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Micro Exam VI > OtherSTIBacterialInfectionsII > Flashcards

Flashcards in OtherSTIBacterialInfectionsII Deck (47):
1

What parts of female reproductive tract have microbes?

**Anterior urethra** and vagina are permanently colonized.

2

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

Lactobacillus

3

**Features of Lactobacillus:

**Gram (+) rod. Microaerophilic or anaerobic**

4

Lactobacillus and UTIs:

Cannot cause UTIs because they cannot grow in urine.

5

**Lactobacillus and Vaginal pH:

**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

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

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

7

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

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

8

Bacterial vaginosis results from:

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

9

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

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

10

**Whiff Test:

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

11

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

Normal, Lactobacillus dominant

12

Nugent Score of 4-6 in Diagnosis of Bacterial Vagninosis

Intermediate; mixed morphotypes

13

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

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

14

Complications of Infection with Bacterial Vaginosis (4):

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

15

**Treatment of Bacterial Vaginosis:

Oral Metronidazole or Clindamycin

16

Vulvovaginal candidiasis is what type of infection:

A common FUNGAL infection found in women of childbearing age

17

**Discharge present with Vulvovaginal Candidiasis:

**Thick, ODORLESS, white vaginal discharge ("COTTAGE CHEESE-LIKE")**

18

Definition of Complicated Vulvovaginal Candidiasis:

Four or more episodes in 1 year

19

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

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

20

At 37 C Candida Albicans rapidly form:

hyphae called GERM TUBES

21

Most commonly isolated specimen during Vulvovaginal Candidiasis:

Candida Albicans. Is part of normal flora

22

Diagnosis of Vulvovaginal Candidiasis:

Microscopic exam reveals hyphae and budding yeast

23

**Treatment of VVC:

1-3 day regimen of topical azole for uncomplicated VVC

24

C. Albicans causes what other diseases:

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

25

VVC is generally seen in what type of patients:

Pregnant. Corticosteroids. Contraceptives. HIV. **Abx use** Diabetes

26

Most common, curable sexually transmitted disease:

Trichomoniasis

27

Most women infected with Trichomoniasis will present with:

70% asymptomatic

28

Symptoms of Trichomoniasis:

Mild to severe vaginitis with itching and dysuria and DISCHARGE.

29

Discharge with Trichomoniasis infection:

**Yellow-green, frothy, foul-smelling discharge**

30

Men and Trichomoniasis:

Primarily asymptomatic carriers

31

Features of Trichomonas Vaginalis:

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

32

Pathogenesis of T. Vaginalis (3):

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

33

Strawberry Cervix

Present in infection with T. Vaginalis due to petechial hemorrhages

34

Diagnosis of T. Vaginalis:

Detecting SWIMMING T. Vaginalis in exudate

35

**Treatment of Trichomoniasis:

Metronidazole

36

Immunity to T. Vaginalis:

There is NONE. Reinfection is possible.

37

Menstrual Toxic Syndrome was first linked to:

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

38

Causative Agent of Menstrual Toxic Syndrome:

S. Aureus

39

Staph Aureus Features:

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

40

S. Aureus Toxin:

TSST-1

41

Features of TSST-1 (2):

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

42

Symptoms of Menstrual Toxic Syndrome (5):

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

43

4+/1+ Culture from Vagina/Blood:

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

44

Treatment of MTSS:

Penicillin or Vancomycin

45

Immunity to Menstrual Toxic Shock Syndrome:

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

46

Case Presentation of TSS:

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

47

Major Criteria for MTSS Diagnosis (3):

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