Genitourinary fall 2009

Genitourinary fall 2009 - 1 Diseases of the genitourinary...

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1. Diseases of the genitourinary tract. A. Overview….Fig. 26.1, 26.2 B. Normal flora of the genitourinary system 1) Lactobacillus 2) Staphylococcus (Coagulase neg.) 3) Haemophilus 2. Bacterial agents for Genitourinary tract infections A. Cystitis (Table 26.1) 1) E. coli most often responsible. E. coli has a flagella that allows it to be mobile and move?? a. Pili virulence mechanism – allows the bacteria to bind strongly to wall of the bladder. b. Can progress to plelonephritis. 2) Treatment a. Increase fluid intake. b. Cranberries have lectin that mimics attachement site of pili to prevent attachment to lining of bladder. c. Void after intercourse. B. Vulvovaginal candidiasis (Table 26.4) Yeast infections 1) Caused by Candidia albicans a. Normal flora that can cause symptoms if allowed to overgrow. b. Associated with the use of antibiotics. 2) Symptoms are due to inflammatory response to infection. C. Toxic Shock Syndrome (TSS)( Table 26.5). Staph aureus – remember that it cannot compete well against other organisms. 1) Symptoms: Sudden fever, headache, vomiting, diarrhea, sunburn-like rash, confusion. Sudden drop in blood pressure leads to death. 1
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2) Transmission:? It is a secondary staphylococcal infection. 3) Disease: Due to strains producing TSST-1 (Toxic shock syndrome toxin- 1) toxin and exotoxins that are SUPERANTIGENS (Fig. 19.12). Activate TH elper cells non-specifically by binding to MHC class II /TCR molecules outside the peptide binding groove. Cause toxic overproduction of cytokines. Huge inflammatory response – vascular dilation – shock /death could occur within hours of the infection. 4) Epidemiology: First associated with menstruating women and tampon use. Also associated with surgical wound infections. (Nasal surgery) 5) Prevention: Awareness of symptoms. Prompt treatment. A. 3. Sexually transmitted diseases (Table 26.6/26.7, Fig.26.7) A. Facts 1) Who is most at risk? 2) AMC… or what will and won’t protect you 3) Problems B. Gonorrhea (Table 26.8) 1) Causative agent is Neisseria gonorrhoeae, gram neg. diplococci (1 st gram neg. diplococci we have come across) . Not to be confused with commensal Neisseria found in urogenital tract. Causes urethritis. a.
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Genitourinary fall 2009 - 1 Diseases of the genitourinary...

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