Deck 20: Urogenital and Sexually Transmitted Diseases

Question 1

Nosocomial UTIs are a significant problem for patients who have indwelling catheters; the etiology most likely would be

A) Staphylococcus epidermidis
B) Proteus vulgaris
C) Escherichia coli
D) all of the above

Answer 1

D

Question 2

Cystitis is inflammation of the

A) urinary bladder
B) urethra
C) nephron
D) kidney

Answer 2

A

Question 3

In healthy individuals all of the following parts of the urinary tract are sterile except

A) lower folds of urinary bladder
B) portion of the urethra closest to the urethral opening
C) ureter of the kidney
D) nephrons

Answer 3

B

Question 4

Which of the following groups has the most problem with UTIs?

A) females, infants
B) males, infants
C) females, over 60 years
D) males, adults

Question 5

A patient has a UTI with a low number of bacteria in the patient's urine sample and only one pathogen was detected. What condition(s)could have led to the infection?

A) pyelonephritis
B) cystitis
C) acute prostatitis
D) two of the above

Question 6

All of the following defense mechanisms are present in the urogenital system except

A) normal flora competing with opportunists
B) sphincter muscles
C) flushing action of fluids
D) high pH

Question 7

Toxic shock syndrome is associated with all of the following except

A) Staphylococcus aureus
B) super-absorbent tampons
C) exotoxin C
D) elderly men

Question 8

Prostatitis is characterized by all of the following except

A) urgent & frequent urination
B) blood in urine
C) low fever
D) back pain

Question 9

Dysuria means

A) an increased volume of urine produced
B) blood in the urine
C) discolored urine
D) pain on urination

Question 10

If cleansing beneath the foreskin is inadequate,a voided urine specimen may contain

A) Escherichia coli
B) Staphylococcus aureus
C) Mycobacterium smegmatis
D) Micrococcus luteus

Question 11

Diagnosis of Gardnerella vaginitis is made by the appearance of

A) anaerobes in a microscope slide
B) clue cells
C) epithelial cells
D) endotoxin

Question 12

The acid pH in the vagina is predominantly due to ______ fermenting the _____ present in vaginal cells.

A) Staphylococcus, glycogen
B) Escherichia, glucose
C) Staphylococcus, starch
D) Lactobacillus, glycogen

Question 13

Glomerulonephritis is caused by cross-reacting antibodies produced in response to the bacterial pathogen

A) Escherichia coli
B) Staphylococcus aureus
C) Streptococcus mutans
D) Streptococcus pyogenes

Question 14

Leptospirosis is characterized by all of the following except

A) a zoonosis
B) humans are infected by contact with contaminated water
C) Weil's syndrome might develop
D) an abscess develops at the site of entry

Question 15

Non-specific vaginitis is characterized by

A) Gardnerella
B) Bacteroides and Peptostreptococcus
C) Staphylococcus aureus
D) two of the above

Question 16

The etiology of pyelonephritis is most often bacterial,________ ,and less commonly the yeast,______.

A) Escherichia coli, Candida albicans
B) Streptococcus mutanr, Pityrosporum ovale
C) Escherichia coli , Saccharomyces cerevisiae
D) Streptococcus mutans, Saccharomyces cerevisiae

Question 17

Which is the causative agent in 80% of UTIs?

A) Escherichia coli
B) Chlamydia trachomatis
C) Staphylococcus
D) Pseudomonas aeruginosa

Question 18

Pyelonephritis is inflammation of the

A) bladder
B) rectum
C) kidney
D) urethra

Question 19

Which is an immune complex disease?

A) cystitis
B) glomerulonephritis
C) prostatitis
D) pyelonephritis

Question 20

A major cause of UTIs is

A) eating something that doesn't agree with you.
B) incomplete emptying of the bladder.
C) immunosuppression.
D) two of the above

Question 21

Which of the following pairs is incorrectly matched?

