Micro chpter 23

Know the parts of the Urinary Tract

Are often considered skin infections but they are also often sexually transmitted. Caused by HSV 1 and 2

Herpes

Infection of a newborn by herpesvirus transmitted vertically from its mother, who has genital herpes. Transmitted trans-placental during or after delivery. Affects the baby’s body including the brain, liver, kidney, and lungs

Neonatal Herpes

Sexually transmitted infections. Are primarily transmittted through sexual activity, which includes genital, oral-genital, and/or genital contact. Some are asymptomatic or symptomatic.

STI

gram negative- like obligate intracellular pathogen.

It has several serotypes infecting the reproductive tract and the eye (trachoma)

The most frequently reported STI disease in the US but many people are unaware they are infected

The major cause of nongonococcal urethritis in the US

75% of infected women have no symptoms

Chlamydia

Caused by Bram-negative diplococcus Neisseria gonorrhoeae

It has developed resistance to antibiotics used to treat it

Most infected exhibit symptoms, whereas women are asymptomatic

Binds to CD4 T cells inhibiting T cell activation

Symptoms generally occur 2-7 days after infection but take as long as 30 days to develop

Most infected men (85-90%) exhibit symptoms such as painful urination, yellowish-white discharge from the penis and sometimes swelling of the testicles and penis.

Most Women (80%) do not present symptoms and make up the major reservoir of the organism

Symptoms include a painful burning sensation when urinating and vaginal discharge that is yellowish-white and sometimes bloody

as infection spreads through the uterus and fallopian tubes, pelvic inflammatory disease (PID) occurs

Gonorrhea

Candida is part of the normal vaginal microbiota of most women

it is not opportunistic

It is not sexually transmitted

It is only an overgrowth of Candida

Diabetes, hormone therapy (hormone replacement and birth control), coricosteroids and antibiotic treatments increase risk

Also known as a yeast infection

Symptoms include intense vulvar itching and irritation, dysuria, curd-like discharge and no odor

Most premeopausal women will have experience as least one episode

Candidiasis

Mildly acidic nature of the vagina ( pH about 4.5)

it is not opportunistic

It is not sexually transmitted (sexual activity is a risk factor)

it is only the overgrowth of bacteria

Major cause of BV is *Gardnerella vaginalis*, however,                                                 *Mycoplasma hominis* and *Peptostreptococcus* spp. are also associated with BV



•*Lactobacillus* species produce lactic acid which lowers the vaginal pH to an acidic 3.4-4.5

•The largest vaginal species is the                 acid-tolerant *Lactobacillus acidophilus*

•Lactic acid is effective at killing many pathogens

•Douching is also associated with a higher risk for BV

Bacterial vaginosis

Caused by spirochete Treponema pallidum.

inflammatory reaction at the site of infection

Has Cancres (painless and hard and contains spirochetes)

Can cross the placental barrier and infect the fetus, causing congenital S. Giving newborns notched teeth.

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Primary Syphilis

syphilis with a generalized rash

secondary syphilis

syphilis that effects heart and the CNS

Contains Gummas (dead tissue)

Patient may develop dementia and die from the disease

Tertiary syphilis

•Flagellated protozoan that is sexually transmitted



•Approximately 2-3 million infections occur each year in the US



•Can infect both men and women, but men are usually asymptomatic



•25-50% of women are asymptomatic



•No cyst in life cycle of *T. vaginalis*, transmission in trophozoite stage only

•Growth can cause vaginal pH to rise above 4.5

•4.2-5.0 is normal

•Female symptoms include vaginal itching and/or burning, pain during intercourse, green vaginal discharge (often frothy) and musty vaginal odor

•Male symptoms include painful urination, urethral or testicular pain and lower abdominal pain

Trichomoniasis vaginalis

There are two types: Bladder infection (cystitis) and Kidney infection (pyelonephritis)

Women risk- shorter perineum, shorter urethra, frequency of intercourse, postmenopausal

Men risk- Catheters

Children risk- incomplete emptying of bladder, postponing emptying of bladder, can lead to serious scarring of the kidney, Prevalence decreases as they get older

Prophylatic (preventative) continous antibiotic therapy is used to prevent infections from recurring

Post-coital antibiotic prophylaxis is an alternative to continuous therapy for some

UTI

Which of the following is part of the internal male reproductive system? 

Vas deferens

The normal microbiota of the adult vagina consist primarily of 

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Lactobacillus

All of the following are ways that HIV can be transmitted from person to person EXCEPT 

kissing

Which of the following is NOT considered a clinical progression of an HIV infection?

increase in immune function

Which of the following is caused by an opportunistic pathogen?

Candidiasis

The observation of a "strawberry" cervix is a symptom of 

trichomoniasis

vaginal itching and cheesy discharge are symptoms of 

candidiasis

Which of the following is true about the urinary system? 

Excess water is removed and returned to the vascular system through the collecting duct.

Reoccurring UTIs can be a result of all of the following EXCEPT

birth control pills

Which of the following is an example of a non-sexually transmitted infection?

yeast infection 

Which of the following is considered to be a sterile body site? 

cerebrospinal fluid 

A patient is seen for a draining abscess on his left forearm. Which of the following would most likely be used to collect a sample from this site? 

swab

Which of the following samples would be expected to be free of microorganisms unless an infection is present?

blood

An advantage of a point-of-care (POC) test is that

antibiotic therapy can begin without a delay of waiting for off-site laboratory results.

Which of the following samples would be expected to contain normal microbiota? 

fecal stool sample 

An advantage of using polymerase chain reaction (PCR) instead of relying on biochemical tests is that PCR 

can be completed within hours instead of days.

Eosin methylene blue (EMB) agar contains dyes that inhibit the growth of Gram-positive organisms and bile salts that prevent the growth of Gram-negative bacteria other than fecal coliforms. Also included in EMB are stains that show a color change when an organism ferments lactose. This media is best described as 

selective and differential. 

Lumbar puncture is the most common method for obtaining a sample of

cerebrospinal fluid.

What does it mean when bacteria can produce catalase? 

The bacteria can convert hydrogen peroxide into H2O and O2. 

Which of the following agencies would be the first to receive information about a reportable disease in the United States? 

a state health agency

How does global warming help the spread of mosquito-borne disease? 

It increases the habitat of vectors

Measles has not been endemic in the United States since 2000; however, we still record 50–100 cases per year. This is considered 

an outbreak

Vaccinating wild rodents or poultry

reduces transmission of zoonotic diseases to humans

Which is NOT a link in the chain of infection

surveillance

What features would allow a virus to be used effectively as a bioweapon? 

person-to-person transmission

If humans continue to develop rapid transportation systems into more parts of the world, we should expect to see

pandemics tracing the path of the transportation systems

Which of the following is NOT an example of aseptic technique? 

use of trash can liners in all patient rooms

Florence Nightingale's techniques showed that soldiers in the Crimean war died mostly from 

infection

Why is a nonendemic area free of disease?

There is no reservoir