urogenital 2 of 2

Question 1

A woman presents with

• genital: itchin, burnin and whitish vaginal discharge

Question 2

4th most common cause of nosocomial infections

Answer 2

vaginal candidiasis

exceeds gram-negative infections

Question 3

explain the two types of transmission with candidiasis

Answer 3

1. endogenous
   
   1. most types of infections
   2. self innoculating
2. exogenous
   
   1. health care worker-> patient, patient-> patient

Question 4

a microscopic sample for oral and vaginal tissue collection of cutaneous and mucosal lesions, oberserves the following

1. budding yeast-like forms and pseudohyphae can be seen with a fluorescence microscope
2. disease
3. casues
4. treatment

Answer 4

candidiasis/vulvovaginal candidiasis

1. opportunistic infection
   
   1. exogenous/endogenous
2. treatment
   
   1. azoles
      
      1. inhibits the fungal cyt-P450
   2. antimetabolites
      
      1. flucytosine
         
         1. interferes with teh synthesis of DNA, RNA and proteins

Question 5

a patient is put on azoles and antimetabolites, what is the infection?

Answer 5

candidasis/ fungal infection

Question 6

patient is brought into the ER. She has low SES, reports of poor maintinence of mentrual hygiene.

• sudden fever, chills, vomiting, muscle aches, rashes
• blood pressure drops and kidneys are failing
• what could cause this?

Answer 6

staphylococcal toxic shock- S. aureus

1. associated with use of tampons abrade the vaginal wall

Question 7

patient presents with desquamation of the palms and soles. She was very ill and still sufferes from: chills, fever, vomiting, diarreah.

what could it be

Answer 7

staphylococcal toxic shock

Question 8

what are the following at risk for?

1. menstruating women
2. women using barrier contraceptives
3. Those who have undergone nasal surgery
4. postoperative wound infections

Answer 8

staphylococcal toxic shock

Question 9

1. this bacteria is an obligate human parasite.
   
   1. do not survive well ouside the host
   2. transmission must be direct
2. what is it? describe
   
   1. gram
   2. shape
   3. location
3. method of resistance?

Answer 9

1. neisseria gonorrhoeae
   
   1. gram neg
   2. diplococcus
   3. foundi nurethral pus
   4. attach to host cells by use of pili
      
      1. can express many types
2. increase number of strains contain R plasmids
   
   1. ​resistance to antibiotics such as penicillin tetracycline

Question 10

Describe the antigenic variation of N. gonorrhoeae

1. different type of
2. enzyme
3. special protein

Answer 10

1. antigenic variation via differnt pili types
   
   1. allow for evasion of the immune system
   2. adherance to many cell types
2. produce protease breaking down IgA
3. Opa proteins
   
   1. increase adherance between
      
      1. gonococci
      2. eukaryotic cells
         
         1. phagocytes
      3. epithelial cells
   2. outermembrane
      
      1. attach to CD4 lymphocytes, preventing activationa nd proliferation

Question 11

untreated N gonorrhoeae can lead to what

1. men
2. women
   
   1. how does the bacteria tranverse, with being immotile?

Answer 11

1. men
   
   1. urethitis
   2. sterilty along with prostatic disease
2. women
   
   1. pelvic inflammatory disease
   2. the N gonorrhoeae attaches to the sperm and ttransits to the fallopian tubes

Question 12

diffirentiate chlamydia trachmoatis from neisseria gonorrhoeae

Answer 12

symptoms are very similar.

1. sample will show the difference
   
   1. CT
      
      1. gram -
      2. spherical
      3. obligate intracellular bacterium
      4. men-grey white discharge,painful testes
      5. women - increased vaginal discharge, painful menses and urination
   2. Ng
      
      1. gram -
      2. diplococcus
      3. men-urethritis, thick pus discharge
      4. women-painful urination, vaginal discharge

Question 13

has subtypes that may cause blindness

Answer 13

chlamydia trachomatis

Question 14

treatment for the following

1. gonnorrhea
2. trachomatis
3. syphilis

Answer 14

1. fluoroquinolones, cephalosporins
   
   1. pregnant-1% silver nitrate or eryhtromycin
2. azithromycin, tetracylcin, erythromicin
3. penicillin

Question 15

what are the stages of syphilis

Answer 15

1. primary
   
   1. single chancre
   2. 10-90 post exposure
2. secondary
   
   1. if no treatment in primary stage
   2. skin rash mucus membrane lesions
3. tertiary
   
   1. damage to internal organs: NCS, heart, blood vessels
   2. gumma
   3. hypersensitive to treponema pallidum- causes blindness

Question 16

trponema pallidum

1. causes
2. shape
3. motility
4. identified by
5. congenital exposure

Answer 16

1. syphilis
2. spirochete
3. motile
4. dark field microscopy, not gram stain
5. congenital
   
   1. damage apears ~4th month of pregnancy
   2. hutchinsosns teeth
   3. facial deformities

Question 17

small red bumbs on genitalia appear ->blisters

1. genital burning/itching
2. severe pain

• type
• initial infection vs latent

Answer 17

HSV-2

1. double stranded DNA, enveloped virus
   
   1. apears similar to HSV1
2. inital
   
   1. fluid filled blisters (Vesicles) contain large number of infecious virons
3. latent
   
   1. partial transciption
   2. no blisters

Question 18

risk of newborn to HSV2

treatment?

Answer 18

if mother has primary infection near delivery time, baby has 1/3 risk of acquiring infection->death or disabeled. baby is usually cesrian

1. treatment-decrease the attacks, NO CURE
   
   1. acyclovir
   2. famcicblovir

Question 19

GENITAL WARTs and cervica lcancer is associated with

1. type
2. incubation

Answer 19

HPV

1. most common STI
2. type
   
   1. non-enveloped
   2. DNA
3. incubation = 3 months

Question 20

yellowinsh green frothy vaginal discharge

1. causative agent
2. incubation
3. motility

Answer 20

1. Trichomonas vaginalis
   
   1. strawberry cervix
   2. burning discomfort upon urination
   3. itching
2. 4-20 days
3. 4 flagella viewed, allow for jerky motility
4. don’t have mitochondria
   
   1. hydrogenosomes
      
      1. remove the pyruvate and transfer electrons to hydrogen ions forming hydrogen gas

Question 21

Infection of this indicates child abuse.

what should the treatment be?

Answer 21

trichomonas vaginalis

treatment-metronidazole