2 incubation period

101
Q

Immunocompetent pts w/ HSV-2 Manifestations

A

mostly asymptomatic, classic S/S: clear, fluid-filled vesicles on erythematous base (vesicle -> pustule -> ulcer -> crust); inguinal LAD; aseptic meningitis if disseminated

102
Q

Immunocompromised pts w/ HSV-2 Manifestations

A

perirectal herpetic lesions (AIDS), viremia -> hemorrhagic necrosis in affected organs

103
Q

Recurrent HSV-2 infection

A

prodrome (pain & tingling), milder lesions ~4d & healing in 10d

104
Q

Perinatal Herpes S/S appear

A

9-14d after birth (contracted during birth)

105
Q

Perinatal Herpes S/S

A

SEM, Disseminated, Encephalitis (fatal)

106
Q

Stain for HSV-2

A

Tzanck or Pap

107
Q

Microscopy of HSV-2

A

Syncytia formation + Intra-nuclear inclusions (Cowdry A)

108
Q

Serology test for HSV-2

A

EIA or NAAT

109
Q

Treatment for HSV-2

110
Q

Acyclovir MOA

A

activated by thymidine kinase, nucleoside analogue that gets incorporated into the growing viral genome, causing chain termination

111
Q

Acyclovir is not a cure for HSV but does

A

reduce duration of lesions, stops shedding, prevents Sx of recurrence

112
Q

N. gonorrhoeae bacterial charcteristics

A

GN diplococci, facultative intracellular, oxidase (+), antigenic pili, IgA protease

113
Q

N. gonorrhoeae transmission

A

while Sx or aSx, auto-inoculation, perinatally

114
Q

N. gonorrhoeae Tx

A

Ceftriaxone (2nd or 3rd Cephalosporin)

115
Q

C. trachomatis D-K causes

A

cervicitis, urethritis, PID

116
Q

C. trachomatis D-K infects

A

the columnar epithelial cells of the mucosal surface

117
Q

C. trachomatis D-K transmission

A

while Sx or aSx, auto-inoculation, perinatally

118
Q

C. trachomatis D-K Tx

A

Tetracycline, Azithromycin, Doxycycline

119
Q

Cervicitis Sx

A

“tender, friable cervix” mucopurulent exudate, vaginal discharge, erythema, edema, dyspareunia, dysuria

120
Q

Gonococcal Cervicitis may involve

A

Infection may involve the Skene’s and Bartholin’s glands

121
Q

Cervicitis is asymptomatic how often with each agent

A

60-85% for C. trachomatis & ~50% for N. gon

122
Q

PID may spread to cause

A

produce acute peritonitis and acute perihepatitis

123
Q

PID can lead to

A

Tubal factor infertility, ectopic pregnancy, chronic pelvic pain, Fitz-Hugh-Curtis Syndrome

124
Q

PID Sx

A

asymptomatic, or fever, lower and pain, dysmenorrhea, irregular menses, cervical motion tenderness, adnexal tenderness/mass

125
Q

Fitz-Hugh-Curtis Syndrome Sx

A

RUQ pain, jaundice, ascites, adhesions w/ perihepatitis

126
Q

PID Tx

A

2nd or 3rd generation Cephalosporin (Gonorrhea)
Tetracycline, Doxycycline (Chlamydia)
Metronidazole (Anaerobes)

127
Q

Urethritis asymptomatic by agent

A

C. trachomatis 50-60%; N. gonorrhoeae 5-10%

128
Q

Sx of Urethritis

A

Painful urethritis, mucopurulent discharge &/or dysuria (esp w/ gonorrhea), “bonjour spots” discharge on under garments in morning

129
Q

Incubation period for Urethritis

A

2-10d, longer for C. trachomatis

130
Q

Disseminated Gonococcal Infection (DGI)

A

rare, several days after genital infection

131
Q

Sx of Disseminated Gonococcal Infection (DGI)

A

fever, joint pain (septic arthritis), rash (variable – sparse pustular or hemorrhagic)

132
Q

Reactive Arthritis after cervicitis/urethritis

A

no systemic signs, sterile, aseptic conjunctivitis & urethritis, arthralgia

133
Q

Opthalmia neonatorum

A

hyperacute, mucopurulent conjunctivitis contracted by the neonate during birth d/t untreated gonococcal infection

134
Q

Inclusion conjunctivitis

A

conjunctivitis contracted by the neonate during birth d/t untreated Chlamydia infection

135
Q

Agar used for N. gonorrhoeae

A

Thayer-Martin

136
Q

Diagnosis of N. gonorrhoeae

A

Gram stain: GN diplococci in PMNs

137
Q

Diagnosis of Chlamydia trachomatis

A

DFA, NAAT, LCR

138
Q

Non-gonococcal Urethritis

A

50-90% is C. trachomatis

139
Q

Other agents of Cervicitis/Urethritis/PID

A

Ureaplasma, Mycoplasma, T. vaginalis

140
Q

N. gonorrhoeae is resistant to

A

beta-lactams, tetracycline, fluoroquinolones, Cefixime

141
Q

HPV characteristics

A

Small, non-enveloped, icosahedral dsDNA virus

142
Q

Strains causing Dysplasia/Cervical Carcinoma

A

HPV-16 & 18

143
Q

Strains causing Genital Warts

A

HPV-6 & 11

144
Q

HPV has a tropism for

A

squamous mucosal epithelium (stratum granulosum & corneum)

