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140 Cards in this Set
- Front
- Back
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Combined, UTIs account for how many office visits each year?
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9 million
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what are the symptoms of a UTI?
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burning sensation: dysuria
frequent and urgent urination with only a small amount of urine passed (sometimes) pus in urine |
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what is Dysuria?
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burning sensation or unrination, feels like you're "peeing Knives"
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what actually causes the intense pain associated with a UTI?
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inflammation of the muscle causing constant spasms that cause pain all the way down the urethra
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what is Urethritis?
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inflammation of the urethra
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what is CYSTITIS?
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inflammation of the bladder
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what is URETHROCYSTITIS?
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involves both the urethra and the bladder
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what is PROSTATITIS?
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inflammation of the prostate
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what is PYELONEPHRITIS?
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inflammation of the kindey: VERY SERIOUS
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what percentage of infections are caused by escherichia coli?
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80 percent
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what causes e. coli?
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coliform: bacteria found from the colon
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what type of a bacteria is escherichia coli?
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enteric bacteria: it is found in the digestive system
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what is the special virulence factor associated with e. coli?
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FimH-helps E. Coli stick to the walls of the bladder
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what is the diagnosis and treatment for E. Coli?
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diagnosis: culture
Treatment: varies due to susceptibilities and sensitivities |
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what are the 6 main causative agents of UTIs (besides E. Coli)?
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staphylococcus saprphyticus: very common in women and the only staph that causes UTIs
proteus mirabilis klebsiella pneumoniae pseudomonas aeruginosa enterococcus species any enteric bacteria can be opportunists |
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what are the 11 risk factors to UTIs?
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-fecal contamination
-incomplete emptying of the bladder during urination -any abnormality of the urinary tract that obstructs or slows the flow of urine makes it easier for bacteria to grow -people who have diabetes mellitus -immunosupressed patients -catheters or tubes placed in the bladder -sexual intercourse -Diaphragm and/or spermicides kill the sperm and normal flora, making one more susceptible to a UTI -postmenopausal women: hormones -pregnant women: baby on bladder + hormones -women are effected 40-50% more than men because of urethra length: 4 cm in women and 20 cm in men |
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For pregnant women; if asymptomatic bacteriuria (bacteria in the urine) is left untreated, what can occur?
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up to 40% of the women will develop a kidney infection. This is especially severe to have when pregnant
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what percentage of all nosocomial infections are UTIs?
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35-40%
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How do you diagnose UTIs (specifically)
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-find bacteria in the urine
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what must the amounts of bacteria in the blood be between?
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50,000 to 100,000 cfu/ml (colony forming units per milliliter) from a "clean catch specimen" will indicate an infection
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all abnormalities in from a catheterized specimen should be treated as significant-such as...
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blood
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what does CCMS stand for?
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clean catch mid stream: if instructed properly; you clean yourself, urinate and stop mid way before putting the cup underneath
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what are the 5 major treatments of a UTI?
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-amoxiciliin
-sulfonamides aka Bactrin -quinolones (norfloxacin or ciprofloxacin -nitrofurantoin |
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what is glomerulonephritis and what is it also known as?
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aka bright's disease
-inflammation of the glomeruli of the kidney |
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what is glomerulonephritis caused by
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the accumulation of antigen antibody complexes in the glomeruli following strep or viral infections
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what is prostatitis?
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inflammation of the prostate
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where is the prostate located?
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under the bladder
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what are the four sources of infection of the bladder that lead to prostatitis?
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-ascent from the urethra
-back-flow of contaminated urine -organisms from the rectum passing through the lymphatics -descent from the blood |
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what are the 4 main symptoms of prostatitis?
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-urgent and frequent urination
-low fever -back pain -sometimes muscle and joint pain |
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what percentage of cases of prostatitis is caused by e.coli?
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80%
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what is pyelonephritis?
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inflammation of the kidney
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what causes pyelonephritis?
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most of the time infections are ascending caused by the back up of urine by urinary tract blockage or anatomical defects
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what percentage of cases of pyelonephritis is caused by e.coli?
