Skildum's genital micro; 4.11 Flashcards Preview

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Flashcards in Skildum's genital micro; 4.11 Deck (29):
1

Lactobacilli are the dominant microorganism in reproductive vaginas. What kind of bacteria are lactobacilli?

Gram+ rods/bacilli
Facultative anaerobes

2

What do lactobacilli breakdown?

Glycogen → racemic lactic acid

3

What is the significance of lactobacilli producing racemic lactic acid?

Humans can only take up L lactic acid...D lactic acid remains and decreases the pH

4

What is necessary for glycogen formation in the vaginal epithelium?

Estradiol

5

Other than lactic acid, what else is produced by lactobacilli?

Hydrogen peroxide (likely little consequence)
Hydroxyl radicals
Bacteriocins (form pores in other bacteria)

6

What increases the likelihood of getting BV?

Not having a lactobacilli dominating vaginal flora...Gardnerella predominate instead

7

How is BV treated?

Oral/intravaginal metronidazole
Boric acid (symptom relief)

8

What is required for metronidazole efficacy?

Anaerobic organisms...like gardnerella

9

What is SaPI1? What does it do?

Staph aureus Pathogenicity Island 1 → TSST-1 → superantigen

10

What does SaPI1 contain?

Non-essential genes
Toxins
Other proteins that enhance virulence

11

How does SaPI1 happen?

Viral (phage) transduction

12

Toxic shock syndrome (TSS) is usually caused by staph a (90%). Do patients with TSS usually have Staph a sepsis?

No...patients WITH Staph a sepsis RARELY get TSS

And, patients that GET TSS usually DON'T have Staph a sepsis

13

How does circumcision help protect from STDs?

Decreased anaerobes...increased aerobes and facultative anaerobes → reduced inflammation and decreased CD4+/CCR5+ macrophages in urethra

14

What causes epididymitis in prepubertal patients?

E. coli

15

What causes epididymitis in post-pubertal patients < 35yo?

Chlamydia
N. gonorrhea

16

What causes epididymitis in patients > 35yo?

E. coli
Pseudomonas spp.

17

Prostatitis is divided into types (I-IV). What is type I?

Type I is acute bacterial prostatitis

18

What are the symptoms seen with type I prostatitis?

Dysuria
Suprapubic or perianal pain
Fever
Nausea
Sepsis

19

What gram- bacteria can cause type I prostatitis?

E. coli (most common)
Klebsiella, proteus, pseudomonas
Neisseria, chlamydia

20

What gram+ bacterium can cause type I prostatitis?

Enterococcus

21

How is type I prostatitis diagnosed?

Culture organism from urine
>10 WBC per field in urine
Palpate prostate

22

What is type II prostatitis?

Type II is chronic bacterial prostatitis?

23

What are the symptoms of type II prostatitis?

Dysuria
Pain (penis, testicular, lower back)
Recurrent UTI
Urethritis
Epididyitis
NO systemic symptoms

24

What is the second most common cause of type II prostatitis...because E. coli is still number 1?

Enterococcus is number 2

25

How is type II prostatitis diagnosed?

Culture organism from expressed prostatic secretions or post-prostate massage urine
>10 WBC per field in urine

26

What is type IIIa prostatitis?

Type IIIa is inflammatory chronic pelvic pain syndrome

27

What are the symptoms of type IIIa prostatitis?

Pain
Sometimes dysuria

28

What causes type IIIa prostatitis?

Maybe not bacteria...

29

Type IIIb and IV are both asymptomatic...

but type IIIb is called noninflammatory chronic pelvic pain syndrome...and type IV is called asymptomatic prostatitis