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Microbio > UG Tract > Flashcards

UG Tract Flashcards

1
Q

Normal vaginal flora varies according to what changes at different ages?

A

Hormonal influences

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2
Q

What is the primary bacteria in the vaginal flora in the childbearing years?

A

Lactobacillus

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3
Q

What is the morphology and gram stain of lactobacillus? Aerobic?

A

Gram positive, microaerophilic rods

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4
Q

Does lactobacillus causes UTIs? Why/why not?

A

No, b/c they cannot grow in urine

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5
Q

What causes the low pH found in the vagina?

A

Lactic acid fermentation by lactobacilli

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6
Q

Why is lactobacillus the main organism in the vagina?

A

Lowers pH, killing off other bacteria

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7
Q

What happens to lactobacillus as women age?

A

Becomes less prominent

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8
Q

How much does menstruation change normal vaginal flora?

A

Transient changes

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9
Q

What happens with a hysterectomy in regard to the normal vaginal flora? (3 species increase)

A

Increase in bacteroides fragilis, E.coli, and enterococcus species

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10
Q

What is BV?

A

Dysbiosis of bacterial vaginal flora, with overgrowth of anerobic species

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11
Q

What happens to [Lactobacillus] in BV infections?

A

Lowers

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12
Q

What are the symptoms of BV?

A

Asymptomatic

Burning, itching, pain, odor

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13
Q

Is BV an STD?

A

No

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14
Q

What are the risk factors for BV?

A

Oral sex
Douching
Smoking
Sex during menses

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15
Q

How do you diagnose BV?

A

Clue cells in vaginal prep

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16
Q

What is the discharge associated with BV?

A

White-grey milky appearance

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17
Q

What is the whiff test?

A

Adding KOH and smelling Fishy odor d/t release of amines

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18
Q

What do clue cells look like?

A

Granular looking epithelial cells

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19
Q

Clue cells are diagnostic for what?

A

BV

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20
Q

A vaginal pH above 4.5 is indicative of what? Why?

A

BV d/t lack of lactobacillus

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21
Q

What is the Nugent score?

A

Numerical score based on quantifying the types of bacteria present

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22
Q

What are the components of an amsel criteria?

A
  1. Discharge
  2. Clue cells
  3. Whiff test
  4. pH test
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23
Q

A lower Nugent score is (normal/abnormal)?

A

Normal

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24
Q

What are the complications of BV?

A
  1. Increases the risk for HIV/other STDs
  2. Sepsis post surgery
  3. Miscarriage
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25
Q

What is the treatment for BV?

A

Oral metronidazole or clindamycin

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26
Q

What is vulvovaginal candidiasis caused by?

A

Yeast

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27
Q

What are the symptoms of vulvovaginal candidiasis?

A

Thick, odorless white vaginal discharge

Pruritus

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28
Q

What is the discharge associated with vulvovaginal candidiasis?

A

Cottage-cheese like appearance

29
Q

What is the criteria for complicated candidiasis?

A

more than 4 in one year

30
Q

What does candida look like under the microscope?

A

Oval, yeast like from

Pseudohyphae and aseptate hyphae

31
Q

What does a germ tube indicate?

A

Candida albicans

32
Q

What does the india ink stain indicate?

A

Cryptococcus neoformans

33
Q

What is the most common yeast found in candidiasis?

A

Candida albicans

34
Q

True or false: Candida albicans is normal host flora

A

True

35
Q

What usually predisposes someone to candidiasis?

A

Recent Abx use

36
Q

What else does Candida albicans cause? (4)

A

Diaper rash

Oral thrush

37
Q

What are the two infections that can occur with Candida albicans in immunocompromised patients?

A

Esophagitis and disseminated if immunocompromised

38
Q

What are the factors associated with increased susceptibiliy of candidiasis?

A
  1. Oral contraceptive use
  2. prego
  3. DM
  4. HIV
  5. Abx
39
Q

How do you diagnose candidiasis?

A

Microscope

40
Q

What is the treatment for Candidiasis?

A

1-3 days of topical azole

7-14 days of oral fluconazole if complicated

41
Q

What is trichomoniasis?

A

Gross parasite that does not produce cysts

42
Q

What are the symptoms of trichomoniasis? Discharge?

A

Yellow-green frothy, foul smelling

itching, dysuria

43
Q

Men are asymptomatic or symptomatic with trichomoniasis infections? Women?

A

Men primarily asymptomatic

Women more often display symptoms, but still usually not

44
Q

Is trichomoniasis motile?

A

Yes, has undulating membrane

45
Q

Is trichomoniasis aerobic?

A

Anaerobic

46
Q

Does trichomoniasis have a cyst form? What is the consequence of this?

A

No, only protozoa/trophozoite form

Can only spread via sexual contact

47
Q

What is the pathogenesis of trichomoniasis?

A

Petechial hemorrhages on the cervix

48
Q

Strawberry cervix is associated with what?

A

trichomoniasis

49
Q

How do you diagnose trichomoniasis?

A

Seeing swimming organisms on a wet mount of discharge

50
Q

Do you develop immunity to trichomoniasis?

A

No

51
Q

What is the treatment for trichomoniasis? Who else should be treated?

A

Metronidazole (BOTH partners)

52
Q

What is menstrual toxic shock syndrome? What is it caused by?

A

S. Aureus toxin production d/t tampons or wound

53
Q

What is the gram stain and morphology of S. Aureus?

A

Gram positive cocci

54
Q

Is staph catalase positive or negative? Coagulase?

A

Both positive

55
Q

Is S. Aureus intracellular or not?

A

Intracellular

56
Q

Does S. Auerues produce toxins? Is this relevant in toxic shock syndrome?

A

Yes, and yes

57
Q

What is the toxin that S. Aureus produces in menstrual toxic shock? What type of toxin is it?

A

TSST-1

Superantigen (attaches to MHC class II)

58
Q

What is the MOA of superantigens?

A

Binds to MHC class II, causing T cell acitvation and release of proinflammatory cytokines

59
Q

What are the cytokines released in toxic shock syndrome?

A

TNFbeta, TNF-alpha

IL-2

60
Q

What are the symptoms of toxic shock syndrome? (5)

A

n/v/d
Malaise
Fever

61
Q

What are the signs of TSS?

A

Hypotension
Conjunctival erythema
Sunburn rash
Myalgias

62
Q

How do you diagnose TSS?

A

Culture vaginal tract but NOT blood

63
Q

What is the treatment for TSS?

A

Remove tampon

Beta-lactamase resistant PCN or vanco

64
Q

What percent of pts fail to mount an antibody response to TSS? What is the consequence of this?

A

50%

High likelihood for recurrence, so should avoid tampon use

65
Q

What are the characteristic features of trichomonas vaginalis?

A

Undulating membrane

Flagella

66
Q

Can trichmonas vaginals survive on fomites?

A

No

67
Q

Which gram positive cocci grows in grapes? Which smells like grapes?

A

S. Aureus

Smell = pseudomonas

68
Q

What is erythroderma? Which disease that we discussed is associated with this?

A

Diffuse erythema, particularly on the soles and palms

Toxin shock syndrome by Staph Aureus toxin

Microbio (50 decks)

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