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90%
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repeated infections of pyelonephritis can lead to what?
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kidney damage
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what is the treatment for pyelonephritis and why?
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same as UTIs but often administered by IV so that the medication goes directly to the kidneys
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what is the causative agent of leptospirosis?
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leptospira interrogans
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what are the main hosts for leptospirosis and 2 other places it is found?
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main hosts = rats
other places found: dog and cat urine -people who clean pet messess and swim with their pets are often infected |
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what does leptospirosis cause?
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a febrile illness that runs a 2-3 week course
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how does leptospirosis enter the body?
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thru mucous membranes of the eyes, nose or mouths
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what is primary leptospirosis?
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a multisystem disease characterized by muscle pain, dilation of blood vessels of eye, and involvement of liver and kidney
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what is the morphology and gram stain of leptospira interrogans?
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gram-negative tightly spiraled spirochete
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how is leptospirosis treated?
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penicillin: the earlier the better in order to avoid contact with bacteria
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what causes bacterial vaginitis?
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gardnerella vaginalis in combination with anaerobic flora
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what is produced as a result of bacterial vaginitis?
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a frothy, fishy-smelling discharge
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what is used to treat bacterial vaginitis?
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metronidazole
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what is another specific cause of bacterial vaginitis besides gardnerella vaginalis? and what would this strand be treated with?
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candida albicans: treated with antifungal miconazole
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what causes toxic shock syndrome?
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staphylococcus aureus
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what are the specific virulence factors of TSS?
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toxic shock syndrome toxin-1 (TSST-1)
enterotoxin B exotoxin C |
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what is toxic shock syndrome associated with?
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a new super absorbent tampon
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where may TSS originate from?
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a boil; or prolonged tampon usage
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what are the signs and symptoms of TSS?
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generalized rash; hair and nail loss; red rash that later peels; prolonged fatigue, muscle weakness; myalgia; systemic toxicity and multi-organ involvement
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what is the treatment of TSS?
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nafcillin
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Trichomoniasis is what type of infection and what is the causative agent?
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parasitic infection
-trichomonas vaginalis |
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Trich is usually an STD but can be contracted how else?
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from toilet seats and contaminated linens and hot tubs
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what is the most common protozoan in industrailized countries?
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trichomoniasis
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what are the symptoms associated with trich?
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intense itching and a thick white discharge
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how is trichomoniasis identified?
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wet mount
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what is trich treated with?
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metronidazole aka flagyl
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what is the causative agent for gonorrhea?
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neisseria gonorrhoeae
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what are the virulence factors for gonorrhea?
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-attachment pili: attach to the epithelial lining and to sperm cells
-an endotoxin that damages the mucosa of fallopian tubes -an extracellular protease that digests IgA -survival inside neutrophils: allows for it to settle in joints and cause arthritis |
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what is the only host for GC?
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humans
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what occurs in 95% of men who show symptoms of gonococcus?
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they will have a urethral drip of green pus
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what do women do to increase their chances of contracting GC?
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increased sexual activity, the pill and IUDs
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where can a GC infection occur?
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male urethra, female vagina, pharyngeal infections and anorectal
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1/2 of females infected with GC will develop what?
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Pelvic inflammatory disease: PID: leads to destruction of fallopian tubes and eventual infertility
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what type of infection is trichomoniasis?
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a parasitic infection
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what is the causative agent of trich?
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trichomonas vaginalis
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how can the trich be transmitted?
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usually an STD but can be contracted from toilet seats and contaminated linens and hot tubs
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what is the most common protozoan in industrialized countries?
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trichomoniasis
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what are the symptoms for Trich?
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intense itching and a thick white discharge
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how do you ID trich?
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by a wet mount
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what is the trich treated with?
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metronidazole aka Flagyl
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what is the causative agent for Gonorrhea?
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neisseria gonorrhoeae
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what are the virulence factors of gonorrhea?
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-attachment pili
-an endotoxin that damages mucosa of fallopian tubes -an extracellular protease that digests IgA -survival inside neutrophils: allows for it to settle in joints and cause arthrits: this is also what leads to PID |
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what percentage of infected females will become asymptotic carriers?
