UTI & STIs Flashcards
Most common cause of uncomplicated UTI?
E. Coli
Urease producer of uncomplicated UTI?
P. mirabilis
Who is an uncomplicated UTI patient?
Healthy, non-pregnant adult female
Gram (-) cause of complicated UTI
P. aeruginosa
G (+) urease producer that can cause complicated UTI
S. Saprophyticus
Pathology of UTI
Ascending - usu. E. Coli from GI or iratrogenesis
Complicated UTI patient?
DM, pregnant, Hx pyelo, Sx > 7days before Tx, MDR, HAP, renal failure, HX UTI as a child
STI cause of a UTI
C. trachomatis/ N. gonorrhea
Tx UTI
Bactrim…then Cipro
Tx pyelonphritis
Cipro/Levo
Spirochete with slow rotational motility; produces AB’s to somatic proteins and cardiolipin of host mitochondrial membranes
T. pallidum
What org causes syphilis
T. pallidum
VF of T. pallidum
membrane protein = adhesion, fibronectin, hyaluronidase
Chancre with smooth base, raised border that is firm and indurated; painless
syphilis chancre
Which stage is the chancre in syphilis
primary (entry stage)
The stage of syphilis that is the highly infectious stage; Latent stage; maculopapular rash (can spread to palms)
secondary stage
Stage of syphilis where there are neuro sx, cardio sx, granuomata systemic
tertiary stage: usu 5-20 years later
Dx Syphilis
Chancre; Dark field micro for treponemes; Nontreponemal: cardiolipin flocculation test; Treponemal: specific AB tests
Hutchinson’s Triad
notched incisors, keratitis, 8th nerve deafness (congenital syphilis)
Syphilis lesions primarily due to
cytokines = inflammation
G(-) kidney-beaned shaped cells; fastidious growth
N. gonorrhoeae
VFs of N. gonorrhoeae
Pili, porin protein, IgA protease, & plasmid chromosome mediated drug resistance
PH: N. gonorrhoeae
entry & attachment to epithelia via pili & surface proteins. Injury to host cell via LPS, which allows for spread to other tissues
Clinical presentation of gonorrhea
Males: mucopurulent discharge in anterior urethra
Females: presence in endocervix with urethral colonization
Gold Standard for Gonorrhea Dx
Nucleic Acid Amp.
Migratory polyarthralgia; Arthritis-dermatitis syndrome is indicative of…
Disseminated gonoccoal infection (DGI)
Gonorrhea is most common in:
adolescents; rates are increasing in the US due to change in sex habits, detection, & beta-lacatamse resistance
Can gonorrhea be transmitted to neonates during birth?
Yes
Obligate intra-cellular, G (-) without peptidoglycan. Requires host ATP
Chlamydia
C. trachomatis
Inflammation in Chlamydia is due to
toxin-producing strains (Toxin B)
Toxins break down proteins in host cells allowing mucosal cells to separate
Clinical spectrum of Chlamydia
similar to gonorrhea: urethritis (thin-watery discharge), cervicitis (yellow-green discharge), salpingitis, epididymitis, PID
Causes post-partum fever and chorioamnionitis in pregnant women
Nongonoccal urethritis
Organism that causes NGU
Ureaplasma urealyticum
Main réservoir of ureaplasma urealyticum in NGU
GU tract of sexually active persons
Causes ~50% of nongonococcal, nonchlamydial urethritis in men
Ureaplasma urealyticum: NGU
Flagellated protozoan; exists as a trophozoite ONLY; extracellular anaerobe
T. vaginosis
How is T. vaginosis transmitted?
STD only
Frothy malodorus vagina a/w cellular atypism
T. vaginosis
Is Bacterial vaginosis an STD?
No
Opportunistic pathogen due to the overgrowth of T. vaginosis
Bacterial vaginosis
Criteria for Bacterial Vaginosis (any 3)
Clue cells Fishy amine odor Vaginal pH > 4.5 Curved (-) rods Homogenous secretion
Underlying causes of candida
absence of normal flora, intro to abnormal site, change in micoenviornment, immune defect, broad spectrum abx
Form pseudohyphae, germ tubes, hyphae
C. albicans: vulvovaginal candidiasis
Clinically presents as vulvar edema, erythema, cottage cheese appearance
Vulvovaginal candidiasis
Dx vulvovaginal candidiasis
vaginal swab: stain & culture
Germ tube test is strongly presumptive of
Vulvovaginal candidiasis
Predisposing factors of vulvovaginal candidiasis
Local- tight clothing, warm macerate skin, incorrect toilet habits, sensitization, physical damage, IUD, trauma w/ intercourse
What org causes chancroid?
H. ducreyi; Tropical countires
This chancre is a soft, tender ulcer with sharp margins. It is painful and bleeds. No induration
Chancroid ulcer
Dx of chancroid
History is critical.
Media needs growth supplements for growth.
PCR-based method
Which organisms cause PID
N. gonorrhoeae or C. trachomaits
PH of PID
Gonorrhea moves via retrograde menses to uterus/fallopian tubes & colonize during menses sloughing.
Spreading causes scars and inflammation
Dx of PID
inflammation = fever
leukocytosis
elevated ESR
Lower abdominal pain, abnormal vaginal discharge, painful intercourse, increased pain during menstruation, irregular menses, fever, chills, scarring.
What is this condition?
PID
