Deck 20: Urinary and Reproductive System Infections

Question 1

The demographic group most likely to experience a urinary tract infection caused by Staphylococcus saprophyticus is

A) pregnant women.
B) elderly individuals of both sexes.
C) sexually active young men.
D) elderly men with an enlarged prostate gland.
E) sexually active young women.

Answer 1

sexually active young women.

Question 2

Which statement is not true about the urinary microbiome?

A) The most consistently detected species are Lactobacillus and Streptococcus.
B) Most species can be cultivated using standard laboratory techniques.
C) Shifts in microbiome composition may be associated with physiological concerns such as incontinence.
D) The healthy urinary tract was believed to be sterile until molecular methods of analysis became available.
E) The species composition is consistent throughout the urinary system, across the lifespan or from person to person.

Answer 2

Most species can be cultivated using standard laboratory techniques.

Question 3

As with all human herpes virus infections, an important characteristic of HSV- 2 infection is

A) progressively worsening outbreaks each time the virus comes out of latency.
B) complete immunity once the infection has been successfully eradicated by the body.
C) that it is highly dangerous even to immune- competent adults.
D) an ongoing a latent infection in peripheral nerves which can reactivate periodically.
E) resistance to all anti- viral medications.

Answer 3

an ongoing a latent infection in peripheral nerves which can reactivate periodically.

Question 4

TORCH pathogens are all characterized by

A) transmission through sexual contact and the ability to cause intrauterine infections.
B) the ability to cause intrauterine infections which are linked to infertility.
C) the ability to cross the placenta to infect a developing fetus.
D) transmission through sexual contact, the ability to cause intrauterine infections which are linked to infertility, and the ability to cross the placenta to infect a developing fetus.
E) transmission through sexual contact.

Question 5

Uropathogenic E. coli can use all the following virulence factors to establish infection in the urinary tract except

A) invade bladder cells to become intracellular.
B) siderophores.
C) proteases and toxins.
D) antigen mimicry.
E) pili and adhesions.

Question 6

The placenta

A) consists only of maternal tissue.
B) allows diffusion of nutrients, gases, and wasted between the mother and the fetus.
C) consists only of fetal tissue.
D) is a site in which bacteria have never been detected.
E) allows mixing of maternal and fetal blood.

Question 7

A urine dipstick test can diagnose urinary tract infections by indicating

A) conversion of nitrite to nitrate in the urine.
B) elevated levels of leukocyte esterase.
C) the presence of glucose in the urine.
D) direct detection of Gram- positive or Gram- negative bacteria.
E) elevated creatine and BUN levels.

Question 8

Urinary catheters pose risks of causing urinary tract infections because

A) they block urine flow out of the bladder.
B) they block urine flow out of the bladder and they can introduce bacteria from the skin, anal, or external genital areas into the bladder.
C) they can introduce bacteria from the skin, anal, or external genital areas into the bladder.
D) they provide a surface for bacterial biofilms to establish and they can introduce bacteria from the skin, anal, or external genital areas into the bladder.
E) they provide a surface for bacterial biofilms to establish.

Question 9

Infection in the urinary tract is limited by all the following except

A) the urinary microbiome.
B) the slightly acidic pH of urine.
C) constriction of the urethra by the prostate gland in men and the placement of the urethra near the anus in women.
D) the flushing action of urine through the ureters and urethra.
E) constriction of the urethra by the prostate gland in men.

Question 10

Of the following, which is the most serious condition?

A) urethritis and cystitis
B) ureteritis
C) pyelonephritis
D) urethritis
E) cystitis

Question 11

A man presents to the physician's office complaining of irritation in the genital area. Examination reveals a bright red rash with raised pustules with clear fluid. Upon questioning, the man reports he has recently been sexually active. What is the most likely diagnosis based upon the appearance of the genital lesions?

A) syphilis
B) genital warts caused by HPV
C) chlamydia
D) genital herpes caused by HSV- 2
E) gonorrhea

Question 12

The dominant genus in the vaginal microbiome of reproductive- age women, Lactobacillus, acts to limit infection by

A) producing bacteriocins, a group of antimicrobial peptides.
B) producing lactic acid, hydrogen peroxide, and bacteriocins.
C) producing lactic acid by fermenting glycogen secretions, lowering pH.
D) producing hydrogen peroxide, which is toxic to anaerobic pathogens.
E) producing lactic acid and hydrogen peroxide.

Question 13

The advantages of the Pap smear as a means of cancer detection include

A) it can detect reproductive tract cancers in both women and men.
B) it can detect early- stage cancers and precancerous changes.
C) it is inexpensive and easy to perform.
D) it is inexpensive and easy to perform, and it can detect early- stage cancers and precancerous changes.
E) it is inexpensive and easy to perform, and it can detect reproductive tract cancers in both women and men.

