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Flashcards in OtherSTIBacterialInfectionsII Deck (47)
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1
Q

What parts of female reproductive tract have microbes?

A

Anterior urethra and vagina are permanently colonized.

2
Q

What bacteria is predominating in the female reproductive system during childbearing years:

A

Lactobacillus

3
Q

**Features of Lactobacillus:

A

Gram (+) rod. Microaerophilic or anaerobic

4
Q

Lactobacillus and UTIs:

A

Cannot cause UTIs because they cannot grow in urine.

5
Q

**Lactobacillus and Vaginal pH:

A

Glycogen is metabolized to lactic acid by lactobacillus resulting in a vaginal pH of 4-5 = optimal for lactobacilli growth and inhibits other organisms

6
Q

**Alterations in Normal Microbiota of the Vagina are due to (3):

A

Due to: Age, Menstruation, Hysterectomy with removal of cervix

7
Q

*How does Hysterectomy with removal of cervix change vaginal microbiota (3):

A

Increase in prevalence of Bacteroides Fragilis, E. Coli and Enterococcus (BEE)

8
Q

Bacterial vaginosis results from:

A

an overgrowth of ANAEROBIC species. Lactobacillus is typically reduced with BV.

9
Q

**Amsel Criteria: Diagnosis of Bacterial Vaginosis (4):

A

**Discharge usually WHITE or GREY. Presence of CLUE CELLS in vaginal secretion, (+)Whiff test, Vaginal pH > 4.5 ** MUST HAVE 3 of 4

10
Q

**Whiff Test:

A

KOH added to discharge > strong FISHY ODOR= POSITIVE for Bacterial Vaginosis

11
Q

Nugent Score of 0-3 in Diagnosis of Bacterial Vaginosis:

A

Normal, Lactobacillus dominant

12
Q

Nugent Score of 4-6 in Diagnosis of Bacterial Vagninosis

A

Intermediate; mixed morphotypes

13
Q

Nugent Score of 7-10 in Diagnosis of Bacterial Vagninosis:

A

+ Bacterial Vaginosis; absence of lactobacilli, predominance of 2 other morphotypes

14
Q

Complications of Infection with Bacterial Vaginosis (4):

A

Increased susceptibility to HIV infection + other STDs, Increased risk of passing HIV to partners. post-surgical infection, preterm delivery, miscarriage

15
Q

**Treatment of Bacterial Vaginosis:

A

Oral Metronidazole or Clindamycin

16
Q

Vulvovaginal candidiasis is what type of infection:

A

A common FUNGAL infection found in women of childbearing age

17
Q

**Discharge present with Vulvovaginal Candidiasis:

A

Thick, ODORLESS, white vaginal discharge (“COTTAGE CHEESE-LIKE”)

18
Q

Definition of Complicated Vulvovaginal Candidiasis:

A

Four or more episodes in 1 year

19
Q

Vulvovaginal candidiasis caused by C. Albicans Gram stain and KOH prep:

A

Exists as oval yeastlike forms that produce budding with pseudohyphae or hyphae

20
Q

At 37 C Candida Albicans rapidly form:

A

hyphae called GERM TUBES

21
Q

Most commonly isolated specimen during Vulvovaginal Candidiasis:

A

Candida Albicans. Is part of normal flora

22
Q

Diagnosis of Vulvovaginal Candidiasis:

A

Microscopic exam reveals hyphae and budding yeast

23
Q

**Treatment of VVC:

A

1-3 day regimen of topical azole for uncomplicated VVC

24
Q

C. Albicans causes what other diseases:

A

Vaginitis (MORE FREQUENT AFTER ABX) Diaper Rash, Oral Thrush

25
Q

VVC is generally seen in what type of patients:

A

Pregnant. Corticosteroids. Contraceptives. HIV. Abx use Diabetes

26
Q

Most common, curable sexually transmitted disease:

A

Trichomoniasis

27
Q

Most women infected with Trichomoniasis will present with:

A

70% asymptomatic

28
Q

Symptoms of Trichomoniasis:

A

Mild to severe vaginitis with itching and dysuria and DISCHARGE.

29
Q

Discharge with Trichomoniasis infection:

A

Yellow-green, frothy, foul-smelling discharge

30
Q

Men and Trichomoniasis:

A

Primarily asymptomatic carriers

31
Q

Features of Trichomonas Vaginalis:

A

Small, pear shaped protozoa, They are MOTILE exist only in TROPHOZOITE form

32
Q

Pathogenesis of T. Vaginalis (3):

A

Contact results in destruction of epithelial cells, neutrophil influx, petechial hemorrhages (strawberry cervix)

33
Q

Strawberry Cervix

A

Present in infection with T. Vaginalis due to petechial hemorrhages

34
Q

Diagnosis of T. Vaginalis:

A

Detecting SWIMMING T. Vaginalis in exudate

35
Q

**Treatment of Trichomoniasis:

A

Metronidazole

36
Q

Immunity to T. Vaginalis:

A

There is NONE. Reinfection is possible.

37
Q

Menstrual Toxic Syndrome was first linked to:

A

Hyperabsorbant TAMPONS that allow S. AUREUS to multiply and release TOXIN

38
Q

Causative Agent of Menstrual Toxic Syndrome:

A

S. Aureus

39
Q

Staph Aureus Features:

A

Catalase (+). Coagulase (+). Gram (+) cocci in grape-like clusters

40
Q

S. Aureus Toxin:

A

TSST-1

41
Q

Features of TSST-1 (2):

A

Can penetrate mucosal barrier and lead to systemic effects. Is a SUPERANTIGEN = stimulates T-cell activation and release of cytokines

42
Q

Symptoms of Menstrual Toxic Syndrome (5):

A

Diarrhea. Nausea and vomiting. High fever. Hypotension Widespread red rash with possible desquamation of palms and soles

43
Q

4+/1+ Culture from Vagina/Blood:

A

4+ from Vagina= More than 90% positive cultures > TSS 1+ from Blood= Less than 10% positive > TSS

44
Q

Treatment of MTSS:

A

Penicillin or Vancomycin

45
Q

Immunity to Menstrual Toxic Shock Syndrome:

A

50% of TSS patients fail to mount Ab-response to TSST > RISK OF RECURRENCE

46
Q

Case Presentation of TSS:

A

Pharyngitis. Vaginitis. Vomiting + diarrhea. Febrile. HYPOTENSIVE. DIFFUSE ERYTHEMATOUS RASH. PEELING OF PALMS AND SOLES CAN OCCUR (1-2 weeks after)

47
Q

Major Criteria for MTSS Diagnosis (3):

A

Hypotension. Fever. Diffuse Erythroderma (with late skin desquamation)