Urinary and Reproductive Systems Flashcards
What structures comprise the urinary system?
- Two kidneys
- Two ureters
- One urinary bladder
- One urethra
How is infection prevented?
- Valves prevent back flow to the kidneys
- Acidity of urine
- Mechanical flushing
What is excreted in the urine?
Primarily nitrogenous waste products and water. Organs of the urinary system regulate chemical composition and volume of blood, wastes are filtered out and excreted.
Why is the opening of the urinary system more susceptible to bacterial growth as compared to skin?
It is a mucous membrane and is moist.
What are the components of the female reproductive system?
- Two ovaries
- Two fallopian tubes
- Uterus, including cervix
- Vagina
- External genitals (vulva)
What are the components of the male reproductive system?
- Two testes
- System of ducts:
- Epididymis
- Ductus (vas) deferens
- Ejaculatory duct
- Urethra
- Accessory glands
- Penis
What are the predominant microbes of the vagina?
- Lactobacilli produce
- H2O2 to inhibit growth of other bacteria
- Lactic acid which maintains an acidic pH to inhibit growth of pathogens
- Streptococci, anaerobes, some gram-negatives
- Candida albicans yeast
Urethritis
Inflammation of the urethra
Cystitis
Inflammation of the urinary bladder
Ureteritis
Infection of the ureters
Pyelonephritis
Inflammation of one or both kidneys
Urinary tract infections caused by
Mostly due to Escherichia coli
Why are things like urethritis and cystitis more common in females?
- Length of the urethra is shorter
- Proximity of anus to the urethra
- Personal hygiene
Cystitis is usually cause by what microorganism?
Most commonly by E. coli, but also Staphylococcus saprophyticus
Dysuria
difficult or painful urination
Pyuria
condition of the urine containing white blood cells or pus
How is cystitis diagnosed?
Greater than 100 CFU (colony forming units) per ml of potential pathogens along with a positive LE (leukocyte esterase) test
How is cystitis treated?
Trimethoprim-sulfamethexazole
What is the most common cause of pyelonephritis?
75% E. coli
What are the symptoms of pyelonephritis?
Fever and back or flank pain.
Diagnosis of pyelonephritis…
> 10,000 CFU/ml and a positive LE test
Pyelonephritis is treated with?
Cephalosporin
What is the most dangerous part of pyelonephritis?
It can form scar tissue in the kidneys that can be life-threatening
What is the cause of leptospirosis?
Caused by Leptospira interrogans which is a gram-negative, obligate aerobe spirochaete
How is leptospirosis contracted in humans?
Transmitted by skin/mucosal contact from urine-contaminated water from domestic or wild animals.
What are the signs and symptoms of leptospirosis?
Headaches, muscular aches, fever.
- Kidney failure due to leptospirosis (Weil’s disease)
- Pulmonary hemorrhagic syndrome
How is leptospirosis diagnosed and treated?
Rapid serological test. Treated with doxycycline.
How many types of STI’s are there?
Over 30 types.
How do STI home test kits work?
If there is a line on the T or test indicator it is a positive.
What are the pros of STI home test kits?
- More cases are diagnosed
- Better access for patients
- Quicker treatment
Cons of home testing
- Cost
- Privacy
- Not all home test kits are equally accurate
What is the cause of gonorrhoeae?
Neisseria gonorrhoea which is a gram-negative diplococus.
How does N. gonorrhoea cause disease?
- Attaches to the epithelial mucosa by the fimbriae
- Invades the space between the columnar epithelial cells
- Causes inflammation
- Forms pus
What are some other types of gonorrhoea?
Pharyngeal or anal
What are the symptoms of gonorrhea?
Men: painful urination and discharge of pus; epididymitis
Women: fewer symptoms; pelvic inflammatory disease
What may happen if gonorrhoea remains untreated?
May disseminate and become systemic - Endocarditis - Meningitis - Arthritis Opthalmia neonatorum: infant blindness due to a gonorrhoeal infection of the eyes if untreated
Why is gonorrhoea so insidious and difficult to treat?
It prevents adaptive immunity because of antigenic variability. Gonococcus has certain proteins called Opa proteins that bind to T cell receptors preventing activation and immunological memory.
How is gonorrhoea diagnosed?
Gram stain, ELISA or monoclonal antibodies
How is gonorrhoea treated?
Cephalosporins are first line. Fluoroquinolones are not recommended because they will contribute to resistance
What is nongonococcal urethritis?
Nonspecific urethritis - any inflammation of the urethra not caused by N. gonorrhoea
What is NGU or NSU caused by?
- Chlaymydia trachomatis
- Mycoplasma hominis
- Ureaplasma urealyticum
What are symptoms of NGU or NSU?
Painful urination and watery discharge, PID (may be asymptomatic)
How is NGU diagnosed and treated?
