unit 14 Flashcards
Kidneys , ureters, bladders are…
sterile
Streptococcus , Bacteroides , Neisseria sp. are microbes found in where
urethra
Yeast, lactobacillus , Group B strep, are microbes found where
vagina
Why are women more likely to develop UTI’s?
shorter urethra than males (closer to fecal-oral matter)
Are most nosocomial infections uti’s
true
Bacterial infections of the urinary system
cystitis
pyelonephritis
Leptospirosis
Glomerulonephritis
Cystitis
-inflammation of the bladder
- symptoms = dysuria/pyuria
- E.coli , Proteus , Staph, pseudomonas
Treatment for cystitis
Nitrofurontoin/sulfur drugs
Pyelonephritis
- inflammation of the kidneys
- symptoms = dysuria , pyuria, fever, backpain
- can lead to permanent kidney damage
- generally results in bacteremia
Treatment for pyelonephritis
broad spectrum antibiotics
Leptospirosis
- Leptospira sp.
- diseases of humans/ dogs/rate urine
- immunnisze dogs
- mode of transmission = ingestion of urine/ contaminated water
Glomerulonephritis
- inflammation of the glomeruli
- type III immune complex disease
- sequelae infection from S. pyogenes
STD
- disease of the reproductive systems transmitted by sexual activity
STI
- term std has been replaced with sti
- disease has signs/symptoms while sti’s do have any apparent signs/symptoms
Bacterial diseases of reproductive system
gonorrhea
Nongonoccal urethritis (NGU)
Syphillis
Gardnerella vaginitis
Lymphogranuloma venereum
Chancroid
Gonorrhea (GC)
- Neisseria gonorrhoeae
- gram - cocci
-attached to mucosal wall of epithelial tissue - no symptoms in females/ painful urination, yellow pus discharge from urethra in males
-no immunity developed
complications of gonnorrhea in males
-blocked urethra
-testes infected resulting in sterility
complications of gonnorrhea in females
- scarring of fallopian tubes
-sterility
-ectopic pregnancy - systemic infections
Treatment for gonnorrhea
cephalosporins
Nongonnococcal urethritis (NGU)
- usually due to chlamydia trachomatis
- most common reportable STI in the US
- same complications as gc
-co infection with gonnorrhea
-transferred to newborn’s eyes
Diagnosis for NGU
NAAT- nucleic acid amplification tests
Treatment for NGU
doxycycline/ tetracycline
Syphillis (treponema pallidum)
- relies on host / spirochete not cultured in lab
- transmission = sexual contact/breaks through skin
- penetrates mucous membranes
-immunity developed unlike GC
Primary stage of syphillis
-infectious
-chancres (small painless, hard) can be non visible
- found on cervix, urethra or external genitalia
- spirochetes -> blood
Secondary stage of syphillis
- highly infectious sexually
- skin/mucous membrane rash due to inflammatory complexes that lodge at different body sites
- spirochetes in rash
-possible transferred non sexually via breaks in skin
Latent stage of syphilis
- no symptoms
- goes away with/without treatment
- majority cases do not progress beyond latency stage
Tertiary stage of syphilis
- non infectious
- starts many 10-20 years after acquired
- gummas in organs/ external skin
- damages heart, blood vessels, CNS
Congenital syphilis
- transmission = across placenta -> unborn fetus
- occurs when pregnancy happens during latent stage
-still births occur during 1st/2nd stage
diagnosis for stages of syphilis
- 1st = microscopic with darkfield scope / test chancre
-2nd and latent stage = serological testing
-3rd = test csf
Treatment for syphilis
penicilin / tetracycline
Gardnerella vaginitis
- bacterial vaginalis
- may/may not be sexually transmitted
- decreased # of lactobacillus
-vaginal pH increases - overgrowth of gardnerella
Gardnerella in males
may harbor in urethra with no symptoms
Gardnerella in females
- vaginitis = frothy/ gray discharge
-increase in vaginal pH (5) - clue cells
Treatment for Gardnerella
flaggyl
Lymphogranuloma Venereum (LGV)
- transmission = sti
-microbe is invasive/infects lymphoid tissue - chlamydia trachomatis sub species