A) Herpes Whitlow - fingers
B) HSV 2 - genital herpes
C) HSV 1 -- labial fever blisters
D) Herpes gladiatorium -- pneumonia

Question 22

Syphilis

A) is often detected in the primary stage as the symptoms don't go away
B) is easiest to treat in the tertiary stage as that is when there are the fewest organisms
C) can be spread by kissing in the secondary stage
D) two of the above

Question 23

Chlamydia trachomatis is the causative agent of

A) non-gonococcal urethritis
B) lymphogranuloma venereum
C) inclusion blennorrhea
D) all of the above

Question 24

Secondary syphilis is characterized by

A) the appearance of gummas
B) the appearance of pustular rash
C) the appearance of a chancre
D) the appearance of a chancroid

Question 25

The U.S. incidence of gonorrhea by states indicates that most cases are found in

A) mid-western states
B) Pacific southwest
C) Atlantic northeast
D) southeast

Question 26

In the United States,the most prevalent STD is caused by

A) Chlamydia trachomatis
B) Haemophilus ducreyi
C) Treponema pallidum
D) Neisseria gonorrhoeae

Question 27

Which of the following statements is false?

A) leptospirosis can be controlled in your pets by vaccination
B) low numbers of bacteria in a urinalysis rule out infection
C) douching too much can lead to bacterial vaginitis
D) urine specimens with a variety of organisms are usually contaminated

Question 28

What are the signs associated with congenital syphilis?

A) Huchinson's teeth
B) Saber shin
C) Saddle-nose
D) all of the above

Question 29

Gonorrhea

A) can be treated with ciprofloxacin or other quinolones
B) is easy to treat as antibiotic resistance is rare
C) should only be treated with a cephlasporin (ie ceftriaxone) and another antibiotic
D) two of the above

Question 30

Diagnosis of syphilis is confirmed by

A) immobilization tests
B) using moledular probes
C) culturing the organism
D) PCR

Question 31

Herpes infections are most successfully treated with daily doses of

A) penicillin
B) interferon
C) AZT
D) acyclovir

Question 32

Chancroid is caused by

A) Escherichia coli
B) Haemophilus ducreyi
C) Treponema pallidum
D) Neisseria gonorrhoeae

Question 33

Gonorrhea and syphilis share which of the following properties?

A) Both may be diagnosed by direct culture of the pathogen
B) Both pathogens are spirochetes
C) Both may be passed to a newborn (either during gestation or at birth)
D) two of the above

Question 34

Syphilis is caused by

A) immunodeficiencies
B) Neisseria gonorrhea
C) Treponema pallidum
D) Haemophilus ducreyi

Question 35

Neisseria gonorrhoeae is characterized by all of the following except

A) Gram-negative diplococci
B) has a latent stage
C) replicates inside polymorphonuclear leukocytes
D) cleaves IgA

Question 36

Which of the following is the correct match of the disease and organism?

A) Trichomonas vaginalis - bacterial vaginitis
B) Gardnerella vaginitis - toxic shock syndrome
C) Trichomonas vaginalis - itching and white discharge
D) Escherichia coli -- glomerulonephritis

Question 37

Pelvic Inflammatory Disease is a complication in 50% of the cases of

A) syphilis
B) gonorrhea
C) chancroid
D) vaginitis

Question 38

Donovan bodies are diagnostic mononuclear cells from lesions associated with

A) non-gonococcal urethritis
B) lymphogranuloma
C) granuloma inguinale
D) Chlamydia infections

Question 39

Chancroid is characterized by

A) a rash
B) a gumma
C) a painless chancre lesion
D) a painful chancre lesion

Question 40

The routes of infection in prostatitis include all of the following except

A) by ascent through the urethra
B) from bloodborne organisms
C) by back-flow of contaminated urine
D) by descent from the seminal vesicles

Question 41

Which of the following viruses can lead to fever blisters (cold sores)on the mouth and lips?