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60-80%
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what percentage of males will develop symptoms from ???
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40%
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of the males who are symptomatic, what percentage will have a urethral drip in 14 days?
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95%
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what has lead to the increase of GC in women?
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-increased sexual activity
-the pill: 98% chance of being infected upon exposure because the pill alters vaginal conditions in favor of GC growth -IUDs: spreads into the endomentrial cavity and fallopian tubes 2-9 times faster |
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how many of the infected females will develop pelvic inflammatory disease?
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half
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what is PID?
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pelvic inflammatory disease: leads to sterility due to scarring of the fallopian tubes
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what are the disseminated infections that occur in 1 to 3 percent of cases?
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fever, bacteremia, joint pain and skin lesions
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what is the most common joint infection in 16 to 50 year olds?
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it comes from Neisseria Gonorrhea
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how do you diagnose NG?
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-gram stain with evidence of macrophages containing gram negative diplococci with evidence of macrophages in the pus: males only
-genetic probes -PCR |
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what is the treatment for NG?
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single injection of cefrizxone (sephalosporin): ciprofloxacin can no longer be used because of the large amount of resistant strains
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what is the treatment for chlamydia that is given to people with NG because it is presumed that the person will have that as well
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oral doxycycline and azithromycin
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what is the most common std in the US?
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chlamydia
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what is the second most common STD in the US?
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gonorrhea
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what is the causative agent for syphilis?
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treponema pallidium
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how do you diagnose syphillis?
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can't be grown in the lab because it has fastidious growth requirements; so you are tested by seeing if you have the antibody
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what are the virulence factors of Syphilis?
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proteins that enable it to adhere to human cells and hyaluronidase (what holds the cells together) which helps it to infiltrate intracellular cells
-highly motile |
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what does syphilis trigger?
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vascular damage by the immune system
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what is the morphology of syphilis?
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gram negative spirochete: seen in a darkfield microscopy
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what are the stages of syphilis and give a brief description of each
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-incubation stage: 2-6 wks: the organisms multiply and spread everywhere in the body
-primary stage: chancre forms and disappears in 4-6 wks: infectious -primary latent period: all extrenal signs disappear but diagnostic tests are still positive, if treated it stops here -(if not treated) secondary stage: 3-6 wks after chancre appeared: a copper colored rash appears on the palms of the hand and soles of the feet: contagious when sores/rash are present: many patients have negative serological tests -tertiary stage: "the great imitator": nothing you can do at this point |
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describe what happens during tertiary stage of syphilis?
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-permanant damage occurs throughout the body
-formation of gummas which is granulomatous inflammations -damage to brain nerves, eyes, heart, blood vessels, liver and bones and joints -tumors on organs, blindness, insanity or paralysis can occur |
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what is the specific diagnoss for syphilis?
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-antibody tests
-VDRL-Venereal Disease research laboratory -RPR: rapid plasma reagin -Fluorescent treponemal antibody-absorption (FTA-ABS) test -observation of treponema under dark field microscopy with fluorescent Ab stain |
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what are the treatments for syphilis?
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penicillin, tetracycline or erythromycin
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what is congenital syphilis?
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passed from omther to child across placenta: can result in death, mental retardation, malformation of organs or development of hutchinson teeth, saber shin and saddle nose
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what is chancroid?
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soft chancre (different from syphilis)
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what is the causative agent for chancroid?
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haemophilus ducreyl
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where is chancroid most offten seen?
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-developing countries
-only about 800 cases in the US per year -sudden increase in the hispanic population in southern california |
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chancroid is number what on top std list?
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4
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what is the diagnosis of chancroid?
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identification of the MO from scrapings of the lesion
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what is the treatment of chancroid?
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appropriate antibiotics increases the rate of cure
-lesions are self limiting -azithromycin (zithromax) ceftriaxone -there is almsot no immunity to the MO so infections can occur repeatedly |
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what is chlamydia?
