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Microbiology Flashcards

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1
Q

What is the normal pH of the vagina?

A

acidic - 4.5

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2
Q

What organism predominates in the vagina and is protective?

A

lactobacillis - gram +ve bacilli

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3
Q

What do lactobacillis produce?

A

lactic acid and hydrogen peroxide

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4
Q

What exist in small numbers in the vagina?

A

candida
group B haemolytic strep
strep viridens

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5
Q

What organism commonly causes candida infection?

A

Candida albicans

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6
Q

What predisposes to a candida infection?

A

recent antibiotic therapy
high oestrogen levels
poorly controlled diet
immunocomprimised patients

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7
Q

How does candida present?

A

“cottage cheese”

intensely itchy white vaginal discharge

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8
Q

What swab is done for candida?

A

high vaginal for culture

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9
Q

What is the treatment of candida?

A

AZOLE
topical clotrimazole pessentery or cream
oral fluconazole

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10
Q

What is candida balantis?

A

spotty rash on the tip of a males penis

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11
Q

Is candida balantis sexually transmitted?

A

NO

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12
Q

What organism causes gonorrhoea?

A

nisseria gonnorhea

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13
Q

What does nisseria gonnorhea look like on microscopy?

A

gram negative intracellular diplococcus

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14
Q

What is the action of nisseria gonnorhea?

A

attaches to host epithelial cells and is endocytosed into the cell to then replicate within the host cell and be released into the subepithelial space

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15
Q

How is gonnorhoea diagnosed?

A

1st line - NAATS

2nd line - swab of pus + culture

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16
Q

How does gonnorhea present?

A

purulent discharge
can infect the urethra, rectum, throat, and eyes
endocervix in females

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17
Q

Is gonnorhea always symptomatic?

A

NO - 50% of women with it have no symptoms

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18
Q

What happens to a baby if the pregnant mother has gonnorhea?

A

sticky eyes

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19
Q

What is the benefit of doing NAATs over culture?

A

the organism dies quickly so better to look for DNA remnants

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20
Q

How is gonnorhea treated?

A

IM Ceftriaxone 1G

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21
Q

What are possible gonorrhea complications for males?

A

tysonitis
rectal and periurethral abscesses
epididymis
prostatitis

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22
Q

What are possible gonorrhea complications for females?

A 
bartholinitis
rectal and periurethral abscesses 
PID
endometritis
ectopic pregnancy
hydrosalphinix 
infertility
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23
Q

What is the most common bacterial STI?

A

chlamidya

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24
Q

What serovar corresponds to the genital infection?

