Class 21 Reproductive and Urinary Tract Infections Quiz

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Questions and Answers

What is the causative agent of the disease discussed?

Human Immunodeficiency Virus (correct)

Parasites

Bacteria

Fungi

Which group was primarily focused on during the early studies of this viral STI?

Homeless individuals

Children

Homosexual men (correct)

Healthcare workers

What type of virus is HIV-1 described as?

Single-stranded DNA virus

Single-stranded RNA+ virus (correct)

Double-stranded RNA virus

Double-stranded DNA virus

Which of the following enzymes is NOT carried within the HIV capsid?

Cellulose synthase Signup and view all the answers

What is the primary characteristic of primary syphilis?

Development of a hard 'chancre' at the infection site. Signup and view all the answers

HIV primarily attaches to which surface protein on host cells?

CD4 Signup and view all the answers

What role do lymph nodes play in syphilis infection?

They may facilitate the spread of bacteria from the site of infection. Signup and view all the answers

What unique feature existed among the original group of HIV patients discussed?

They had good health insurance Signup and view all the answers

What condition signifies secondary syphilis?

Presence of infectious lesions on skin and mucous membranes. Signup and view all the answers

Which symptom is associated with tertiary syphilis?

Chronic granulomas known as gummatous syphilis. Signup and view all the answers

What was a common reaction in various countries towards HIV patients?

Denial of the existence of the disease Signup and view all the answers

Which cellular components are primarily affected by HIV infection?

Helper T cells Signup and view all the answers

What occurs during the asymptomatic stage of secondary syphilis?

The body engages in a war between inflammatory response and bacteria. Signup and view all the answers

What are the potential consequences of untreated primary and latent syphilis?

Progression to tertiary syphilis with systemic complications. Signup and view all the answers

What is a notable feature of congenital syphilis?

It occurs when syphilis is transmitted from mother to fetus. Signup and view all the answers

What type of symptoms can neurosyphilis cause?

Full range of neurological symptoms. Signup and view all the answers

What role do pili play in UPEC's interaction with bladder epithelial cells?

They allow bacteria to attach to receptors. Signup and view all the answers

What occurs when UPEC bacteria creates intracellular bacterial communities (IBCs)?

Bacteria replicate inside the epithelial cells. Signup and view all the answers

How does the cervix function during menstruation?

It is filled with antimicrobial mucus. Signup and view all the answers

What is a common characteristic of sexually transmitted infections (STIs)?

They can be transmitted through intimate contact. Signup and view all the answers

What typically happens to sperm after they are collected in the epididymis?

They undergo significant maturation. Signup and view all the answers

What can disrupt microbial ecology in the vagina, leading to genital system diseases?

Use of certain medications or antibiotics. Signup and view all the answers

What characterizes Vulvo-Vaginal Candidiasis?

It involves an overgrowth of Candida yeast. Signup and view all the answers

What role do mucosal membranes play in relation to urinary tract infections (UTIs)?

They facilitate the entry of pathogens, increasing the risk of UTIs. Signup and view all the answers

What is the primary danger posed by Toxic Shock Syndrome?

A sudden drop in blood pressure. Signup and view all the answers

Which of the following best describes how urine helps protect against UTIs?

Urine flow can wash away microorganisms. Signup and view all the answers

Which infective agent is known to cause urinary symptoms without infecting through the urethra?

Schistosoma hematobium Signup and view all the answers

What is one reason females are more likely to get urinary tract infections compared to males?

They have shorter urethras. Signup and view all the answers

Which of the following statements is true about the bacteria typically responsible for UTIs?

They commonly attach to urethra walls and resist urine flow. Signup and view all the answers

What protective mechanism exists in the urinary tract to prevent infections?

High acidity of urine. Signup and view all the answers

How does the anatomical structure of the male urinary tract contribute to a lower rate of UTIs compared to females?

Males possess longer urethras. Signup and view all the answers

Which characteristic helps certain UTI agents withstand the urinary tract conditions?

Ability to evade macrophages. Signup and view all the answers

What is a primary characteristic of sexually transmitted infections (STIs) regarding their infectivity?

STIs require long-term survival in their hosts. Signup and view all the answers

What mechanism of transmission is considered a major virulence factor in the spread of STIs?

Asymptomatic stages Signup and view all the answers

Which of the following is NOT identified as a major virulence factor for STIs?

Fear of medical treatment Signup and view all the answers

In terms of epidemiology, what is a significant risk factor for the transmission of STIs?

Multiple unprotected sexual encounters Signup and view all the answers

What is the primary causative agent of syphilis?

Treponema pallidum Signup and view all the answers

What feature allows Treponema pallidum to penetrate host tissues effectively?

Corkscrew-like motility Signup and view all the answers

Which of the following is a method by which Treponema pallidum inhibits phagocytosis?

Coating itself with host proteins like fibronectin Signup and view all the answers

Which body fluids are commonly associated with the transmission of STIs?

Body fluids during sexual contact Signup and view all the answers

What process occurs after the virus enters the cytoplasm?

Reverse transcriptase converts ssRNA into dsDNA. Signup and view all the answers

Which of the following is NOT a result of the high mutation rate of the viral genome?

Improved immune response in the host. Signup and view all the answers

What is the normal range of CD4 lymphocytes in a healthy individual?

500 - 1200 cells/mm3 Signup and view all the answers

What happens to opportunistic infections when CD4 cell count drops below 200 cells/mm3?

They become life threatening. Signup and view all the answers

What role do macrophages and dendritic cells play in the context of HIV infection?

They serve as a permanent reservoir for the infection. Signup and view all the answers

What is a significant risk of antiviral drugs in relation to an integrated viral genome?

They may fail to target latent infections. Signup and view all the answers

In relation to the historical spread of HIV, what is speculated about its initial exposure?

Up to 100 cases were reported before mid-1950s. Signup and view all the answers

Which of the following conditions is NOT recognized as an AIDS defining condition?

Tuberculosis Signup and view all the answers

Study Notes

Reproductive and Urinary Tract Infections (and STIs)

Mucosal membranes are key in both reproductive and urinary tracts, different from the digestive tract.
The digestive tract is sterile at one end and contaminated at the other.
Kidneys remove waste and excess fluids, releasing waste into the bladder.
Waste fluid travels down ureters to the bladder, then is periodically released through the urethra.
Sphincter muscles near the urethra keep the system closed.
Urine flow washes away microorganisms, typically sterile.
Urine contains organic acids and antimicrobials.
Women have shorter urethras, increasing UTI risk.

UTI Infective Agents

Some agents attach to urethra walls and resist urine flow.
They withstand acid and evade macrophages.
Common agents live near the exit point (E. coli, lactobacillus, etc.). Variants have adapted.
Male urethras are longer, farther from the alimentary canal, and contributes to gender difference in UTIs.
Females have shorter urethras, proximity to both the alimentary canal and vaginal opening increase potential UTI agents.
Schistosoma hematobium infects through skin, not urethra.

Exceptions

Schistosoma hematobium is a helminth.
It infects through skin exposed to contaminated water.
Helminths migrate to mate in veins around the bladder.
Eggs penetrate vein walls and tissues. Some pass to the bladder.

More normal Bacterial cystitis (Uropathogenic E. coli)

Pili attach to bladder epithelial receptors.
Death/sloughing of epithelium allows bacteria to enter underlying tissue via endocytosis.
Create intracellular communities (IBCs).
Bacteria detach and move to bladder lumen, creating more IBCs.
Bacteria establish chronic reservoirs in epithelium, resisting antibiotics and remaining undetected by the immune system.
Filamentous forms help evade the innate immune response.

Genital Systems

Female

Two ovaries, two fallopian tubes, uterus, vagina, and external genitalia (vulva).
Ovum (egg) released each month during ovulation.
Fertilized ovum moves via cilia to the uterus.
Otherwise, menstruation happens.
Cervix opens to the vagina, filled with antimicrobial mucus (except during menstruation).

Male

Testes, tubes, ducts, glands, and penis (outside the abdominal cavity in the scrotum).
Sperm cells collected in the epididymis, carried to the urethra by vas deferens.
Sperm, prostate gland, and seminal vesicle secretions form semen.
Antimicrobial properties.
In older males, prostate can enlarge, slowing urine flow.

Genital System Diseases and STIs

Genital system diseases can be related to UTIs.
Microbial ecology disruptions are common, especially in the vagina (e.g., pH changes, loss of normal flora).
Vulvo-vaginal candidiasis (yeast infections) are another type of infection.
Local inflammation (itching, pain), and odor are common symptoms.
These diseases are usually not transmitted between people.

Toxic Shock Syndrome

High growth levels of one type of Staphylococcus leads to toxin secretion, especially in the presence of a protected area (e.g., tampon).

Sexually Transmitted Infections (STIs)

STIs are generally poorly infective, requiring long-term survival in the host.
They need contact with mucosal membranes between people (e.g., vagina, urethra, rectum, mouth).
They can spread to pelvic areas in females and systemic infections in both sexes.
Most STI infections initially cause no symptoms in the infected person.
They may contribute to inflammation and cell destruction if symptomatic or untreated.
STIs can cause permanent damage and infertility in some cases.
The most common contributing factors to spread are commonly due to the fear or embarrassment associated with the infection and a fear from discovery.

Biggest STI "Virulence" Factors

Fear of discovery and embarrassment are common drivers affecting spread of STIs.
Disbelief of the disease plays a role.

Epidemiology

STIs such as HIV are transmitted through contact with body fluids.
Transmission risk increases with unprotected sex, open sores/inflammation & symptoms.
Cases can be asymptomatic.
Transmission can also occur between mother and fetus.
Many methods exist to stop the transmission of STIs.

Bacterial STI—Syphilis

Causative agent: Treponema pallidum (slender, motile spirochete).
Viewed via darkfield microscopy or silver stain.
Propels with endoflagella, allowing penetration of tissues and organs (humans only).
Secrete enzymes to loosen mucous and have corkscrew motility aiding penetration.
Outer membrane proteins bind to host cells and coat themselves in host proteins, inhibiting phagocytosis.

Progress of Syphilis (infective dose ~100 bacteria)

Enters via contact, multiplies near contact area.
Localized inflammatory response (hard chancre) develops.
Often visible on external genitalia (e.g., penis).
Can resolve in 2-6 weeks.
Infection has already spread to lymph nodes and bloodstream.

Secondary Syphilis

Asymptomatic stages of syphilis are characterized by a war between the inflammatory response and bacterial growth.
Body can display infectious lesions on the skin and mucus membranes if the syphilis gets an upper hand.
This can occur due to immune system stress.
Every lesion is a potential infection source.

Tertiary Syphilis

Systemic disease that can occur years after untreated primary or latent disease.
Chronic granulomas (gummatous syphilis).
Cardiovascular infections (ascending aorta, potential aneurysms).
Neurosyphilis: inflammation of the brain.

Congenital Syphilis

Treponema pallidum easily crosses the placenta.
Fetal damage can occur at various stages of pregnancy.
Damage to the fetus can range from spontaneous abortion/stillbirth to late-stage deformities (e.g., bone, cartilage, teeth, eyes).

Syphilis Transmission

Commonly transmitted via bodily fluids, shared cooking utensils or contact with infected people.
Transmission is commonly associated with poverty and poor sanitation.
Historically, the spread was particularly noticeable in tropical regions with colder climate influences.

Drug Treatments

HIV treatment focuses on preventing other infections from becoming fatal.
Antiretroviral therapies (ART) are often successfully used in combination with other medications that are targeted to other, related diseases and infections.
Medications can suppress symptoms and control infections.

Infection

Viruses cannot move in mucous, needing cell membrane contact.
Anal sex is more efficient in transmission than vaginal sex.
Transmission can also occur through shared needles or blood transfusions.
The virus is not transmitted through insect bites or casual contact.

Vertical Transmission

HIV infection in mothers that is maintained at a high viral load may be vertically transmitted across the placenta.
Vaginal birth, if not properly controlled/managed with existing medications and practices, may also increase transmission probability.
C-sections can provide a method for reducing risk.

STIs Summary

Prevention strategies (e.g., abstinence, monogamy, honest conversations) are important.
STIs can be contracted with various methods of contact, so it's vital to use precautions if possible to reduce risk of transmission.
Testing, condoms, and prophylaxis (if available) may be useful preventative measures.
Fight against embarrassment, fear, and disbelief about STIs impacts the societal and personal levels of contracting STIs and being treated properly.

Viral STI—Human Immunodeficiency Virus (HIV)

In 1981, a group of young men developed threatening infections.
The infections appeared to be largely contained in this group and considered homosexual related.
Retrospectively, this suggests HIV-related infections were already a global issue and were occurring in other populations.
The lack of awareness in other populations suggested potentially unique factors, such as insurance status, which can impact diagnosis and treatment.

Pathogenesis of HIV

Mutation rate is high, enabling rapid development of drug resistance.
The virus hides in macrophages and dendritic cells, acting as reservoirs for the infection.
HIV infection may integrate into the host genome.
Opportunistic infections often occur due to immune system suppression.

Disease Progression

The acute phase is often characterized by flu-like symptoms.
Next is the clinical latency period, with viral levels suppressed due to CD4 lymphocytes.
Then AIDS appears, with significant opportunistic infections.
Death is often linked to opportunistic infections.

Pathology of HIV

CD4 T cell count drops below 200, leading to opportunistic infections.
AIDS-defining conditions like Kaposi sarcoma, Pneumocystis jirovecii pneumonia, Toxoplasma infections, Cryptosporidium increase.

Historical Background of HIV

The disease emerged in the 1970s, first impacting certain communities (e.g., homosexual men).
Initial misidentification and limited awareness in Africa may have led to the slow notice of the infection in the region.
Tuberculosis rates may have disguised the emergence of HIV, obscuring the early rise of the virus.
Additional information or further study suggestions from the document/text is required for further study notes.

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Description

Test your knowledge on reproductive and urinary tract infections, including their causes and mechanisms. This quiz will help you understand the differences in urinary tract anatomy between genders and the role of mucosal membranes. Learn about common infective agents and their characteristics.