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3820: Microbiology & Immunology > Week 11 - GU > Flashcards

Week 11 - GU Flashcards

1
Q

Upper UTI

A

Kidney & ureter infection

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2
Q

Lower UTI

A
  • Urinary bladder, prostate. Urethra
  • Non-specific = lower - bladder infection
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3
Q

Pyelonephritis

A
  • Infection of renal pelvis - urine drains into ureters & carried to bladder
  • More rare, higher up
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4
Q

UTI Risk Populations

A
  • Children & elderly
  • Women - pregnancy, menopause, sexual intercourse
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5
Q

E. Coli

A
  • Common causative agent of urinary system infection
  • Facultative anaerobic
  • Bacterial pathogen
  • Found in lower intestine
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6
Q

UTI Impairments

A
  • Disrupt normal washout of agent from urinary tract through flow
  • Change to protective properties of mucin lining
  • Disrupt protective function of normal bacterial flora
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7
Q

UTI Infectious Process

A
  • Bacteria enter through urethra with aid of pili
  • Colonize in bladder
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8
Q

Pyelonephritis Infectious Process

A

Infection can ascend from urinary tract to upper region

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9
Q

UTI Test Markers

A
  • Positive leukocytes
  • Positive blood
  • Occasionally protein
  • Positive nitrites - E.coli
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10
Q

UTI Testing

A
  • Sterile sample of midstream urine
  • Urine dipstick - point of care test
  • C&S
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11
Q

BV Causes

A
  • Multiple sex partners
  • New sex partner
  • Vaginal douching
  • Lack of vaginal lactobacilli
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12
Q

BV Infectious Process

A
  • Shift of vaginal flora
  • Reduced numbers of lactobacillus species
  • Overgrowth of Gardnerella vaginalis & some other anaerobes
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13
Q

Overgrowth of Vaginal Anaerobes

A
  • Increase conversion of vaginal peptides to variety of amines - high pH
  • Become volatile & malodorous
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14
Q

Elevated pH Conditions

A
  • Gardnerella vaginalis adhere to exfoliating epithelial cells of vaginal mucosa
  • Create clue cells
  • Epithelial cells covered with masses of coccobacilli
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15
Q

Candidiasis (Yeast Infections)

A
  • Common cause of vulvovaginitis
  • Candida albicans common organism
  • Not considered STI
  • Can be passed between partners
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16
Q

Yeast Infection Diagnosis

A
  • Vaginal culture
  • Show budding yeast filaments (hyphae) & spores
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17
Q

Epididymitis

A
  • Inflammation of epididymis
  • Can be associated with gonorrhea & chlamydia
  • Gram negative rods (e.coli)
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18
Q

Epididymitis Infectious Process

A
  • Pressure associated with voiding/physical strain fore pathogen urine up
  • Urine goes up ejaculatory duct into epididymis
  • Pre-pubertal - associated with congenital urinary tract abnormality
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19
Q

Epididymitis Testing

A
  • Urinalysis
  • Urine culture
  • Urethral swabs
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20
Q

Orchitis

A
  • Infection of testes
  • Precipitated by primary GU tract infection
  • Spread to testes via bloodstream/lymphatic
  • Caused by mumps virus
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21
Q

Protatitis

A
  • Variety of inflammatory disorders of prostate gland - some bacterial
  • Catheterization, instrumentation, secondary to other GU diseases
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22
Q

Acute Bacterial Prostatitis

A
  • Subtype of UTI
  • Ascending urethral infection, reflux of infected urine into prostatic ducts
  • Commonly e.coli
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23
Q

Balanitis

A
  • Fungal origin
  • Common in uncircumcised males
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24
Q

