UTIs and STIs

Question 1

Is the urinary tract sterile?

Answer 1

Yes

Question 2

Symptoms of a UTI

Answer 2

Cystitis, can get parenchyma of the kidneys and lead to pyelonephritis

Question 3

How many people get a UTI each year?

Answer 3

150 million

Question 4

Women lifetime risk? Men lifetime risk?

Answer 4

Women - 50%, men - 0.5%

Question 5

Why do young boys get UTIs? Why do older men get UTIs?

Answer 5

young boys - problems with valves

older men - prosthetic hypotrophy

Question 6

What does the production of urease lead to?

Answer 6

Build up of renal calculi

Question 7

What is the main causative agent?

Answer 7

E.coli

Question 8

obtaining a sample

Answer 8

• Midstream urine sample
• Bag sample
• Suprapubic aspiration

Question 9

Diagnosing a UTI

Answer 9

• CLED - allows for growth of coliforms
• Gram stain - E.coli negative
• Dipstick - E.coli makes nitrites from nitrates - cheap and efficient
• flow cytometry - quantification - greater than 10^5

Question 10

Virulence factors in UTIs

Answer 10

pap pilli
Fimbriae
Cytotoxins
Haemolysin

Question 11

Syphillis

Answer 11

Caused by T.pallidum
4500 cases per year
3 stages:
-primary stage - chancres and can be treated with penicillin
-secondary stage - 6-8 weeks after infection leading to generalised malaise and a rash and condylomata (infectious)
-tertiary - 3-30 years and leads on gumma on the head and cardiovascular problems
-cant be cultured in the lab

Question 12

Gonorrhoea

Answer 12

• second most common STI in the UK
• obligate intracellular pathogen
• 20% women are asymptomatic, 90% of men are asymptomatic
• Characterised by; pus and burning sensation and non genital complication ie arthritis
• Symptoms of epidinitis and oratis occur 2-7 days after infection. Can lead to blockages of the fallopian tubes, PID and septic arthritis
• Plated on VPAT (vancopmycin, polymixin, amphotericin B and trimethoprim) and incubated for 48 hours at 5-10% Co2
• Can be passed onto baby as opthalmia neonatorum

Question 13

Chlamydia

Answer 13

• Chlamydia trachomatis - obligate intracellular pathogen
• D and K serovars most prevalent in the UK.
• 50% men and 80% women are asymptomatic.
• 10-40% of women who get it getting PID.
• Use a type III secretion system
• NAAT used to diagnose
• Tropical genital ulcerations have been seen in patients in developing countries by serovars L1, L2 AND L3 of C; this leads to lymph node infections in men

Question 14

Haemophilus ducreyi

Answer 14

Painful chancres

Question 15

Klebsiella igunale (donovanosis)

Answer 15

Localised loss of tissue function leads to erosion around the penis

Question 16

Giardnerella vaginalis and bacteroides

Answer 16

Bacterial vaginosis