Question 14

A young woman presents to the emergency room with fever, headache, and vomiting. Food poisoning is suspected, she is given supportive care, and released. One week later she returns to the hospital in acute renal failure. A medical history reveals that she had been a volunteer at an orphanage in a rural section of a Caribbean island recently hit by a hurricane. During evacuation from the island, she had to wade through floodwaters suffered several abrasions on her legs and feet. What is the most likely pathogen based on her symptoms and history?

A) candiduria
B) uropathogenic E. coli
C) Staphylococcus saprophyticus
D) BK virus
E) leptospirosis

Question 15

Bacterial infections that reach the kidneys can result in which serious complication?

A) impaired renal function due to scar tissue
B) bacteremia as bacteria use the renal blood vessels to enter wider circulation
C) bacteremia and impaired renal function
D) bacteremia, impaired renal function, and malignancies
E) malignancies of the kidney

Question 16

The more dangerous CNS and disseminated forms can be minimized through which of the following interventions?

A) administration of antiviral drugs to the affected newborn and delivery by cesarean section
B) administration of antiviral drugs to the affected newborn
C) vaccination of pregnant women
D) delivery by cesarean section and vaccination of pregnant women
E) delivery by cesarean section

Question 17

Compared to complicated urinary tract infections (UTIs), uncomplicated UTIs are less likely to

A) recur after initial treatment.
B) involve a bacterial infection.
C) be diagnosed in women rather than men.
D) respond to antibiotic therapy.
E) be diagnosed in otherwise healthy individuals.

Question 18

Anatomical factors that cause women to be at higher risk of urinary tract infections than men include

A) more acidic urine in women.
B) the flushing of the urethra during ejaculation in men.
C) antimicrobial peptides found in the seminal fluid in men.
D) separate openings for the urinary and reproductive tracts in women.
E) a shorter urethra positioned closer to the anus in women.

Question 19

Characteristics of the human papilloma virus include all except

A) have a high mutation rate, meaning vaccine development is challenging.
B) multiple strains, most of which cause asymptomatic infections.
C) easily spread through any kind of sexual contact.
D) ubiquitous-virtually all sexually active individuals will become infected at some point.
E) promote cell division in epithelial cells.

Question 20

Which is not an innate protection of the female reproductive tract?

A) Normal microbiome members generate products which prevent pathogen growth.
B) The vaginal lining contains ciliate cells which trap and expel bacteria from the tract.
C) The vaginal lining sheds its cells every few hours.
D) Lysozyme and antimicrobial peptides are present in vaginal secretions.
E) Mucous secretions trap microbes.

Question 21

Which is the true statement about vaginosis and vaginitis?

A) The two conditions are always mutually exclusive.
B) Vaginitis is always due to microbiome dysbiosis.
C) Vaginosis is not likely to be sexually transmitted.
D) Vaginitis describes vaginal inflammation while vaginosis does not.
E) The two conditions are always seen together.

Question 22

Chlamydia and gonorrhea often present a similar clinical picture except that

A) only chlamydia can be passed to and affect a newborn.
B) only gonorrhea is implicated in pelvic inflammatory disease.
C) gonorrhea infection confers strong long- term immunity while chlamydia does not.
D) chlamydia is more likely to be asymptomatic in women while gonorrhea is more likely to be asymptomatic in men.
E) few strains of chlamydia are antibiotic- resistant while gonorrhea shows extensive antibiotic resistance.

Question 23

The majority of human papilloma virus strains are oncogenic, and most infections lead to cancer.

Question 24

Unlike many other STIs, chanchroid is often symptomatic with resulting in quick treatment as patients actively seek medical attention.

A) painful lesions, disseminated body- wide rash, and high fever
B) painful lesions
C) disseminated body- wide rash
D) painful lesions and disseminated body- wide rash
E) high fever

Question 25

Why is hyphal morphology (as opposed to a unicellular morphology) necessary for symptomatic vaginal candidiasis to develop?

A) The hyphal form causes hormonal changes in the patient which promotes dysbiosis.
B) The hyphal form is resistant to anti- fungal drugs.
C) The hyphal form displaces the normal bacterial residents of the vagina.
D) The hyphal form produces proteases that cause cellular damage which results in inflammation.
E) The hyphal form is easily sexually- transmitted.

Question 26

Although HSV- 1 usually causes oral lesions and HSV- 2 usually causes genital lesions, it is possible that oral sexual contact can transmit HSV- 1 to the genitals and HSV- 2 to the mouth.

Question 27

Which of the following is not one of the signs assessed using Amsel's criteria to diagnose bacterial vaginosis?

