Microbiology of the GU tract

Question 1

gonococci affecting the male urethra produce a strong __ response

Answer 1

neutrophilic

Question 2

“dripping tap of pus”

Answer 2

gonococcus

Question 3

“watery discharge”

Answer 3

chlamydia

Question 4

what STI can be contracted from an inianimate source?

Answer 4

trichomonas vaginalis

Question 5

vagina is an acid/alkali environment with a pH of _ to _

Answer 5

acid

4 to 4.5

Question 6

predominate bacteria in the vagina?

Answer 6

lactobacillus

Question 7

less predominate microorganisms in the vagina?

Answer 7

GABHS
candida
strep viridans

Question 8

when can GABHS on a vaginal swab be a problem

Answer 8

pregnant women who are symptomatic

Question 9

which is more resistant to treatment: candida albicans or non-albicans candida?

Answer 9

non-albicans

Question 10

predisposing factors for candida infection?

Answer 10

recent ab therapy
high oestrogen levels
poorly controlled diabetes
immunocompromised patients

Question 11

what can increase your oestrogen levels

Answer 11

pregnancy

contraceptives

Question 12

presentation of candida infection?

Answer 12

intensely itchy white vaginal discharge

Question 13

“spotty rash on penis that is itchy”

Answer 13

candida balanitis

Question 14

is bacterial vaginosis an infection?

Answer 14

no, not sexually transmitted

Question 15

what is discharge like in bacterial vaginosis?

Answer 15

creamy, white, fishy discharge

Question 16

pathology in bacterial vaginosis?

Answer 16

normal flora is replaced with anaerobes

Question 17

what is the most common anaerobe present in BV?

Answer 17

gardnerella vaginalis

Question 18

what substance is used to test for BV and what does it shiw?

Answer 18

potassium hydroxide

amplifies the smell

Question 19

what happens to lactobacilli in BV?

Answer 19

decrease in number and are replaced

Question 20

pH paper result of BV?

Answer 20

will show up alkaline

Question 21

“epithelial clue cells on gram stain”

Answer 21

BV

Question 22

Tx of BV?

Answer 22

metronidazole ONLY if symptomatic for 7 days

Question 23

causes of BV?

Answer 23

ASCENDING INFECTION
endometritis
salpingitis
preterm delivery
ruptured membranes

Question 24

male sexual partners should be treated if a female has BV T or F

Answer 24

F, shows no benefit

Question 25

name 3 bacteria responsible for STIs

Answer 25

chlamydia trachomatis neisseria gonnorhoeae treponema pallidum mycoplasma genitalium

Question 26

what bacteria causes syphilis?

Answer 26

treponema pallidum

Question 27

mycoplasma genitalium causes what infection?

Answer 27

non-gonococcal urethritis

Question 28

what bacteria cause urethritis

Answer 28

mycoplasma genitalium chlamydia gonorrhoea

Question 29

what viruses can cause STIs?

Answer 29

HPV HSV hepatitis HIV

Question 30

what parasites can cause HIV

Answer 30

trichomonas vaginalis phthirus pubic (crabs) scabies

Question 31

what serovars of chlamydia cause genetic infection

Answer 31

serovars D to K

Question 32

why are gram stains not routinely done for chlamydia?

Answer 32

it cant be easily grown

Question 33

chlamydia will infect the area it is exposed to T or F

Answer 33

T, eg if it was the vagina it will be in the vagina

Question 34

Tx of chlamydia

Answer 34

doxycycline 100mg bd for 7 days

Question 35

what infection is caused by chlamydia serovars A to C

Answer 35

trachoma

Question 36

Ix of chlamydia

Answer 36

PCR test | combined nucleic acid amplification tests

Question 37

how is a sample for chlamydia test collected in men?

Answer 37

first past urine sample

Question 38

how is a sample for chlamydia test collected in women

Answer 38

vulval vaginal swab (self taken)

Question 39

how long should you wait before a chlamydia retest

Answer 39

5 weeks

Question 40

Ix of gonorrhoea

Answer 40

same as chlamydia: PCR test combined nucleic acid amplification tests swab for culture

Question 41

pathogenesis of gonorrhoea

Answer 41

endocytoses into host epithelial cells

Question 42

gram -eve intracellular diplococcus on gram stain...

Answer 42

gonorrhoea (looks like 2 kidney beans facing each other)

Question 43

what is discharge like in gonorrhoea?

Answer 43

purulent tap of discharge

Question 44

where in the body can gonorrhoea grow?

Answer 44

urethra rectum throat eyes

Question 45

"pus cells" on gram stain

Answer 45

gonorrhoea

Question 46

pharyngeal gonorrhoea is primarily asymptomatic T or F

Answer 46

T

Question 47

who gets routine screening of rectal gonorrhoea?

Answer 47

MSM

Question 48

Tx for gonorrhoea

Answer 48

ceftriaxone IM (secondary care only)

Question 49

common cause of prostatitis in older men?

Answer 49

UTI

Question 50

what sexually transmitted organisms can cause prostatitis in younger men?

Answer 50

chlamydia | gonorrhoea

Question 51

Tx of prostatitis

Answer 51

ciprofloxacin | trimethoprim if high risk of c diff

Question 52

syphilis does/does not stain with gram stain

Answer 52

does not

Question 53

Ix for syphilis

Answer 53

1. PCR serological tests- IgM, IgG 2. non-treponemal tests

Question 54

what are the secondary symptoms of syphilis?

Answer 54

snail track mouth ulcers generalised rash flu like symptoms

Question 55

what is chancre in syphilis?

Answer 55

organism multiplies at inoculation site to form a chancre and gets into the bloodstream

Question 56

late stage complications of syphilis

Answer 56

paralysis cardiac complications neurovascular disease

Question 57

name the 3 specific serology tests for syphilis

Answer 57

``` enzyme immunoassay (EIA) haemagglutination assay (TPHA) particle agglutination assay (TPPA) ```

Question 58

what antibodies are raised in syphilis?

Answer 58

IgG | IgM

Question 59

a rapid plasma reagin test indicates...

Answer 59

indicates tissue inflammation/activity

Question 60

Tx of syphilis

Answer 60

penicillin

Question 61

topical treatment for genital herpes

Answer 61

lignocaine

Question 62

location of dormant genital herpes?

Answer 62

sacral root ganglion

Question 63

where can genital herpes also present and why?

Answer 63

thigh buttock low back follows the sacral roots from the ganglion

Question 64

Tx of genital herpes

Answer 64

aciclovir

Question 65

Ix of genital herpes

Answer 65

PCR

Question 66

Ix for trichomonas vaginalis

Answer 66

high vaginal swab for microscopy

Question 67

Tx of trichomonas vaginalis

Answer 67

oral metronidozole

Question 68

Tx of pubic lice

Answer 68

malathion lotion