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Microbiology > Repro: Genital Tract/ STIs > Flashcards

Repro: Genital Tract/ STIs Flashcards

(100 cards)

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1
Q

What is the main organism found in normal vaginal flora?

A

Lactobacillis sp

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2
Q

What does lactobacillis sp produce?

A

Lactic acid

Hydrogen peroxide

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3
Q

Why does lactobacillis produce 2 acids?

A

To lower pH of vagina

Suppress growth of any other bacteria

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4
Q

What are 3 other organisms found in normal vaginal flora?

A

Strep viridans
Group B beta-haemolytic streptococcus
Candida sp

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5
Q

What percentage of women have a candida infection but no symptoms?

A

30%

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6
Q

Name 4 predisposing factors to a candida infection

A

Recent antibiotic therapy (broad spectrum)
High oestrogen levels (pregnancy, contraceptives)
Poorly controlled diabetes
Immunocompromised patients

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7
Q

What is the common presentation of candida infection?

A

Intensely itchy white discharge

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8
Q

How is candida infection diagnosed?

A

Clinical diagnosis

High vaginal swab for culture

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9
Q

What is the most common type of candida to cause infection?

A

Candida albicans

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10
Q

What is the treatment of candida infection?

A

Topical clotrimazole pessary/ cream

Oral fluconazole

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11
Q

What causes bacterial vaginosis?

A

Imbalance of bacteria (rather than infection)

Overgrowth of bacteria like gardnerella vaginalis and monbiluncus sp

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12
Q

What are the symptoms of bacterial vaginosis?

A

Thin, watery, fishy-smelling vaginal discharge

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13
Q

How is bacterial vaginosis diagnosed?

A

Clinical diagnosis

pH > 4.5

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14
Q

What investigations can be done for bacterial vaginosis?

A

Microscopy to look for Clue cells

Use the Hay-Ison scoring system to estimate proportions of clue cells to epithelial cells and lactobacilli

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15
Q

What is the treatment for bacterial vaginosis?

A

Oral Methronidazole (because it is an anaerobic infection)

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16
Q

What are the symptoms of acute bacterial prostatitis?

A

Like a UTI but may also have lower abdo pain/ back / perineal/ penile pain and tender prostate on examination

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17
Q

What organisms usually cause acute bacterial prostatitis?

A

E. coli

Enterococcus sp

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18
Q

Are E coli gram negative or positive?

A

Negative rods

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19
Q

Are enterococcus gram negative or positive

A

Positive cocci

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20
Q

How is a diagnosis of acute bacterial prostatitis made?

A

Clinical signs

Midstream uring sample for culture and stain

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21
Q

What is the treatment of acute bacterial prostatitis?

A

Quinolone e.g. ciprofloxacin for 28 days

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22
Q

What is the treatment for acute bacterial prostatitis if there is a risk of C. diff?

A

Trimethoprim 28 days

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23
Q

What percentage of bacterial prostatitis is chronic?

A

<5%

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24
Q

What is the commonest bacterial STI in UK?