Retroviridae Family

A
  • Latency
  • Persistent viremia
  • Infection of nervous system
  • Weakened host immune responses
  • Destroys CD4 T-lymphocytes
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25
HIV Composition
- Two layers of lipids - Protein spikes embedded in envelope to enter hosts - High affinity for CD4 lymphocytes & monocytes - Bind to CD4 cells & becomes internalized
26
HIV Binding
- HIV attacks CD4 cell - Binds to CD4 receptor then to CCR5 or CXCR4 co-receptor - Must bind both sites to enter cell
27
CD4 Co-Receptors
- Protein on cell surface - Serves as second binding site for virus/other molecule
28
HIV Fusion
- Viral envelope fuses with CD4 cell membrane - Allows HIV to enter CD4 cells - Release RNA & enzymes (transcriptase & integrase) - once inside
29
HIV Reverse Transcription
- Uses reverse transcriptase to convert its genetic material - HIV RNA into HIV DNA - Allows HIV to enter CD4 cell nucleus & combine with cell's genetic material
30
HIV Integration
- Release integrase - Used to insert/integrate viral DNA into the host DNA
31
HIV Replication
- Once integrated into host CD4 cell DNA - Virus uses CD4 machinery to create long chains of HIV proteins - Building blocks for more DNA
32
HIV Assembly
- New HIV RNA & proteins are made by host CD4 cell - Move to cell surface - Assemble into immature non-infectious DNA
33
HIV Budding
- Immature non-infectious HIV pushes out of host cell - Outside CD4 cell new HIV release protease - Protease breaks up long protein chains forming the non-infectious virus - Smaller HIV proteins combine to form mature infectious HIV
34
HIV Transmission
- Direct contact with virus - Infected bodily fluids - semen/vaginal - Mother to child during pregnancy, labor & delivery, breastfeeding
35
Acute HIV
- Rapid multiplication of virus - Progress to chronic infection - Multiplies less rapidly & levels tend to drop - Extends 2-4wks until body produces enough detectable antibodies
36
Chronic HIV
- As infection advances HIV levels increase - Number of CD4 cells decrease - immune system damage - Antiretroviral therapy can help prevent advancement to AIDS
37
Viral Latency
- Chronic HIV infection - Virus present in body but exists without producing more virus - Doesn't cause noticeable symptoms - can remain in this state for long time - Can be a highly transmissible time for those unaware
38
AIDS CD4 Count
Less than 200
39
AIDS Clinical Manifestations
- Opportunistic infections - protozoal, fungal, bacterial, viral - Malignancies - Dementia type complex
40
HIV Testing
- Point-of-care - finger prick - If POC test positive confirmatory testing done with blood vial - Self-test - antibody levels - Genus HIV1/2 confirmatory assay - standard test confirm reactive HIV antibody - Positive = look for p24 antigen
41
P24 Antigen
- Major protein contained in HIV viral core - Most likely used to detect virus's genetic material
42
HIV Window Period
- Time between exposure and when test can detect virus - 2wks-3mth - Once markers are in detectable amount window period over - Suspect exposure come back 4-12wks for repeat test
43
Viral Load
- Amount of HIV in a sample of blood - Reported as number of HIV copies per mL of blood - Higher viral load = more damage to immune system
44
CD4 Count
- Measures number of CD4 T lymphocytes in blood sample - Most important indicator of immune function - Strongest predictor of HIV progression - Monitor response to antiretroviral therapy - Want count to be as high as possible
45
HIV Mutation
- Exhibits frequent antigenic variations - Error-prone nature of reverse transcriptase - Medication non-compliance can contribute to mutation
46
Syphilis Risk Factors
- Sex between men - HIV (men or women) - Younger than 29 - History of incarceration - Methamphetamine use - Injection drug use - Exchanging sex for money/drugs
47
Syphilis Structure
- Etiologic agent T. pallidum - Spirochete class - Corkscrew shaped - Motile microaerophilic bacterium - Cannot be view by normal light microscopy
48
Primary Syphilis
- Proliferate, sensitize lymphocytes, activate macrophages - Formation of primary lesion at inoculation site - Chancre appears 2-3wks after acquisition - Highly infections - Heal spontaneously 3-8wks
49
Secondary Syphilis
- Hematogenous dissemination - 4-10wks after onset of primary chancre
50
Latent Syphilis
- Persistence of T. pallidum organisms in body without symptoms - Classified into early & late - Early = less than 1 year
51
Tertiary Syphilis
- Rare due to antibiotic availability, screening, early treatment - Without treatment 50% progress in 2-50years
52
Neurosyphilis
- Invasion of CNS - can occur at any stage - Tends to form after multiple years/decades - CSF abnormalities scan occur - Meningeal syphilis common manifestation - weeks to moths after initial infection