- tropical/subtropical regions in world
- treatment = tetracycline and doxycycline
Chancroid (haemophilis ducreyi)
- soft chancre
- tropical regions
- difficult to diagnose
- lymph nodes may be infected
- treatment = cephalosporin
what is chancres
soft, painful
found on mucous membranes in mouth/ genetalia
Genital herpes (HSV-2)
-oral -genital contact
-no cure- antiviral drugs
- Herpes legions
-transmission = with lesions present , without lesions/symptoms present = semen
Genital herpes in women
vessicles on external genetalia
seldom within vagina/cervix
Neonatal herpes
- initial infection during pregnancy
- abortion/ fetal damage
- possible c section
Genital warts (HPV human papillomavirus
- most common sti worldwide
-HPV 6 / 11 =warts
-HPV 16/18 = cervical cancer - oral, anal, and penile cancer caused by HPV
Vaccine for genital warts
gardasil
- for men/women
Treatment for genital warts
- imquimod (aldara)
-stimulates body to produce interferon
-not a cure
Candidiasis ( fungal disease)
- vulvovagnitis
- yeast (candida albicans)
- diagnosis = microscopic exam of discharge
- males = asymptomatic
-females = lesions , vaginalis, thick white cheese like discharge
treament for candidasis
miconazole or nystatin
Trichomoniasis: trichomonas vaginalis (protozoan disease)
- co infection with gc
- cause protozoa to overgrow wjem vaginal pH increases
- usually sexually transmitted
- relatively benign
- normal flora of vagina / male urethra
- males = asymptomatic
-females = profuse yellow-green discharge with odor
diagnosis for trichomoniasis
microscopic exam of discharge / urine for males
Treatment for trichomoniasis
metronizole (flagyl) for both partners
Transmission for Hep A/E
oral/anal contact
transmission for hep B/C/D
exchange of blood
sexually transmitted
Lice: pediculosis
- transmission = close fomite contact clings to body hair
- cant hop or fly
- requires blood from host
-diagnosis = lice or nits
Treatment for pediculosis
-OTC treatment = rid or nix
- prescription = Kwell (lindane) - Topical / Ivermectin - oral
- comb out nits
Pediculus humanus capitis
head lice
Pediculus humanus corporis
body louse
Scabies/mites
- sarcoptes scabiei
-burrows under skin
-transmission = fomites / household contact / fomite contact
Diagnosis for scabies
burrows (visible) or microscopic exam of skin
Treatment for scabies
prescribed topical medications
HIV (human immunodeficent virus)
- enveloped RNA reverse transcriptase virus
- Gp 120 spikes: attaches to cd4 receptors
- T helper cells, macrophages , microglial cells
- DNA -> host chromosome and become provirus (remain latent)
AIDs
- evades immune defenses
-rapid antigenic changes
-high mutation rate - hard to develop vaccine against
-infected cells can fuse to unifected cells to avoid circulating Ab’s = cell- cell fusion
3 phases of AIDS
- all infectious
- phase 1 / phase 2 / phase 3
Phase 1 of AIDS
- cd4 t cell count are normal
- asymptomatic or lymphadenopathy (swollen lymph nodes)
- 800 -> 1000 cells/ul
Phase 2 of AIDS
-Cd4 t cells begin to decrease
- decline in immune response
- opportunistic infections = thrush , shingles, diarrhea
Phase 3 of AIDS
-Cd4 t cell count is below 200 cells/ul
- clinical aids
- completely diminished immune system (common cold will kill you)
- oppotunistic infection = PCP, CMV, TB , Toxoplasmosis , systemic yeast infections , Kaposi’s sarcoma
Modes of transmission for aids
-sexual transmission (anal receptive intercourse most dangerous)
- breast milk
- blood contaminated needles
-organ transplants
aid is not transmitted by
- non blood containing urine , feces, saliva , sweat
- donating blood
- hugging/kissing / normal daily contact
-insect bites
-fomites (no blood tho)
Diagnosis for aids
- HIV antibody tests
- rapid Ab tests
-Plasma viral load
-screening tests
-testing blood supply
Plasma viral load (PVL)
- used to monitor treatment/progression of aids
- measures viral rna
- expensive