A

Chlamydia Tachomatis

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25
What does chlamydia infect?
Urethra, rectum, throat, eyes and endocervix
26
Describe the type of bacteria that chlamydia is
Obligate intracellular bacteria with biphasic life cycle
27
Will chlamydia grow on its own outside cell?
No - 'energy parasite'
28
Why is Chlamydia never cultured or gram stained?
No peptidoglycan in cell wall - won't stain
29
What serovars (variation) of chlamydia causes trachoma (eye infection)?
Serovars A - C
30
What serovars of chlamydia causes genital infection?
D - K
31
What serovars of chlamydia causes lymphogranuloma venereum?
L1 - L3
32
What symptoms does lymphogranuloma venereum cause if in penis or vagina?
Abscesses in inguional region (where draining lymph nodes are)
33
What symptoms does lymphogranuloma venereum cause if in rectum?
Proctocolitis symptoms - fistulation
34
What is the treatment of uncomplicated chlamydia?
Azithromycin (1g oral)
35
What is the treatment of lymphogranuloma venereum?
Doxycycline 100mg BD for 7 days
36
What type of bacteria is Neisseria Gonorrhoeae?
Gram negative diplococcus
37
Why do samples of gonorrhoea need to be analysed quickly?
Doesn't grow well outside body
38
What is a sign that clearly indicates gonorrhoea?
'Dripping tap' of purulent discharge
39
How is gonorrhoea diagnoses?
Combined nucleic acid amplification tests (NAATs) | Polymerase chain reaction (PCR)
40
What sample is needed for a NAATs and a PCR on a male?
First pass urine | Rectal and throat (depending on type of sex)
41
What sample is needed for a NAATs and a PCR on a female?
High vaginal or vulvo-vaginal swab | Rectal and throat
42
What sample is needed for a NAATs and a PCR on a newborn?
Eye swab
43
Why are two samples taken for STI test?
One for culture | One for NAATs or PCR
44
Why do you need to be certain of the strain of gonorrhoea before starting antibiotics?
Targeted antibiotic therapy | Some strains are becoming resistant
45
Apart from NAATs and PCR, what are other STI tests for chlamydia and gonorrhoea?
Microscopy | Culture on specifically-selective agar plates
46
4 advantages of PCR/NAATs compared to culture?
1. Less invasive 2. More sensitive 3. Positive even if organisms die in transit 4. Quick - hours
47
2 disadvantages of PCR/NAATs compared to culture?
1. Cannot track sensitivities | 2. Sensitive - tracks dead organisms
48
How long does it take before you can do a test of cure for gonorrhoea/ chlamydia?
5 weeks
49
What is the treatment for gonorrhoea?
IM ceftriaxone | Oral azithromycin
50
What organism causes syphilis?
Treponema pallidum
51
What type of organism is Treponema pallidum?
Spirochaete (spiral) bacterium
52
Does Treponema pallidum stain with gram stain?
No
53
What are the 4 stages of syphilis?
Primary lesion Secondary stage Early latent stage and Late latent stage Late stage
54
What is the primary lesion of syphilis?
Painless ulcer at point of contact (chancre)
55
What is the secondary stage of syphillis?
Many bacteria circulating in blood | Multiple manifestations at many sites
56
What are examples of symptoms of the secondary stage of syphillis?
Snail track mouth ulcers Rash on palms and soles Flu like symptoms
57
What is the third early latent and late latent stage of syphilis?
Low level multiplication of spirochaeta in blood vessel intima
58
Is the third stage of syphilis infectious?
No
59
What is the fourth stage of syphilis?
Many years later Aortia aneurysm Neurovascular
60
What is a neurovascular complication of syphilis?
Loss of proprioception - high stumping gait
61
How is syphilis diagnosed?
Dark ground microscopy Serology PCR (for research - not clinical diagnosis)
62
Why is diagnosis of syphilis not by culture?
Doesn't stain with gram stain | Can't be cultured
63
What is looked for in dark ground microscopy of syphilis?
Spirochaetes in exudate from primary and secondary lesions
64
What is tested for in serology of syphilis?
Specific and non-specific antibodies
65
What are the non-specific serology tests for syphilis?
VDRL (veneral diseases research lab) | RPR (rapid plasma reagin)
66
What do non-specific serology tests for syphilis indicate?
How active the disease is
67
What are non-specific serology tests for syphilis used for?
Monitor response to treatment
68
What might give a false positive non-specific serology tests for syphilis? and why?
SLE, malaria, pregnancy etc | Because it just indicates tissue inflammation
69
What are the specific serology tests for syphilis?
TPPA (T. pallidium particle agglutination assay) TPHA (T. pallidium haemagglutination assay) IgM and IgG ELISA (screening test)
70
What are non-specific serology tests for syphilis used for?
Confirm diagnosis | Often remain positive for life
71
What is the treatment for syphilis?
PENICILLIN PENICILLIN PENICILLIN injectable long acting
72
What is the commonest viral STI?
Genital warts caused by HPV
73
What type of virus is HPV?
Non-enveloped icosohedral virus containing double stranded DNA
74
Can HPV be grown in culture?
No
75
How many types of HPV are there?
>100
76
What types of HPV cause genital warts?
6 + 11
77
What types of HPV are associated with an increased risk of cervical cancer?
16 + 18
78
How are genital warts spread?
Via close genital skin contact
79
How is a diagnosis of genital warts made?
Clinical
80
What is the treatment of genital warts?
Cryotherapy | Podophyllotoxin cream/ lotion
81
What is the HPV vaccine and who is it offered to?
Against types 6, 11, 16 and 18 | Girls age 11 - 13
82
What strain of Herpes causes cold sores?
HSV 1
83
What strain of Herpes causes genital herpes?
HSV 1 and 2
84
What type of virus is HSV?
Enveloped virus containing double stranded DNA
85
Where does the HSV virus replicate?
Within dermis and epidermis
86
After reaching the dermis and epidermis, where does the HSV virus go?
Into nerve ending of sensory and autonomic nerves
87
Why is herpes painful?
Virus causes inflammation at nerve ending
88
Where does the HSV virus 'hide'?
Sacral root ganglion
89
How is HSV diagnosed?
Swab virus in transport medium of deroofed blister | PCR test
90
What is the treatment for HSV?
Aciclovir if taken early | Pain relief
91
What type of organism is Trichomonas vaginalis?
Single celled protozoal parasite
92
How does Trichomonas vaginalis divide?
Binary fission
93
What are symptoms of Trichomonas vaginalis?
Vaginal discharge and irritation
94
How is Trichomonas vaginalis diagnosed?
High vaginal swab for microscopy | Strawberry cervix
95
What is the treatment for Trichomonas vaginalis?
Oral metronidazole
96
What organism causes pubic lice?
Phthirus pubis
97
What causing the itching symptom of pubic lice?
Lice bite skin and feed on blood
98
How long do male lice live?
22 days
99
How long do female lice live?
17 days
100
What is the treatment for pubic lice?
Malathion lotion

Microbiology (6 decks)

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