53
Congenital Syphilis
- Transmitted from pregnant women to fetus - Less often occurrence at time of delivery - Primary & secondary stages - 3rd trimester
54
Syphilis Enzyme Immunoassay EIA
- Treponemal test - Measures IgM & IgG abs for T. pallidum - Once test is positive, will stay positive for life
55
Rapid Plasma Reagin RPR
- Non treponemal test - Measures antibody titres - correlate with disease activity - Indicator of response to therapy - fall in titers over time
56
Syphilis Treatment
- Penicillin G - parenteral admin, all stages - Doxycycline oral used for penicillin allergy
57
STI Complication
- Fertility - Gynecological issues - Pelvic inflammatory disease - abscesses & scaring of vagina, uterus, ovaries - Pelvic pain - painful periods - Ectopic pregnancies
58
Chlamydia
- Obligate intracellular pathogen - Lack of symptoms present
59
Chlamydia Process
Bacteria enters through tiny breaks in perigenital skin/mucous membranes
60
Gonorrhea
- Diplococcus - Virulent strains have pili for attachment - Outer membrane & lipids - escape phagocytosis - Produces endotoxin
61
Gonorrhoea Infection
Same time as chlamydia - treat both at same time
62
Trichomoniasis
- Flagellated protozoa - Considered STI - Not a reportable disease to public health - Predisposing factor: multiple partners - Men often asymptomatic
63
Pregnancy & Trichomoniasis
- Premature rupture of membranes - Preterm birth - Low birth weight
64
Condylomata Acuminata (Genital Warts)
- Caused by HPV - HPV infection can occur with any skin-to-skin contact - Often asymptomatic, transient, resolve without treatment
65
HPV
- Non-enveloped - Double stranded DNA virus - Cause proliferative lesions of squamous epithelium - Subtypes based on likelihood of inducing dysplasia/carcinoma
66
HPV Subtypes 6 & 11
Considered low risk - found in most external genital warts
67
HPV Subtypes 16 & 18
High risk - cervical dysplasia & anogenital cancers
68
Genital Warts
- Soft, raised - Fleshy lesion on external genitalia - Can be flat, rough-surface, pedunculated
69
Genital Warts Timeline
- Incubation 6wks-8mths for genital warts - Immune system clear virus in most people over 2y
70
Molluscum Contagiosum
- Viral disease of skin - gives rise to multiple umbilicated papules - Mildly contagious - Dom-like lesions, dimpled appearance - Benign, self-limiting infection - Spontaneously regress over 6mth-1y
71
Molluscum Contagiosum Transmission
- Skin-to-skin contact - Fomites - Auto-inoculation
72
Human Monkeypox MPOX
- Not an STI - Symptoms similar to smallpox patients - clinically less severe - Enveloped - Double strand DNA - Clade I & II - I most prominent
73
MPOX Transmission
- Animal hosts: rodents & non-human primates - Close contact with respiratory secretions - prolonged face to face contact - Skin lesions of infected person - Recently contaminated object - Pregnant women to unborn baby
74
MPOX Risk Factors
- Men who have sex with men - Preexisting HIV
75
MPOX Timeline
- Invasion period 0-5 days - Skin eruption begins 1-3 days after fever starts - Incubation 6-13 days up to 21 days - Symptoms last 2-4wks - longer with weakened immune system
76
MPOX Testing
- Detection of viral DNA by PCR testing - Diagnostic specimen taken directly from rash - Deroofing 1 of the lesions
77
Imvamune Vaccine
- Live attenuated - 2 doses, 28 days apart - Given within 4 days of contact with MPOX - up to 14 days if no symptoms develop
78
Gonorrhea & Chlamydia Testing
- Urine first catch - NAATs detect presence of infection DNA
79
HIV, Hep, Syphilis Testing
- Antigen detection - Blood test
80
HPV Testing
- No specific testing recommended to verify presence/type of warts - DNA/RNA tests to detect genotypes
81
HSV Testing
- Fluid for culture/NAAT detection - swab lesion - Scrape base of lesion for ulcers - Active lesions must be present to test
82
Not Curable
- HSV - HIV/AIDS - Hep B
83
Urine Dip Analysis
- Glucose - Protein 'blood - Nitrites - Leukocytes - pH - Non-sterile urine sample
84
Urine C&S
- Growing bacteria from urine sample - Determine which antibiotics can treat identified bacteria - Takes 24-48h - Sterile urine sample
85
Nucleic Acid Amplification Tests (NAATs)
- Amplify specific segments of genetic material (DNA/RNA) - PCR to replicate target genetic material - Copies of target make it easier to detect
86
Wet Mount Microscopy
Visually identify trichomonas parasite
87
Syphilis Testing
- Blood test - Antibodies produced in response to bacteria - Treponemal antibody test -most common - If positive 2nd test done (non-treponemal test) - Can identify current & past infections
88
Herpes Testing
- Blood test & viral culture/PCR - Type specific herpes antibody test

3820: Microbiology & Immunology (11 decks)

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