Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DERS (reproductive) > L37- Urogenital Infections I > Flashcards

L37- Urogenital Infections I Flashcards

1
Q

______ are the only colonized regions of the urogenital system

A

anterior urethra

vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list the protective components of the urogenital system

A
  • antimicrobial properties of Urine (urea, Igs)

- presence of normal microbiota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

lower UTI Sxs

A 
(cystitis)
frequency
urgency
burning
dysuria
suprapubic tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

upper UTI Sxs

A 
(cystitis + pyelonephritis)
fever, chills
n/v
hypotension
costovertebral angle tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

UTI risks:

  • (1) is main risk for recurrence of UTIs in women
  • (2) risks of pregnant women with untreated UTIs
A

1- >3 UTIs

2: inc risk of delivering baby with low birth weight / premature
- smooth muscle relaxation
- urethral dilation
- greater chance to progress to pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe normal flora of urethra

A
  • Lactobacilli
  • Strep. spp.
  • coagulase neg Staph. spp.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe normal flora of vagina

A

-highly diverse, influenced by hormones

Newborns: Lactobacilli –> vaginal flora becomes more diverse over time –> Lactobacilli becomes more prominent at puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lactobacilli:

  • (1) locations
  • (2) key microbial features
  • (rarely/often) cause of UTI
A

1- mouth, intestines, stomach, vagina, urethra

2- gram- rod, facultative/strict anaerobes, Lactic Acid producing

3- rare, grows poorly in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list the risk factors for UTI

A
  • F > M
  • h/o recurrent infections
  • recent sex –> abrasions
  • recent use of diaphragm with spermicide
  • urinary catheter
  • diabetics
  • h/o long-term antibiotic use
  • lifestyle/behavioral practices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

UTIs are most (as/des)-cending

A

ascending- travels from urethra –> bladder –> kidney

descending is way less common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

UTI clinical presentations

A

-sometimes asymptomatic

  • frequency, painful urination, dysuria
  • general malaise and pain
  • pressure, fullness, lower abdominal pain
  • cloudy, blood-tinged urine, strong odor

Fever in pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Asymptomatic bacteriuria:

  • (rare/common)
  • (2) has about 100% risk of development
  • (3) will inc the incidence
A

1- common

2- all Pts with catheters w/ open drainage for >48hrs

3- anatomic obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define recurrent UTIs- indicate main bacteria

A

3 or more UTIs in 12 mos

  • relapse, reinfection, or new infection
  • there are predisposing factos

20-25% women w/ acute uncomplicated cystitis have 2 or more infections per year

-mainly different types of E. coil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

compare uncomplicated vs complicated UTIs

A

Complicated:

  • pre-disposing factors (vs 0) like anatomic, functional, metabolic abnormalities
  • more aggressive evaluation and f/u
  • often polymicrobial

Uncomplicated:

  • no particular pre-disposing factors
  • 95% monomicrobial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

compare risk factors of uncomplicated and complicated UTIs

A

Uncomplicated: female, extremes of age

Complicated: catheters, immunosuppression, urinary tract anomalies, antibiotic exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

list the complications of long-term catheterizations

A
  • UTIs
  • obstruction –> bacterial glycocalyx / biofilm
  • infection stones (urea + other substances)
  • local infections: urethritis, periurethral abscess, epididymitis, prostatitis
17
Q

____ is the main cause of cystitis and pyelonephritis

A

E. coli- UPEC (uropathogenic E. coil), normally in GIT

-gram- rods in general

18
Q

list main virulence factors for E. coli

A

(gram- rod)

  • adhesins: pili, fimbriae
  • IgA protease
  • hemolysin –> CK release + inflammation
  • siderophore expression
  • other factors promoting colonization and movement
19
Q

UPEC = (1)

  • (2) and (3) are main virulence factors (include infection type)
  • (4) are additional virulence factors
A

1- uropathogenic E. coli

2- Type I pili –> cystitis
3- P pili –> pyelonephritis

4- α-hemolysin, siderophore, pathogenicity islands

20
Q

list the factors of host defense against UTIs

A
  • high urine flow (+ unidirectional) and cell exfoliation
  • innate and adaptive immune responses

w/in bladder:

  • antimicrobial properties
  • competition w/ Fe sequestering proteins
  • Tamm-Horsfall Protein
21
Q

describe function of Tamm-Horsfall protein

A

(anti-adherence factor)

binds type I fimbriated E. coli to prevent UPEC binding to urothelial receptors

22
Q

list some other non-E. coli / non-UPEC causal agents of UTIs

A
  • Staph. saprophyticus
  • Proteus mirabilis
  • Klebsiella spp.
  • Mycoplasma, Ureaplasma
  • Candida
23
Q

(1) causes ‘honeymoon cystitis, where it mostly affects (2) people.