A) HSV-1
B) Herpes simplex virus
C) HSV-2
D) all of the above

Question 42

Genital herpes can be acquired

A) by kissing gingivostomatitis lesions of the mouth
B) during sexual contact with a partner infected with HSV-2
C) by oral sex - often with HSV-1
D) two of the above

Question 43

In the Tuskegee Syphilis Study (1932-1972),399 poor and mostly illiterate African-American sharecroppers were denied treatment for Syphilis and not even told they had syphilis. What is the treatment for syphilis? Why was it unethical for the Tuskegee scientists to withhold treatment? Do you think researchers of HIV in developing countries should be required to give anti-retroviral treatment to their test subjects? Do you think HIV studies in developing countries that don't provide antiretroviral treatment to all their test subjects is comparable to the Tuskegee Syphilis study?

Question 44

The correct progression of a typical case of syphilis is

A) incubation à copper colored rash à chancre à latent period à gummas
B) chancre à latent period à rash à latent period à neurological damage
C) gummas à chancre à rash à neurological damage
D) incubation à heart valve damage à latent period à chancre

Question 45

Disseminated CMV

A) always involves brain involvement and in adults leads to neural damage
B) can occur 1 to 4 months after an organ transplant
C) can lead to severe and often lethal pneumonia in bone marrow transplant patients
D) two of the above

Question 46

A person with fever blisters from HSV 1

A) is still susceptible to herpes simplex virus type 2 which causes genital herpes
B) will always have herpes virus in the ganglia of their sensory nerves
C) cannot shed the virus when asymptomatic
D) two of the above

Question 47

The strains of HPV that cause cervical cancer

A) are the same strains that cause external genital warts
B) also cause cold sores
C) are different from the strains that cause external genital warts
D) two of the above

Question 48

Which is a true statement about fetal and infant CMV infections?

A) CMV can only be contracted during birth as it doesn't cross the placenta
B) maternal antibodies can cross the placenta to inactivate CMV virus
C) infections contracted after birth have more permanent defects than those before birth
D) two of the above

Question 49

Human papilloma virus causes

A) condylomas
B) laryngeal papilloma
C) genital warts
D) all of the above

Question 50

Which statement about the detection of cervical cancer is true?

A) Pap smears are far more accurate than an HPV DNA test
B) HPV DNA test can determine if there are abnormal cells present
C) vaccination against HPV will give false positives on the HPV DNA test
D) 60% of women with a positive HPV DNA test will show some abnormality in 5 years

Question 51

Cytomegalovirus causes

A) severe disease in fetuses, neonates and immunocompromised people
B) frothy, fishy-smelling discharge
C) painful bleeding lesions on genitals
D) warts on genitals and intense itching

Question 52

Are the organisms that cause vaginitis part of the normal microflora or does their presence always lead to disease? Why would a physician prescribe a douche of live-culture yogurt after a course of antibiotics? Are the organisms that cause toxic shock syndrome (TSS)part of the normal vaginal flora? If toxic shock syndrome is supposed to come from tampons why do men,children and postmenopausal women now account for most cases of TSS?

Question 53

Who is at the greatest risk for having a vaginal yeast infection?

A) young women who just finished a course of antibiotics
B) diabetic fifty year old man
C) elderly man with a kidney transplant
D) women who use super absorbent tampons

Question 54

Which of the following statements about STDs is false?

A) gonococcal arthritis is the most common joint infection in people younger than 50
B) latency is a hallmark of herpes infections
C) approximately 80% of the population carries CMV asymptomatically
D) CMV symptoms are more severe in patients with AIDS and other immunodeficiencies

Question 55

While incidence of gonorrhea and syphilis are at an all time low in the United States there are still over 300,000 cases of gonorrhea and 6,000 cases of syphilis annually. Explain at least one potential reason for the high incidence of gonorrhea as compared with syphilis. Describe treatment methods for both gonorrhea and syphilis. Why do you think doctors prescribe treatment for Chlamydia when a patient has gonorrhea?