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obligate intracellular pathogen-bacterial but has to grow inside other cells: survives inside phagocytes: almost virus like
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chlamydial infections are also known as
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non gonococcal urethritis (NGU)
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how many new cases occur each year in the US of chlamydia?
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3-5 million
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what is epididymitis and what std is it associated with?
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a result of chlamydia: doesn't allow sperm to pass through therefore causes infertility
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what can chlamydia cause in women?
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PID and ectopic pregnancies
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how do you diagnose chlmaydia?
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genetic probe testing for the presence of RNA/DNA
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what is chlamydia trachomatis?
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pus infection in a new born and trachoma eye disease
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what is the treatment for chlamydia?
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doxycycline or azithromycin (zithromax): this is the same as chancroid
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what are the 2 causative agents of herpesvirus infections?
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HSVI: fever blisters adn cold sores and HSVII: genital herpes
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facts about HSV I
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-generally found from the waist up
-usually establishes latency in the trigeminal ganglion: from below your ear and up the face below the chin |
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facts about HSV II
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-generally found from the waist down
-usually establishes latency in the sacral ganglion: from the hip and around |
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what is the hallmark of Herpes virus?
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latency: the ability to remain in host cells and retain the ability to replicate later
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during latency, HSV is...
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protected from the immune system inside a nerve cell
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how many americans are living with genital HSV and how many new cases appear annualy?
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20 million
-500,000 |
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what are the three sequelae caused by the HSV infection in females?
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-increased incidence of miscarriage
-the infant must be delivered by C section -increased risk of cervical carcinoma (cervical cancer) |
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anytime you have an infection with an internal lesion (vaginally or on the cervix) causes one to be more at risk for what?
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HIV: because you have an open lesion and HIV is a blood borne disease
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what is one specific other type of herpes infection?
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whitlow (found on finger): common on the health care professionals
-the check a patient with no gloves and dont wash their hands, result is herpes on the finger tips |
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facts about congenital herpes infections
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-fetus is infected either during the birth process or while in utero
-children can suffer brain damage or no survive -if contracted in utero the lesions may take up to 3 wks to appear -if you have herpes you should not even WORK with babies |
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what is the diagnosis for herpes?
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laboratory diagnosis by cell culture or rapid immunoligical tests (antigen/antibody tests)
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what is the treatment for herpes?
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no cure
-acyclovir decreases viral shedding, prevents the spreading of lesions and shortens healing time |
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what is the causative agent of genital warts?
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human papilomaviruses (about 200 strains): naked DNA viruses
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how can warts be removed?
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cryosurgery (freezing), electrocautery (burning) or laser treatment: occasionally, surgery is needed to remove large warts that have not responded to other treatment
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gardisil is 100% effective against which HPV strains?
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16 and 18: they are responsible for 70% of cases of cervical cancer
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gardasil also helps gaurd against which 2 types of HPV that causes genital warts?
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6 and 11
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what is another name for cytomegalovirus?
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herpes virus 5
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what is the diagnosis and treatment for cytomegalovirus?
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-test saliva or urine for virus
-ganciclovir |
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what are the symptoms of cytomegalovirus (CMV) infections?
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flu like symptoms: more severe in AIDS patients
-CMV supresses the immune system |
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what is the most common cause of birth defects in the USA?
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CMV: results in retardation, brain, nerve and liver damage
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besides causing birth defects, when else is CMV a problem?
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during blood transfusions and transplants
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what is most notable about AIDS?
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crucial immune cells called CD4 positive cells or T helper cells are effected
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how many people have AIDS world wide?
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40 million
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HIV is a retrovirus..what does that mean?
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retroviruses are RNA viruses and in order to replicate (duplicate) the must make a DNA copy of their RNA
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why will we never have a vaccine for HIV?
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the virus has an extraordinarily high mutation rate, such that an infected individual often harbors many variations
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how is HIV transmitted?
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-blood (including menstrual blood)
-semen -vaginal secretions -breast milk |
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what was HIV initially known as?
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GRID: gay related immune deficiency
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who was patient zero?
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a flight steward who is presumed to spread aids to over 1000 people all over the world
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table on slide 61 and 62
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KNOW IT
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