23.E: Urogenital System Infections (Exercises)

23.1: Anatomy and Normal Microbiota of the Urogenital Tract

The urinary system is responsible for filtering the blood, excreting wastes, and helping to regulate electrolyte and water balance. The urinary system includes the kidneys, ureters, urinary bladder, and urethra; the bladder and urethra are the most common sites of infection. Common sites of infection in the male reproductive system include the urethra, as well as the testes, prostate and epididymis. The common sites of infection in females are the vulva, vagina, cervix, and fallopian tubes.

Multiple Choice

When it first leaves the kidney, urine flows through

1. the urinary bladder.
2. the urethra.
3. the ureter.
4. the glomeruli.

Answer

C

What part of the male urogenital tract is shared by the urinary and reproductive systems?

1. the prostate gland
2. the seminal vesicles
3. the vas deferens
4. the urethra

Answer

D

Fill in the Blank

The genus of bacteria found in the vagina that is important in maintaining a healthy environment, including an acidic pH, is _____.

Answer

Lactobacillus

Short Answer

When the microbial balance of the vagina is disrupted, leading to overgrowth of resident bacteria without necessarily causing inflammation, the condition is called _____.

Answer

vaginosis

Explain the difference between a sexually transmitted infection and a sexually transmitted disease.

Answer

An STI is a broader term, including colonization by organisms that may not necessarily cause disease.

In the figure shown here, where would cystitis occur?

Critical Thinking

Epidemiological data show that the use of antibiotics is often followed by cases of vaginosis or vaginitis in women. Can you explain this finding?

23.2: Bacterial Infections of the Urinary System

Urinary tract infections (UTIs) include infections of the urethra, bladder, and kidneys, and are common causes of urethritis, cystitis, pyelonephritis, and glomerulonephritis. Bacteria are the most common causes of UTIs, especially in the urethra and bladder. Bacterial cystitis is commonly caused by fecal bacteria such as E. coli. Pyelonephritis is a serious kidney infection that is often caused by bacteria that travel from infections elsewhere in the urinary tract.

Multiple Choice

Which species is not associated with NGU?

1. Neisseria gonorrhoeae
2. Mycoplasma hominis
3. Chlamydia trachomatis
4. Mycoplasma genitalium

Answer

A

A strain of bacteria associated with a bladder infection shows gram-negative rods. What species is most likely to be the causative agent?

1. Mycoplasma hominis
2. Escherichia coli
3. Neisseria gonorrhoeae
4. Chlamydia trachomatis

Answer

B

Fill in the Blank

Pyelonephritis is a potentially severe infection of the _____.

Answer

kidneys

Short Answer

What is pyuria?

Critical Thinking

What are some factors that would increase an individual’s risk of contracting leptospirosis?

23.3: Bacterial Infections of the Reproductive System

In addition to infections of the urinary tract, bacteria commonly infect the reproductive tract. As with the urinary tract, parts of the reproductive system closest to the external environment are the most likely sites of infection. Often, the same microbes are capable of causing urinary tract and reproductive tract infections. Bacterial vaginosis, Chlamydia, Gonorrhea, and Chancroid are diseases caused by bacteria.

Multiple Choice

Treponemal and non-treponemal serological testing can be used to test for

1. vaginosis.
2. chlamydia.
3. syphilis.
4. gonorrhea.

Answer

C

Lymphogranuloma venereum is caused by serovars of

1. Neisseria gonorrhoeae.
2. Chlamydia trachomatis.
3. Treponema pallidum.
4. Haemophilis ducreyi.

Answer

B

The latent stage of syphilis, which may last for years, can occur between

1. the secondary and tertiary stages.
2. the primary and secondary stages.
3. initial infection and the primary stage.
4. any of the three stages.

Answer

A

Based on its shape, which microbe is this?

(credit: modification of work by Centers for Disease Control and Prevention)

1. Neisseria gonorrhoeae
2. Chlamydia trachomatis
3. Treponema pallidum
4. Haemophilis ducreyi

Answer

C

Fill in the Blank

Soft chancres on the genitals are characteristic of the sexually transmitted disease known as _____.

Answer

chancroid

Short Answer

Compare gonococcal and nongonoccocal urethritis with respect to their symptoms and the pathogens that cause each disease.

Critical Thinking

Chlamydia is often asymptomatic. Why might it be important for an individual to know if he or she were infected?

Why does the CDC recommend a two-drug treatment regimen to cover both C. trachomatis and N. gonorrhoeae if testing to distinguish between the two is not available? Additionally, how does the two-drug treatment regimen address antibiotic resistance?

23.4: Viral Infections of the Reproductive System

Genital herpes is usually caused by HSV-2 (although HSV-1 can also be responsible) and may cause the development of infectious, potentially recurrent vesicles. Neonatal herpes can occur in babies born to infected mothers and can cause symptoms that range from relatively mild (more common) to severe. Human papillomaviruses are the most common sexually transmitted viruses and include strains that cause genital warts as well as strains that cause cervical cancer.

Multiple Choice

Genital herpes is most commonly caused by

1. herpes simplex virus 1.
2. varicella-zoster virus.
3. herpes simplex virus 2.
4. cytomegalovirus.

Answer

C

Koilocytes are characteristic of

1. cells infected with human papillomavirus
2. cells infected with herpes simplex virus 2
3. cells infected with all forms of herpesviruses
4. cervical cancer cells

Answer

A

Fill in the Blank

Condylomata are _____.

Answer

warts

Short Answer

Is it true that human papillomaviruses can always be detected by the presence of genital warts?

How is neonatal herpes transmitted?

Critical Thinking

Recently, studies have shown a reduction in the prevalence of some strains of HPV in younger women. What might be the reason for this?

23.5: Fungal Infections of the Reproductive System

Candida spp. are typically present in the normal microbiota in the body, including the skin, respiratory tract, gastrointestinal tract, and female urogenital system. Disruptions in the normal vaginal microbiota can lead to an overgrowth of Candida, causing vaginal candidiasis. Vaginal candidiasis can be treated with topical or oral fungicides. Prevention is difficult.

Multiple Choice

Which oral medication is recommended as an initial topical treatment for genital yeast infections?

1. penicillin
2. acyclovir
3. fluconazole
4. miconazole

Answer

D

Fill in the Blank

The most common Candida species associated with yeast infections is _____.

Answer

C. albicans

23.6: Protozoan Infections of the Reproductive System

Trichomoniasis is a common STI caused by Trichomonas vaginalis. T. vaginalis is common at low levels in the normal microbiota. Trichomoniasis is often asymptomatic. When symptoms develop, trichomoniasis causes urinary discomfort, irritation, itching, burning, discharge from the penis (in men), and vaginal discharge (in women). Trichomoniasis is treated with the antiflagellate drugs tinidazole and metronidazole.

Multiple Choice

What is the only common infection of the reproductive tract caused by a protozoan?

1. gonorrhea
2. chlamydia
3. trichomoniasis
4. candidiasis

Answer

C

Which test is preferred for detecting T. vaginalis because of its high sensitivity?

1. NAAT
2. wet mounts
3. Pap tests
4. all of the above are equally good

Answer

A

Fill in the Blank

Trichomoniasis is caused by _____.

Answer

Trichomonas vaginalis

Short Answer

Name three organisms (a bacterium, a fungus, and a protozoan) that are associated with vaginitis.