A) clue cells attached to vaginal epithelial visible upon microscopic examination
B) vaginal pH greater than 4.5
C) greyish- white vaginal discharge
D) presence of any type of redness or rash
E) fishy odor after addition of potassium hydroxide to a vaginal smear

Question 28

Characteristics of Treponema pallidum, the bacterium which causes syphilis, include all except

A) Gram- negative spirochete.
B) rapid invasion of host tissues from the initial infection site.
C) ability to avoid immune detection by varying the few antigens it carries on its surface.
D) not treatable with any of type antibiotic.
E) vertical transmission to a fetus during any stage of pregnancy.

Question 29

Which numbered stage(s) of the Chlamydia trachomatis life cycle pictured involves the dormant elementary body?

A) 1 & 5
B) 1
C) 2
D) 2 & 3
E) 5

Question 30

Chlamydia may result in any of the following except

A) pelvic pain with fever in women.
B) pelvic inflammatory disease in women.
C) neonatal conjunctivitis.
D) severe neurological disorders such as seizures, vertigo, memory and sensory impairment, and paralysis.
E) urethritis in males.

Question 31

Despite the approval of several vaccines against human papilloma virus since 2006, infection rates of HPV in young women have not declined.

Question 32

Pelvic inflammatory disease is characterized by all the following except

A) increased risk for ectopic pregnancy.
B) can be caused by several types of bacterial pathogens.
C) inflammation, swelling, or abscesses in the internal reproductive organs.
D) treatment with antibiotic therapy.
E) a clear set of signs and symptoms that make diagnosis straightforward.

Question 33

A 30- year- old woman who is not pregnant presents with a foul- smelling, greenish vaginal discharge, indicating some form of vaginitis. A smear is taken, and routine tests performed. A motile, unicellular eukaryote with multiple flagella and an undulating membrane is observed in the microscope. What treatment is recommended?

A) topical antifungal cream
B) combination therapy of ceftriaxone and azithromycin
C) single dose of metronidazole
D) doxycycline
E) clindamycin

Question 34

A 48- hour old infant is brought to the clinic with signs of severe bacterial conjunctivitis (infection of the eye). The infant was born at home, with the birth assisted only by an unlicensed midwife, and no pharmaceutical interventions performed on the mother or infant. Which infectious agents is the likely culprit?

A) Chlamydia trachomatis
B) HSV- 2
C) bacterial vaginosis due to mixed anaerobic species
D) Neisseria gonorrhoeae
E) Neither Chlamydia trachomatis nor Neisseria gonorrhoeae should be ruled out without further testing.

Question 35

A urine dipstick test is negative for elevated nitrite, but bacteriological culturing reveals Gram- positive cocci. Uropathogenic Escherichia coli is indicated.

Question 36

No bacteria have been detected in the semen of healthy men.

Question 37

Which of the following would be observed as a result of vulvovaginal candidiasis?

A) clue cells
B) a "cottage cheese" discharge
C) pus- filled lesions
D) clue cells and a "cottage cheese" discharge
E) pus- filled lesions and a "cottage cheese" discharge

Question 38

Trichomoniasis is characterized by

A) many asymptomatic infections.
B) the need for long- term antibiotic therapy to result in a cure.
C) dysbiosis of the microbiome.
D) non- motile pathogen that forms persistent biofilms.
E) structural morphogenesis linked to pathology.

Question 39

Ulcerative lesions are characteristic of which stage of syphilis?

A) primary stage
B) secondary stage
C) tertiary stage
D) primary and tertiary stages
E) secondary and tertiary stages

Question 40

Lymphogranuloma venereum differs from the infection caused by the trachoma biovar of Chlamydia trachomatis in that

A) lymphogranuloma venereum may result in the formation of buboes and tissues necrosis.
B) lymphogranuloma venereum bacteria do not have an intracellular lifestyle.
C) lymphogranuloma venereum is not sexually transmitted.
D) lymphogranuloma venereum is not treatable with antibiotics such as doxycycline.
E) lymphogranuloma venereum is not treatable with antibiotics such as doxycycline and is not sexually transmitted.

Question 41

Vaginosis may be experienced without accompanying vaginitis, but vaginitis always accompanies vaginosis.

Question 42

Describe two pathologies that can result from a dysbiosis of the vaginal microbiome and describe how you could differentiae them. What factors can lead to dysbiosis?

Question 43

A vaginal swab examined under the microscope reveals the presence of clue cells. Bacterial vaginosis is likely indicated.

Question 44

Describe how to diagnose a lower urinary tract infection (UTI) and differentiate between common bacterial causes.

Question 45

Men, rather than women, make up the majority of syphilis cases.

Question 46

Describe the features that limit infection in the male and female urogenital systems.