A

1- staph. saprophyticus

2- young, sexually active women; high incidences in the summer

24
Q

list the key factors of Staph. saprophyticus that contribute to uropathogenicity

A
  • urease
  • novel cell wall anchored adhesin
  • redundant uro-adaptive transport system
25
Q

list the key virulence factors of Proteus Mirabilis

A
  • proteases
  • hemolysins
  • biofilm formation
  • urease production
26
Q

describe the key symptomatic feature of Proteus mirabilis UTI

A
  • ammonia smelling urine
  • toxic to kidneys
  • alkaline urine may lead to urine struvite crystals
27
Q

describe diagnostic process for UTIs

A

1) clean catch urine –> looking for RBCs, WBCs, bacteria –> culture / sensitivity testing

20% UTIs have no pyuria –> neg. culture f/u:
2) leukocyte esterase test, Nitrites (via bacterial conversion of nitrates)

28
Q

explain the tests in a Urinalysis related to UTI

A
  • epithelial cells (<5): indicates good sample
  • WBC (<5): pyuria if >10
  • RBC (<5): hematuria
  • leukocyte esterase (absent): positve = pyuria or WBC present
  • Nitrites (absent): positive = bacteria present due to nitrate reduction
  • pH (4.5-8): more alkaline indicated urease producing bacteria
29
Q

(1) is the most serious form of prostatitis with (2) as the common cause via (3) mechanism

A

1- acute bacterial prostatitis (least common though)

2- E. coli

3- reflux of urine from urethra into prostate ducts

30
Q

Epididymitis:

  • (1) route of bacterial inoculation to tissue
  • causal pathogens vary based on (2)
  • (3) predisposing factors
A

1- enter from prostate via ejaculatory duct

2- age (young v old)

3- prostatitis, indwelling catheters, urological surgery

31
Q

E. Coli:

  • gram(+/-) (coccus/rod)
  • urease(+/-)
  • nitrite(+/-)
A

1- gram- rod
2- urease-
3- nitrite+

32
Q

Klebsiella pneumoniae:

  • gram(+/-) (coccus/rod)
  • urease(+/-)
  • nitrite(+/-)
A

1- gram- rod
2- urease+
3- nitrite+

33
Q

Staph. saprophyticus:

  • gram(+/-) (coccus/rod)
  • urease(+/-)
  • nitrite(+/-)
A

1- gram+ coccus
2- urease+
3- nitrite-
(novobiocin resistance)

34
Q

Vaginitis:

  • (1) types and distributions
  • (2) Sxs
A

1-
bacterial vaginosis (BV), 40-45%
vulvovaginal candidiasis (VVC), 20-25%
trichomoniasis, 15-20% (STI)

2- discharge, vulvar itching, irritation, odor

35
Q

Bacterial Vaginosis:

  • results from (1)
  • mostly presents as (2), but can present as (3)
  • most common in (4) group
  • may lead to increase risk of (5)
A

1- disruption of vaginal flora –> replaced by certain overgrowth

2- asymptomatic
3- malodorous discharge (thin, white or gray), pain, itching, burning vagina

4- reproductive women

5- inc in HIV transmission

36
Q

Bacterial Vaginosis Dx (mainly)

A
  • examine discharge (to differentiate from candidiasis or trichomonas)
  • ‘clue cells’ are most indicative
  • fewer than normal lactobacilli (especially in polymicrobial BV)
  • vaginal pH > 4.5 is suggestive of BV
37
Q

describe Amsel Criteria

A

(for bacterial vaginoisis, must have at least 3 of 4 findings):
-vaginal pH: >4.5

  • > 20% per HPF clue cells on wet mount
  • positive amine (or ‘whiff’ test)
  • homogenous, non-viscous, milk-white discharge adherent to vaginal walls
38
Q

define clue cells

A

(indicative of bacterial vaginosis)

epithelial cells covered with small Gram- rods

39
Q

What are the alternate or ‘other’ diagnostic tools for Bacterial vaginosis

A

Vaginal Gram stain (Nugent criteria)- normally abundant Gram+ lactobacilli –> mixed flora indicates BV

DNA Probe

New Ones:

  • PIP, proline aminopeptidase
  • sialidase tests

DERS (reproductive) (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions