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Questions and Answers

What is the significance of the reactivity of certain tests in the context of treatment?

Reactivity declines or disappears within 6-18 months of effective therapy.

What is the difference between the venereal disease research laboratory (VDRL) test and the rapid plasma reagin (RPR) card test?

VDRL is highly valued, while RPR can be applied on plasma as well as serum and CSF.

What is the main advantage of treponemal tests?

They detect specific antibodies for cellular components of the organism.

What is the disadvantage of treponemal tests?

<p>They are expensive and difficult to perform.</p> Signup and view all the answers

What is the significance of the fluorescent treponemal antibody absorption (FTA-ABS) test?

<p>It is a treponemal test used to confirm a positive non-treponemal test.</p> Signup and view all the answers

What is the main difference between non-treponemal tests and treponemal tests?

<p>Non-treponemal tests are non-specific and used for screening, while treponemal tests are specific and used to confirm results.</p> Signup and view all the answers

What is the antigen used in treponemal tests?

<p>The T.pallidum antigen.</p> Signup and view all the answers

What is the significance of cardiolipin lecithin in non-treponemal tests?

<p>It is the antigen used in non-treponemal tests, which are used for screening and to determine treatment efficacy.</p> Signup and view all the answers

How do humans become infected with Leptospirosis?

<p>By contact with urine-contaminated water, with the pathogen entering through minor abrasions in the skin or mucous membranes of the upper digestive system.</p> Signup and view all the answers

What is the primary mode of transmission of Leptospirosis?

<p>Contact with urine-contaminated water.</p> Signup and view all the answers

What is the recommended antibiotic for the treatment of Leptospirosis?

<p>Doxycycline (a tetracycline).</p> Signup and view all the answers

What is the most common cause of death in patients with Leptospirosis?

<p>Kidney failure.</p> Signup and view all the answers

What is the purpose of microscopic agglutination test in the diagnosis of Leptospirosis?

<p>For identification of the pathogen.</p> Signup and view all the answers

What is the typical incubation period of Leptospirosis?

<p>1 to 2 weeks.</p> Signup and view all the answers

What is the significance of ELIZA in the diagnosis of Leptospirosis?

<p>It is used for the detection of specific IgM, which is highly sensitive.</p> Signup and view all the answers

What is the typical presentation of acute prostatitis in patients?

<p>Same symptoms as UTI.</p> Signup and view all the answers

What is the most common manifestation of urinary tract infections (UTIs)?

<p>Pain and discomfort during urination (dysuria), urgency and frequency of urination</p> Signup and view all the answers

What is the primary mechanism by which E. coli adheres to the epithelium of the urinary tract?

<p>Fimbria</p> Signup and view all the answers

What is the primary aim of quantitative urine culture in the diagnosis of UTIs?

<p>To determine the causative organisms</p> Signup and view all the answers

What is the typical appearance of E. coli colonies on MacConkey's agar?

<p>Rose pink, lactose-fermenting colonies</p> Signup and view all the answers

What is the primary treatment approach for UTIs caused by E. coli?

<p>According to antibiotic sensitivity test</p> Signup and view all the answers

What is the typical Gram stain morphology of E. coli?

<p>Gram-negative bacilli</p> Signup and view all the answers

What is the primary complication of UTIs if left untreated?

<p>Renal abscess</p> Signup and view all the answers

What is the primary mechanism by which Proteus causes swarming on Nutrient agar?

<p>Swarmming on Nutrient agar</p> Signup and view all the answers

Study Notes

Blood-Borne Infections of the Urinary Tract

  • Infrequent and usually lead to renal abscess
  • Clinical manifestations:
    • Dysuria (pain and discomfort during urination)
    • Urgency and frequency of urination
    • Suprapubic tenderness
    • Fever, flank pain, and tenderness in case of pyelonephritis

Laboratory Diagnosis

  • Urine analysis should be performed in patients symptomatic for urethritis and cystitis without kidney involvement
  • Quantitative culture to determine the causative organisms

Important Bacterial Causes of UTI

Escherichia coli (E. coli)

  • Most predominant facultative anaerobe in GIT
  • Indicator of fecal pollution of water
  • Morphology: Gram-negative bacilli, motile, may be capsulated
  • Culture Characteristics: Rose pink, lactose-fermenting colonies on MacConkey's agar
  • Virulence factors:
    • Fimbria: allows adhesion to epithelium of urinary tract
    • Capsular antigens: interfere with phagocytosis
    • Haemolysin: toxin responsible for kidney damage
  • Laboratory Diagnosis:
    • Sample: Urine
    • Diagnosis: Gram stain, culture on MacConkey's agar and blood agar, quantitative urine culture
    • Identification: colonies examined for morphology, gram stain, and oxidase
  • Treatment: according to antibiotic sensitivity test

Proteus

  • Morphology: Gram-negative bacilli
  • Culture Characteristics: pale lactose non-fermenter colonies on MacConkey's agar
  • Swarmming on Nutrient agar

Leptospirosis

  • Caused by Leptospira bacteria
  • Mode of transmission: contact with urine-contaminated water; pathogen enters through minor abrasions in the skin or mucous membranes
  • Pathogenesis: ranges from mild self-limiting febrile illness to fulminant fatal illness (hepatorenal failure)
  • Laboratory diagnosis:
    • Specimen: blood (first week), urine and CSF (second week)
    • Direct detection: by dark field microscopy or PCR for detection of DNA
    • Cultivation: Fletcher's or Staurt's medium
    • Identification: microscopic agglutination test or PCR
    • Serology: detection of specific IgM by ELISA
  • Treatment: Doxycycline (a tetracycline) is the recommended antibiotic for treatment

Prostatitis

  • Definition: inflammation of the prostate, which can be due to infection or other causes
  • Importance: in the differential diagnosis of UTI, as patients with acute prostatitis present with the same symptoms of UTI

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