Urinary Tract Infections 2

Question 1

_______ is a sexually transmitted protozoa

Answer 1

trichomonad vaginalis

Question 2

“strawberry cervix” and fishy odor with vaginal pH > 4.5 is indicative of _______

Answer 2

trichomoniasis (or BV)

Question 3

the gold standard for culture of trichomoniasis is _______

Answer 3

modified diamond’s media

Question 4

describe the biology of neisseria gonorrhea
oxidase +/-
motile/non motile

Answer 4

gram negative diplococci (like moraxella catarrhalis)
non motile
oxidase +

Question 5

what is the typical presentation of gonorrhea in men?

Answer 5

generally restricted to the urethra; “yellow pus” purulent discharge/ dysuria

Question 6

the most common site of gonorrhea infection in women is the _______

Answer 6

cervix; (in men it is the urethra)

reason why gonorrhea is a risk factor for ectopic pregnancy and infertility

Question 7

the pili in Neisseria gonorrhea has a specialized mechanism of antigenic variation by _______

Answer 7

DNA rearrangment

Question 8

LOS (lipooligosaccharide) is a virulence factor of ______ (organism)

Answer 8

Neisseria gonorrhea; it induces TNF alpha in some cells

Question 9

______ protein in Neisseria prevents the fusion of the phagolysosome

Answer 9

por protein

Question 10

pili and ____ protein help mediate attachment in gonorrhea

Answer 10

opa (opacity protein)

Question 11

modified diamonds media is the gold standard for culturing ________

Answer 11

trichomoniasis

Question 12

because neisseria gonorrhea is non motile and does not have flagella, whats is the proposed mechanism that it can contribute to ascending infections?

Answer 12

urethral and uterine contractions

Question 13

if you suspect a female has gonorrhea, what diagnostic test would you do?

Answer 13

must do a Thayer Martin agar/ Chocolate agar w/ VCN (vancomycin, colistin, nystatin)

cannot do a gram stain because there are other gram negative bacterial in the women’s normal microflora (however CAN do gram stain for males)

Question 14

oxidase ____ is description of neisseria gonorrhea

Answer 14

oxidase positive

Question 15

the discharge in chlamydia is described as _________

Answer 15

mucoid;

gonorrheal discharge is described as purulent

Question 16

which of the following can you use a gram stain to diagnose: gonorrhea/chlamydia

Answer 16

gonorrhea (only in males because in females must do a culture on Chocolate agar)
chlamydia is NOT VISIBLE with gram stain

Question 17

______ is the most sensitive test for diagnosing chlamydia

Answer 17

NAAT

Question 18

describe the biology of chlamydia

Answer 18

atypical bacterium that is “gram negative” but doesn’t stain
has elementary bodies (infectious non replicating) and reticulate bodies (non infectious replicating)
OBLIGATE INTRACELLULAR parasites that gain entry through abrasions or lacerations

Question 19

_______ is a STI that has EB and RB forms

Answer 19

chlamydia trachomatis

Question 20

HSV 1 remains dormant in _________ (nerve)

Answer 20

trigeminal ganglia

Question 21

HSV 2 remains dormant in ______ (nerve)

Answer 21

sacral ganglia

Question 22

treponema pallidum is a _______ (organism type) and is motile/non motile

Answer 22

tightly coiled spirochete; motile via end-flagellum

Question 23

what demographic has the highest number of cases of syphilis?

Answer 23

men who have sex with men

Question 24

the definitive diagnosis of the primary stage of syphilis is by ________

Answer 24

darkfield microscopy

Question 25

syphilis has 3 stages of presentation. | how does the primary stage present

Answer 25

- hard, painless but sensitive ulcer/ chancre that develops 9-90 days after infection - lesion can have a greater with viscous fluid containing T. palladium cells

Question 26

condyloma acuminatum is seen in _____ (stage) of syphilis

Answer 26

primary stage in females (genital warts) and is associated with HPV

Question 27

maculopapular rash is part of the _____ stage of syphilis infection. Does the rash extend over the palms and soles?

Answer 27

secondary; YES, rash extended over face, palms and soles

Question 28

condyloma lata is found in the _______ stage of syphilis

Answer 28

secondary; lesions are "swarming" with the organism and described to be flat, smooth, eroded and moist lata = later

Question 29

what is the presentation of tertiary stage syphilis?

Answer 29

occurs 15-20 years later and present with CNS Symptoms such as progressive dementia, neingitis and hallucinations - also have CVS effects such as aortic aneurysm

Question 30

what is a CVS manifestation of tertiary syphilis?

Answer 30

aortic aneurysm

Question 31

what 2 causative agents are responsible for urethral discharge?

Answer 31

- N. gonorrhea: purulent "yellow pus" discharge - C. trachomatis: Clear watery discharge have symptoms of dysuria and frequent urination

Question 32

gonorrhea and chlamydia most common affect the _____

Answer 32

cervix

Question 33

what are 2 causal agents of vagintis?

Answer 33

- T. vaginitis (trichomoniasis) | - candida

Question 34

which 2 STI's can cause inguinal bubos?

Answer 34

- C. trachomatis (LGV: L1,2,3 | - H. ducreyi (chancroid)

Question 35

Trichomonas is motile/non motile

Answer 35

motile w/ 4 flagella and short undulating membrane

Question 36

frothy gray or yellow grey vaginal discharge is indicative of ______

Answer 36

trichomoniasis

Question 37

wet mouth of vaginal discharge shows motile flagellated protozoa with many WBC's. what is the most likely diagnosis

Answer 37

Trichomoniasis

Question 38

vaginal candidiasis is diagnosed using _____

Answer 38

KOH wet mount

Question 39

if a pregnant mother with gonorrhea gives birth to a child, what are some possible complications?

Answer 39

- blindness | - conjunctivitis

Question 40

antigenic variation of _____ in N. gonorrhea prevents immunity and explains the difficulty in vaccine development

Answer 40

pili (has type IV pili)

Question 41

N. gonorrhea is motile/non motile

Answer 41

non motile and thus in men it is usually limited to urethras but in females the urethral/uterine contracts can contribute to an ascending infection

Question 42

which servers of chlamydia trachomatis is assorted with conjunctivitis, infant pneumonia and urogenital disease

Answer 42

D-K

Question 43

where can receptors for EB's of chlamydia be found?

Answer 43

- mucous membranes of the urethra - endocervix, endometrium, fallopian tubes - anorectum - respiratory tract and conjunctivae

Question 44

donovanosis (caused by _________ ) will have tender/nontender ulcers

Answer 44

donovanosis = granuloma inguinal which is caused by Klebseilla granulomatis will have NON tender ulcers

Question 45

"groove sign" in a genital ulcer/adenopathy is indicative of what cause?

Answer 45

LGV serotype of Chlamydia trachomatis

Question 46

herepsviridae is characterized an enveloped/non enveloped dsDNA

Answer 46

enveloped dsDNA large icosahedral virus

Question 47

Cowdry type A bodies are nuclear/cytoplasmic inclusions seen in infection by ______

Answer 47

eosinophilic intranuclear inclusion bodies seen in cells infected with organisms within the herpesvirus family

Question 48

herpes blocks the effects of ________ and is able to escape anybody neutralization and clearance

Answer 48

interferon → prevents CD8 T cell recognition of infected cells