145
Q

HPV oncogenes MOA

A

E6, E7 bind & inactivate p53 & p105

146
Q

HPV microscopy

A

koilocytosis: cells w/ large perinuclear cytoplasmic vacuoles surrounded by dense cytoplasm

147
Q

Immune response to HPV

A

CMI, but it has limited access to the stratum granulosum and corneum

148
Q

incubation period for HPV

149
Q

Condyloma acuminatum

A

1 or more soft, fleshy cauliflower-like raised lesion of the squamous epithelium of the anogenital region

150
Q

Cervical papillomas

A

dysplasia -> cancer (16, 18, 31, 33)

151
Q

Diagnosis HPV dysplasia

A

Colposcopy - Actowhite test (acetic acid -> white patches)

152
Q

Treatment for HPV

A

Wart removal, interferon Tx, antiviral cream, imiquimod

153
Q

Imiquimod MOA

A

immune response modifier; binds TLR7 to promote Th1 CMI -> production of IFN, TNF, IL-6, IL-8 to induce an immune response at the infection site

154
Q

HPV quadrivalent vaccine

A

Gardasil: HPV-16, 18, 6, 11 (capsid particles)

155
Q

HPV bivalent vaccine

A

Cervavix: HPV-16, 18 (L1 proteins)

156
Q

Vaginal NF

A

anaerobes > aerobes

157
Q

Agents of Vaginal NF

A

Lactobacillus, Peptostreptococcus, Bacteroides, Staphylococcus, Streptococcus (GNR, GPR, GPC)

158
Q

Lactobacillus’s role in protection of the urogenital tract

A

fermentation of glucose to lactic acid (pH ~4) & H2O2 production -> Cl- to kill pathogens

159
Q

Normal cellular makeup of vagina

A

VEC:PMNs should be 1:1

160
Q

Conditions that predispose to vaginal infections

A

menses, oral BC, diabetes, feminine products

161
Q

Trichomonas vaginalis characteristics

A

Pear-shaped, flagellated, facultative anaerobic protozoan, w/ jerky motion

162
Q

Signs of vaginitis or vaginosis

A

increased PMNs, clue cells, KOH (+)

163
Q

Trichomonas vaginalis engulfs

A

bacteria, PMNs, RBCs

164
Q

Trichomonas vaginalis pathogenesis

A

causes desquamation of mucosal epithelium, but not invasive

165
Q

Trichomonas vaginalis Sx

A

profuse, watery or foamy leukorrheal discharge that is highly irritating to the vagina, labia, vulva, & perineum; desquamation + intense pruritis is common

166
Q

Trichomonas vaginalis incubation period

167
Q

Trichomonas vaginalis Diagnosis

A

wet mount w/ motile protozoans

168
Q

Labs for Trichomonas vaginalis

A

elevated vaginal pH, high PMNs, KOH (-)

169
Q

Treatment for Trichomonas vaginalis

A

Metronidazole, vinegar (acid douche)

170
Q

Only protozoan STD

A

Trichomonas vaginalis

171
Q

Candida characteristics

A

Yeast, invasive in all 3 forms (yeast, pseudohyphae, hyphae)

172
Q

Candida albicans is different from other candida bc

A

forms germ tubes at 37C

173
Q

Immune response to Candida

A

CMI + Neutrophils

174
Q

Sx of Candidiasis

A

Pseudomembranous patches on the vaginal mucosa, labia and perineum; Thick yellow-white cottage cheese-like discharge w/ inflammation of the vaginal mucosa, Intense pruritis

175
Q

Diagnosis of Candidiasis

A

Wet mount -> KOH -> methylene blue stain showing budding yeast, hyphae, pseudohyphae

176
Q

Treatment of Candidiasis

A

ketoconazole, nystatin, miconazole, gentian violet, boric acid capsule

177
Q

Labs for Candidiasis

A

normal pH, high PMNs, KOH (-)

178
Q

Refractory cases of Candidiasis

A

C. glabrata, Tx w/ Gentian violet

179
Q

Gardnerella vaginalis characteristics

A

anaerobic, nonmotile, small rod w/ Gram (+) cell wall architecture, but gram variable staining; NF

180
Q

Bacterial vaginosis Pathogenesis

A

Decreased lactobacillus -> increased pH & anaerobe growth

181
Q

Anaerobes produce which enzymes

A

Proteolytic carboxylic enzyme -> malodours amines

Succinate -> inhibit infiltration of PMNs

182
Q

Other agents causing Bacterial vaginosis

A

Mobiluncus: GP curved rod, motile, anaerobe, stains gram-variable
Atopobium vaginae: anaerobe

