UTI & STIs

Question 1

Most common cause of uncomplicated UTI?

Answer 1

E. Coli

Question 2

Urease producer of uncomplicated UTI?

Answer 2

P. mirabilis

Question 3

Who is an uncomplicated UTI patient?

Answer 3

Healthy, non-pregnant adult female

Question 4

Gram (-) cause of complicated UTI

Answer 4

P. aeruginosa

Question 5

G (+) urease producer that can cause complicated UTI

Answer 5

S. Saprophyticus

Question 6

Pathology of UTI

Answer 6

Ascending - usu. E. Coli from GI or iratrogenesis

Question 7

Complicated UTI patient?

Answer 7

DM, pregnant, Hx pyelo, Sx > 7days before Tx, MDR, HAP, renal failure, HX UTI as a child

Question 8

STI cause of a UTI

Answer 8

C. trachomatis/ N. gonorrhea

Question 9

Tx UTI

Answer 9

Bactrim…then Cipro

Question 10

Tx pyelonphritis

Answer 10

Cipro/Levo

Question 11

Spirochete with slow rotational motility; produces AB’s to somatic proteins and cardiolipin of host mitochondrial membranes

Answer 11

T. pallidum

Question 12

What org causes syphilis

Answer 12

T. pallidum

Question 13

VF of T. pallidum

Answer 13

membrane protein = adhesion, fibronectin, hyaluronidase

Question 14

Chancre with smooth base, raised border that is firm and indurated; painless

Answer 14

syphilis chancre

Question 15

Which stage is the chancre in syphilis

Answer 15

primary (entry stage)

Question 16

The stage of syphilis that is the highly infectious stage; Latent stage; maculopapular rash (can spread to palms)

Answer 16

secondary stage

Question 17

Stage of syphilis where there are neuro sx, cardio sx, granuomata systemic

Answer 17

tertiary stage: usu 5-20 years later

Question 18

Dx Syphilis

Answer 18

Chancre; Dark field micro for treponemes; Nontreponemal: cardiolipin flocculation test; Treponemal: specific AB tests

Question 19

Hutchinson’s Triad

Answer 19

notched incisors, keratitis, 8th nerve deafness (congenital syphilis)

Question 20

Syphilis lesions primarily due to

Answer 20

cytokines = inflammation

Question 21

G(-) kidney-beaned shaped cells; fastidious growth

Answer 21

N. gonorrhoeae

Question 22

VFs of N. gonorrhoeae

Answer 22

Pili, porin protein, IgA protease, & plasmid chromosome mediated drug resistance

Question 23

PH: N. gonorrhoeae

Answer 23

entry & attachment to epithelia via pili & surface proteins. Injury to host cell via LPS, which allows for spread to other tissues

Question 24

Clinical presentation of gonorrhea

Answer 24

Males: mucopurulent discharge in anterior urethra

Females: presence in endocervix with urethral colonization

Question 25

Gold Standard for Gonorrhea Dx

Answer 25

Nucleic Acid Amp.

Question 26

Migratory polyarthralgia; Arthritis-dermatitis syndrome is indicative of...

Answer 26

Disseminated gonoccoal infection (DGI)

Question 27

Gonorrhea is most common in:

Answer 27

adolescents; rates are increasing in the US due to change in sex habits, detection, & beta-lacatamse resistance

Question 28

Can gonorrhea be transmitted to neonates during birth?

Answer 28

Yes

Question 29

Obligate intra-cellular, G (-) without peptidoglycan. Requires host ATP

Answer 29

Chlamydia C. trachomatis

Question 30

Inflammation in Chlamydia is due to

Answer 30

toxin-producing strains (Toxin B) Toxins break down proteins in host cells allowing mucosal cells to separate

Question 31

Clinical spectrum of Chlamydia

Answer 31

similar to gonorrhea: urethritis (thin-watery discharge), cervicitis (yellow-green discharge), salpingitis, epididymitis, PID

Question 32

Causes post-partum fever and chorioamnionitis in pregnant women

Answer 32

Nongonoccal urethritis

Question 33

Organism that causes NGU

Answer 33

Ureaplasma urealyticum

Question 34

Main réservoir of ureaplasma urealyticum in NGU

Answer 34

GU tract of sexually active persons

Question 35

Causes ~50% of nongonococcal, nonchlamydial urethritis in men

Answer 35

Ureaplasma urealyticum: NGU

Question 36

Flagellated protozoan; exists as a trophozoite ONLY; extracellular anaerobe

Answer 36

T. vaginosis

Question 37

How is T. vaginosis transmitted?

Answer 37

STD only

Question 38

Frothy malodorus vagina a/w cellular atypism

Answer 38

T. vaginosis

Question 39

Is Bacterial vaginosis an STD?

Answer 39

No

Question 40

Opportunistic pathogen due to the overgrowth of T. vaginosis

Answer 40

Bacterial vaginosis

Question 41

Criteria for Bacterial Vaginosis (any 3)

Answer 41

``` Clue cells Fishy amine odor Vaginal pH > 4.5 Curved (-) rods Homogenous secretion ```

Question 42

Underlying causes of candida

Answer 42

absence of normal flora, intro to abnormal site, change in micoenviornment, immune defect, broad spectrum abx

Question 43

Form pseudohyphae, germ tubes, hyphae

Answer 43

C. albicans: vulvovaginal candidiasis

Question 44

Clinically presents as vulvar edema, erythema, cottage cheese appearance

Answer 44

Vulvovaginal candidiasis

Question 45

Dx vulvovaginal candidiasis

Answer 45

vaginal swab: stain & culture

Question 46

Germ tube test is strongly presumptive of

Answer 46

Vulvovaginal candidiasis

Question 47

Predisposing factors of vulvovaginal candidiasis

Answer 47

Local- tight clothing, warm macerate skin, incorrect toilet habits, sensitization, physical damage, IUD, trauma w/ intercourse

Question 48

What org causes chancroid?

Answer 48

H. ducreyi; Tropical countires

Question 49

This chancre is a soft, tender ulcer with sharp margins. It is painful and bleeds. No induration

Answer 49

Chancroid ulcer

Question 50

Dx of chancroid

Answer 50

History is critical. Media needs growth supplements for growth. PCR-based method

Question 51

Which organisms cause PID

Answer 51

N. gonorrhoeae or C. trachomaits

Question 52

PH of PID

Answer 52

Gonorrhea moves via retrograde menses to uterus/fallopian tubes & colonize during menses sloughing. Spreading causes scars and inflammation

Question 53

Dx of PID

Answer 53

inflammation = fever leukocytosis elevated ESR

Question 54

Lower abdominal pain, abnormal vaginal discharge, painful intercourse, increased pain during menstruation, irregular menses, fever, chills, scarring. What is this condition?

Answer 54

PID