Culture or PCR. Treated with doxycycline and azithromycin.
What is Pelvic Inflammatory Disease (PID)?
Extensive bacterial infection of the female pelvic organs
What is PID caused by?
Usually a polymicrobial infection by - N. gonorrhoea and C. trachomatis
What is the most serious form of PID?
Salpingitis: infection of the uterine tubes. Scarring can cause infertility or ectopic pregnancy.
How is PID treated?
Doxycycline and cefoxitin
What is the cause of syphilis?
Treponema pallidum
- Gram-negative spirochete
- Grows slowly in cell culture
How does syphilis cause disease?
Invades the mucosa or through breaks in the skin it enters the bloodstream.
Is syphilis purely sexually transmitted?
No, some strains can cause yaws (multiple ulcers) on the skin that are not sexually transmitted.
What is the primary stage of syphilis?
Chancre at the site of infection about 3 weeks after exposure. Painless but highly infectious. Disappear after 2 weeks.
Secondary stage of syphilis?
Skin and mucosal rashes, especially on the palms and soles due to an inflammatory response
What is the latent period of syphilis?
No symptoms
What is the tertiary stage of syphilis?
Appears years after latency due to cell-mediated immune reactions.
- Gummas
- Cardiovascular, weakened aorta
- Neurosyphilis: affects CNS, dementia
What is gummatous syphilis?
Gummas (soft, non-cancerous growths) on many organs
What are microscopic tests for syphilis?
Microscopic tests: DFA-TP Direct fluorescent antibody test with monoclonal antibodies
What are types of nontreponemal serological tests for syphilis?
- Slide agglutination VDRL (venereal disease research laboratory) test
- Rapid plasma reagin (RPR) test
What are treponemal-type serological tests for syphilis?
- Enzyme immunoassay EIA
- Fluorescent treponemal antibody absorption test (FTA-ABS)
How is syphilis treated?
Benzathine penicillin
What is LGV?
Lymphogranuloma venereum
What is LGV caused by?
Chlamydia trachomatis
What does LGV do?
Infects the lymphoid tissue
- Regional lymph nodes become enlarged and tender
- Discharge of pus and scarring
What is a chancroid?
it is a soft chancre caused by Haemophilus ducreyi, a gram-negative rod
Where are chancroids usually found?
Painful ulcers of the genitals and swollen lymph nodes in the groin. These are factors in the sexual transmission of HIV and are associated with drug use.
What are chancroids treated with?
Azithromycin and ceftriaxone
What is bacterial vaginosis caused by?
Gardnerella vaginalis, a pleomorphic gram-negative rod
Vaginitis
inflammation of the vagina due to infection
Vaginosis
no sign of inflammation
What are the signs or symptoms of vaginosis?
- pH above 4.5
- fishy odor
- copious frothy discharge
- sloughed off vaginal epithelial cells covered with a biofilm of gardnerella
How is bacterial vaginosis treated?
Metronidazole
What is genital herpes caused by?
Herpes simplex virus type 2 (HSV-2)
How many people have herpes?
1 in 4 people over age 30 are infected
What are the sign and symptoms of herpes?
Painful vesicles on the genitals, painful urination
Heals within 2 weeks
What causes recurrence from herpes virus that is latent in the nerve cells?
Menstruation, emotional stress and illness
How does neonatal herpes develop?
Herpes virus crosses the placental barrier and infects the fetus. This damages the CNS, causes developmental delays, blindness and hearing loss
What is the survival rate of infants exposed to herpes?
40%
What are genital warts caused by?
Also known as condyloma culminate. Caused by human papillomaviruses
Visible warts are caused by which serotypes?
6 and 11
Which serotypes cause cervical cancer?
16 and 18
How are genital warts treated?
Removal of warts; podofilox and imiquimod
How are genital warts prevented?
Gardasil and cervarix
Opportunistic growth candidiasis can be caused by?
- Antibiotic use
- Diabetes
- Hormones
What is trichomoniasis caused by?
Trichomonas vaginalis, normal inhabitant of the vagina and urethra that grows out of control when the normal acidity of the vagina is disturbed
What are the signs and symptoms of trichomoniasis?
Irritation and profuse foul, greenish-yellow frothy discharge
How is trich. diagnosed?
Whiff test or DNA probe
What is the Whiff test?
Some drops of potassium hydroxide solution are added to a sample vaginal discharge to see whether a strong fishy odour is produced. This would indicate that bacterial vaginosis is present
What are the TORCH panel of tests?
Panel of tests to screen for antibodies to infections in pregnant women.
Toxoplasmosis
Other (syphilis, hep B, enterovirus, Epstein-Barr virus, varicella-zoster virus_
Rubella
Cytomegalovirus
Herpes simplex virus
When is the fetus most sensitive to harm from infections?
The first 3-4 months of pregnancy.