183
Q

Sx of Bacterial vaginosis

A

Malodorous discharge (gray, off-white, thin, discharge), fishy-odor most noticeable after intercourse or during menses; no erythema, edema, itching, burning, pain, or dysuria

184
Q

Diagnosis of Bacterial vaginosis

A

Wet mount: clue cells (>20% of VEC); KOH (+) fishy-smelling amines

185
Q

Labs for Bacterial vaginosis

A

high pH, normal PMNs, KOH (+)

186
Q

Treatment for Bacterial vaginosis

A

Metronidazole

187
Q

Agents of Menstrual TSS

A

S. aureus, CoNS, Group A b-hemolytic Strep, Mycoplasma

188
Q

Immune response to TSS

A

Neutralizing Ab

189
Q

Risk factors for TSS

A

colonization w/ S. aureus producing TSST-1, lack of neutralizing Ab

190
Q

Super absorbent tampons may favor TSS bc

A

Low Mg2+ (chelator), surfactants released, higher O2 tension,

191
Q

Sx of Menstrual TSS

A

w/in 2 days of period: Fever, hypotensive shock, intense mucosal hyperemia/erythema, diarrhea, vomiting, myalgias, rash (diffuse macular) followed by desquamation 1-2wks after onset of illness

192
Q

TSST-1 is acquired by

A

lysogenization

193
Q

Treatment of Menstrual TSS

A

Supportive, Macrolides

194
Q

TSS agents are often resistant d/t

A

penicillinases/beta-lactamases

195
Q

Prevention of Menstrual TSS

A

abx prophylaxis to prevent colonization

196
Q

Bacteriuria >10^5 CFU, w/o Sx, Tx

A

no Tx required, unless pregnant!!

197
Q

Pyuria

A

> 10WBCs/HPF (sedimented) or 50-100WBC/mL

198
Q

Agents of Acute Uncomplicated Cystitis in Females

A 
E. coli
S. saprophyticus
K. pneumoniae
Proteus mirabilis
Enterococcus spp
Mixed
199
Q

Agents of Acute Uncomplicated Pyelonephritis in Females

A

E. coli
Proteus mirabilis
K. pneumoniae
Mixed

200
Q

Agents of Complicated UTI

A 
E. coli
Enterococcus spp
Pseudomonas spp
S. epidermidis
Mixed
Proteus mirabilis
K. pneumoniae
Yeasts
S. saprophyticus
201
Q

Agents of Catheter-Associated UTI

A 
Yeast – Candida
E. coli
Mixed
Pseudomonas spp
K. pneumoniae
S. epidermidis
Enterococcus spp
202
Q

Tamm-Horsefall

A

Uromodulin; prevents attachment of uropathogens to the epithelium & prevents kidney stone formation

203
Q

Immune response to UTI

A

PMNs, Neutralizing Abs

204
Q

UTI in children < 2y/o Sx

A

failure to thrive, vomiting, irritability, suprapubic tenderness, fever

205
Q

UTI in Elderly Sx

A

dehydration, vertigo, fever, loss of appetite

206
Q

Acute Uncomplicated Cystitis Sx

A

Abrupt or insidious onset of micturition, urgency, dysuria (voiding small amts of turbid urine), hematuria, suprapubic pain/tenderness

207
Q

Labs of Acute Uncomplicated Cystitis

A

bacteriuria, pyuria, hematuria

208
Q

Acute Uncomplicated Pyelonephritis Sx

A

fever, chills, malaise, n/v, HA, dysuria, micturition, urgency, excruciating flank or low back pain

209
Q

Nephrolithiasis – Complicated UTI Sx

A

Flank pain, hematuria, ammonia-smelling urine (pH 7)

210
Q

Risk factors for UTI

A

females, BPH in males > 50, immune deficiency (IL-8R mutation, neutropenic, agammaglobulinemia), ABH non-secretors, catheters, diabetes

211
Q

Labs of Acute Uncomplicated Pyelonephritis

A

bacteriuria, pyuria, hematuria, paralytic ileus

212
Q

Agents that produce urease and cause Nephrolithiasis

A

Corynebacterium urealyticum, Proteus mirabilis, K. pneumoniae, S. saprophyticus

213
Q

Urease role in Nephrolithiasis

A

cleaves urea, increasing pH, causing precipitation of struvite stones (MgNH3 + CaCO3-apatite)

214
Q

Acute Prostatitis Sx

A

E.coli

Fever, chills, flank pain, dysuria, micturition, urgency

215
Q

White Cast cells

A

suggestive of pyelonephritis

216
Q

Diagnosis for UTI

A

Urine sample (bacteria, WBC, WBC, pH, NH3)
Culture: MacConkey or Blood agar
Urine Dipstick: Esterase, Nitrite

217
Q

Treatment for UTI

A

TMP-SMX, however may be resistance
Ampicillin if resistance to beta-lactams is low
Fluoroquinolones (Cipro)
Nitrofurantoin for pregnant females

218
Q

Diagnosis of Pyelonephritis

A

CT scan - hypodense regions; White cast cells

219
Q

Normal Urine

A

pH ~5, mildly urea, clear/yellow

Microbiology Exam 7 (2 decks)

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