A

D-K

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25
What does serovars A-C correspond to?
trachoma - eye infection | NOT AN STI
26
What does serovars L1-L3 correspond to?
lymphogranuloma venerum (LGV)
27
What is LGV?
occurs in those who are from tropical places and MSM | histologically identical to crohns disease
28
How does LGV present?
rectal pain discharge bleeding
29
What organism causes chlamidya?
chlamidya trachomatis
30
How is chlamidya tachomatis seen on histology?
intracellular bacteria surrounding inflammatory cells no peptidoglycan so doesnt stain on gram staining - gram negative
31
What type of female swab is done for both chlamidya and gonorrhea?
vulvo-vaginal swab - can be self taken
32
What is done to diagnose chlamidya?
NAATS - 1st line done after 14 days | PCR
33
What male swab is done for chlamidya?
first pass urine
34
What is the treatment for chlamidya?
Doxycycline 100mg for 7 days
35
How does chlamidya present for women?
post coital or intermenstrual bleeding pain during sex - dyspareunia lower abdo pain micropurulent cervicitis
36
How does chlamidya present for men?
urethral discharge dysuria urethritis epididymio-orchitis
37
What disease do 9% of women with chlamidya develop?
pelvic inflammatory disease (PID)
38
What does PID increase?
risk of ectopic pregnancy x10 | infertility 15-20%
39
Apart from PID, what are other chlamidya complications?
reactive arthritis | Fitz-hugh-curtis syndrome (perihepatitis - piano string adhesions)
40
What pathogen causes bacterial vaginosis?
trichomonas vaginalis - single celled protozoal parasite
41
What causes bacterial vaginosis?
acidic environment becomes more alkaline and anaerobes take over
42
How is bacterial vaginosis transmitted?
sexual contact | but can be just by using same towels etc
43
How does bacterial vaginosis present?
vaginal discharge and irritation in females
44
What are the complications of bacterial vaginosis?
increased rate of upper GU infections - endometritis and salpingitis can cause premature rupture of membranes and preterm delivery increased risk of HIV
45
How is bacterial vaginosis diagnosed?
high vaginal swab for microscopy
46
How is bacterial vaginosis treated?
oral metronidazole for 7 days
47
Should you offer treatment to the male sexual partners of those with bacterial vaginosis?
no - no benefit
48
What is the pathogen causing syphilis?
treponema pallidum
49
How is treponema pallidum seen on microscopy?
spirochaete
50
What is the primary lesion seen in syphilis?
chancre
51
Will the chancre heal without treatment?
YES
52
What is the incubation period for the chancre?
9-90 days
53
What is the pathogenesis of treponema pallidum?
organism multiples at innoculation site and gets into blood stream then it multiplies in the blood and there are manifestations at different sites
54
What is the secondary stage of syphilis?
large number of bacteria circulating in the blood stream
55
What is the incubation period for the second stage of syphilis?
6 weeks - 6 months
56
What is the latent stage of syphilis?
no symptoms | low level of multiplication of spirochete in intima of small blood vessels
57
What is the primary testing for syphilis?
dark ground microscopy | PCR
58
What is the secondary testing for syphilis?
serology - ELISA | VDRL and RPR
59
What serology is specific for syphilis?
ELISA
60
What serology is non specific for syphilis?
VDRL and RPR
61
What happens to serology after sucessful treatment?
becomes negative | decrease by 4 fold in 3-6 months
62
What is the treatment for syphilis?
penicillin - benzylpenicillin
63
What causes herpes?
HSV 1 and HSV 2
64
What most commonly causes herpes - HSV 1 or HSV 2?
HSV 2 - 4-5 attacks per year
65
How does HSV appear on microscopy?
enveloped virus containing double stranded DNA
66
How is herpes transmitted?
close contact with someone shedding the virus | genital/oropharyngeal
67
What is the pathogenesis of herpes?
virus replicates in the dermis and epidermis then gets into nerve endings of sensory and autonomic nerves inflammation of the nerve endings cause exquisitively painful small vesicles when are easily reroofed virus migrates to the sacral root ganglion and hides from the immune system there the virus can reactivate
68
How is herpes diagnosed?
swab deroofed blister then PCR
69
How is herpes treated?
aciclovir if caught early enough | saline bathing or topical lidocaine if verysore
70
How does herpes present?
``` blistering and ulceration of external genitalia pain external dysuria discharge local lymphadenopathy ```
71
What pathogen causes pubic lice?
pthirus pubis
72
How is pubic lice treated?
malathion lotion
73
What is the most common viral STI?
HPV
74
What HPV types are covered by the vaccine?
6 11 16 18
75
What are the low risk HPV types? What do they cause?
6 + 11 | anogenital warts
76
What are the high risk HPV types? What do they cause?
16 + 18 | neoplasia
77
What do HPV 1 and 2 cause?
palmar and plantar warts
78
What is the incubation period of HPV?
3 weeks - 9 months
79
What is the lifetime risk of aquiring an HPV infection?
80%
80
How does HPV present?
cauliflower lesions around areas of friction | can also get them perianally
81
How is HPV treated?
Podophyllotoxin - warticon (cytotoxic so not for extragenital warts) Imiquimod - 1st line for anogenital warts Cryrotherapy Electrocautery
82
When is the HPV vaccination given?
females aged 11-13 | MSM
83
What is mycoplasma genitalium?
emerging sexually transmitted pathogen associated with non gonococcal urethritis and PID diagnosed by NAAT tests 40% levels of macrolide

1. Reproduction (50 decks)

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