Chapter 20

Pelvic inflammatory disease is characterized by all the following except - can be caused by several types of bacterial pathogens. - treatment with antibiotic therapy. - a clear set of signs and symptoms that make diagnosis straightforward. - increased risk for ectopic pregnancy. - inflammation, swelling, or abscesses in the internal reproductive organs.

a clear set of signs and symptoms that make diagnosis straightforward.

Of the following, which is the most serious condition? - pyelonephritis - ureteritis - cystitis - urethritis

pyelonephritis

Which of the following statements concerning gonorrhea is/are correct? To be marked correct, you'll need to select all applicable statements. - Both men and women infected with Neisseria gonorrhoeae are often asymptomatic. - Gonorrhea is relatively easy to treat and can be completely cured with two doses of Bicillin-LA. - The incubation period of disease is between 10 and 90 days, but symptoms often appear around 21 days post-exposure. - Neonatal exposure to gonorrhea can lead to ophthalmia neonatorum and sepsis.

- Both men and women infected with Neisseria gonorrhoeae are often asymptomatic. - Neonatal exposure to gonorrhea can lead to ophthalmia neonatorum and sepsis.

Which of the following statements concerning neonatal herpes is/are true? To be marked correct, you'll need to select all applicable statements. - Neonatal herpes symptoms typically present within the first month of life. - Skin, eye, and mouth manifestations are the most dangerous clinical presentations of neonatal herpes infections. - Administering antiviral drugs early on can prevent the virus from spreading to the central nervous system or progressing to a full-blown disseminated infection. - Mothers experiencing a re-emergent herpes infection are more likely to transmit HSV-2 to their baby than are mothers who experience a first-time infection.

- Neonatal herpes symptoms typically present within the first month of life. - Administering antiviral drugs early on can prevent the virus from spreading to the central nervous system or progressing to a full-blown disseminated infection.

In healthy people, the urinary tract is typically free of cultivable bacteria. Select all the factors that limit bacteria growth in a healthy person's urinary tract. - The immune system rapidly identifies and eliminates bacteria that would constitute normal urinary tract microbiota. - The flow of urine limits bacterial attachment in the urinary tract. - The pH of the urinary tract prevents microbial colonization. - There is lysozyme in urine

- The flow of urine limits bacterial attachment in the urinary tract. - There is lysozyme in urine

Choose the feature(s) of an uncomplicated UTI. Select all that apply. - The patient did not develop the UTI as a result of a healthcare intervention. - The patient is experiencing a recurring infection. - The patient's urinary tract anatomy is normal. - Caused by antibiotic resistant bacteria.

- The patient did not develop the UTI as a result of a healthcare intervention. - The patient's urinary tract anatomy is normal.

In general, ________ and ________ are the most consistently detected genera in the healthy urinary tract. - Escherichia; Staphylococcus - Mycoplasma; Enterococcus - Lactobacillus; Streptococcus -Streptobacillus; Mycobacterium

Lactobacillus; Streptococcus

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? - Chlamydia trachomatis - Neisseria gonorrhoeae - Neither Chlamydia trachomatis nor Neisseria gonorrhoeae should be ruled out without further testing.

Neither Chlamydia trachomatis nor Neisseria gonorrhoeae should be ruled out without further testing.

Which of the following statements concerning the life cycle of Chlamydia trachomatis is correct? - Once inside the body, the Chlamydia trachomatis reticulate body replicates before converting back to the elementary body. - The elementary body form of Chlamydia trachomatis is noninfectious yet metabolically active, whereas the reticulate body form is infectious but dormant. - Hosts are infected when the reticulate body form of Chlamydia trachomatis gains access to the host through sexual contact. - The life cycle is complete once the reticulate body lyses from infected host cells.

Once inside the body, the Chlamydia trachomatis reticulate body replicates before converting back to the elementary body.

__________ are an important part of preventive care in women because they detect precancerous and cancerous cervical cells and may also help diagnose an HPV infection. - HIV tests - Pap smears - Urine dipstick tests - Serological tests

Pap smears

Genital warts are caused by __________. - Papillomaviridae - Neisseria gonorrhoeae - Trichomonas vaginalis

Papillomaviridae

Which of the following is not considered to be an innate defense of the urinary system? - flushing action of urine - acidic pH - secretory IgA - lactoferrin - lysozyme

Secretory IgA

Your twenty-year-old, sexually-active female patient presents with an urgency to urinate, dysuria, pyuria, and pain in the lower abdomen. The patient has a negative urine dipstick test result, but a bacteriological culture has confirmed the presence of a UTI. A Gram stain analysis of the bacteriological culture reveals Gram-positive bacteria. Based on the evidence and the patient's case history, which of the following pathogens is the most likely etiological agent of disease? - Uropathogenic Escherichia coli - Proteus mirabilis - Leptospira interrogans - Staphylococcus saprophyticus

Staphylococcus saprophyticus

The acronym "TORCH" refers to the pathogens, _______________________, which can be vertically transmitted to a developing fetus and cause congenital defects. - T oxoplasma gondii; R ubella virus; C ytomegalovirus; H erpes simplex viruses - T oxoplasma gondii; O ther infections; R ubella virus; C ytomegalovirus; H erpes simplex viruses - T oxoplasma; O ral-fecal viruses; R ubella virus; C ytomegalovirus; H erpes simplex viruses - T oxoplasma ; O scivirus A; R ubella virus; C ytomegalovirus; H erpes simplex viruses

T oxoplasma gondii; O ther infections; R ubella virus; C ytomegalovirus; H erpes simplex viruses

TRUE or FALSE: Due to anatomical differences in the urinary tract, women have a greater risk than men for urinary tract infections (UTIs).

TRUE

TRUE or FALSE: The most common cause of UTIs are bacteria.

TRUE

Gumma lesions on the skin and bones, heart damage, and neurological symptoms are characteristic of which stage of syphilis? - Congenital syphilis - Secondary syphilis - Tertiary syphilis

Tertiary syphilis

Which of the following microorganisms is a TORCH agent? - Rubeola - Hantavirus - Toxoplasma gondii - Coccidiodomycosis

Toxoplasma gondii

Microscopic examination of vaginal smear shows flagellated eukaryotes. - Candida - Chlamydia - Gardnerella - Neisseria - Trichomonas

Trichomonas

True or false: Vaginal and cervical mucus is enriched with antimicrobial peptides and lysozyme that combat bacteria.

True

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? - doxycycline - topical antifungal cream - clindamycin - single dose of metronidazole

single dose of metronidazole

Which of the following statements are not true about genital herpes (HSV-2) infections? Choose all that apply. - They are contracted sexually. - They are asymptomatic infections that often go untreated and may lead to pelvic inflammatory disease. - The virus may reemerge causing new outbreaks. - They are not transmitted to the fetus but are linked to premature labor and low-birth-weight babies

- They are asymptomatic infections that often go untreated and may lead to pelvic inflammatory disease. - They are not transmitted to the fetus but are linked to premature labor and low-birth-weight babies

Which of the following statements concerning trichomoniasis is/are true? To be marked correct, you'll need to select all applicable statements. - Women afflicted by trichomoniasis often report vaginal itching, burning, and a "cottage cheese-like" discharge. - A non-pregnant patient infected with trichomoniasis should be given a combination therapy of ceftriaxone and azithromycin. - Trichomoniasis is an underdiagnosed, underreported disease. - Wet mount preparations can be used to confirm infection

- Trichomoniasis is an underdiagnosed, underreported disease. - Wet mount preparations can be used to confirm infection

Which of the following is NOT clinical criteria is indicative of vaginosis? - A vaginal pH below 4.5 - Uniform vaginal discharge with a greyish-white appearance - The presence of epithelial cells with bacteria attached - The presence of a fishy odor after adding potassium hydroxide to a vaginal mucus smear

A vaginal pH below 4.5

Genital warts are transmitted by __________. - Autoinoculation - Direct contact - Indirect contact - All of the above

All of the above

A twenty-year old teenage patient presents with intense vaginal itching, burning, and a "cottage cheese-like" discharge. The patient's case history reveals that she was prescribed amoxicillin for treatment of a severe sinus infection. Which of the following treatments should be prescribed for the patient based on disease presentation and the patient's case history? - Acyclovir should be prescribed to reduce the frequency and severity of outbreaks. - A single dose of metronidazole should be given to the patient. - The patient should be given two injections of Bicillin L-A. - An antifungal azole drug should be prescribed.

An antifungal azole drug should be prescribed.

What causes a cerebrovascular accident? - Blood flow to a part of the heart is blocked. - Blood flow to a part of the brain is blocked.

Blood flow to a part of the brain is blocked.

Which of the following terms is best defined as an inflammation of the bladder? - Pyelonephritis - Cystitis

Cystitis

CAUTIs (catheter associated urinary tract infections) have been associated with increased morbidity and mortality, higher hospital costs, and lengthier hospital stays. Which of the following statements is NOT true about CAUTIs? - All CAUTIs are considered nosocomial infections. - CAUTIs result in higher death rates. - Patients diagnosed with a CAUTI will likely spend more time in the hospital than patients being treated for the same overall condition who do not have a CAUTI. - CAUTIs are considered uncomplicated UTIs.

CAUTIs are considered uncomplicated UTIs.

Microscopic examination of vaginal smear shows ovoid eukaryotic cell. - Candida - Chlamydia - Gardnerella - Neisseria - Trichomonas

Candida

True or false: The vaginal epithelium is rich in nitrates, which many vaginal flora reduce to nitrite, effectively increasing the vaginal pH and limiting growth of pathogenic microorganisms.

False

What disease often presents with fluid-filled vesicles? - Candidiasis - Bacterial vaginosis - Genital herpes - Trichomoniasis

Genital herpes

Which organism is the primary biota of the female vagina? - Staphylococcus - Lactobacillus - Pseudomonas - Streptococcus - Candida

Lactobacillus

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? - chlamydia - genital warts caused by HPV - genital herpes caused by HSV-2 - syphilis

genital herpes caused by HSV-2

Characteristics of Treponema pallidum, the bacterium which causes syphilis, include all except - not treatable with any of type antibiotic. - vertical transmission to a fetus during any stage of pregnancy. - rapid invasion of host tissues from the initial infection site. - Gram-negative spirochete.

not treatable with any of type antibiotic