truedeam59
Forum Elite
Topics: 29
Posts: 145
|
A 22-year-old woman presents with a 1-week history of mild lower abdominal pain and a yellowish vaginal discharge. She describes the pain as dull in nature, relieved slightly by acetaminophen and worsened by intercourse. Pelvic examination reveals a red, swollen cervix without motion tenderness. The mucosa is friable.
Potassium hydroxide (KOH) mount is negative, and wet mount does not reveal clue cells. Gram's stain of the exudate reveals gram-negative cocci. Which of the following procedures would most likely lead to the correct diagnosis?
A. Culture the blood on Thayer-Martin agar
B. Order DNA probe assays of endocervical exudates
C. Order serologic tests to identify specific capsular antigens
D. Order the germ tube test
E. Order the rapid plasma reagin (RPR) test
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
A, gonococcus gonorrhea
___________________
The Key to Succeed is Patience.
|
| truedeam59
Forum Elite
Topics: 29
Posts: 145
|
No Robin. AND PLEASE EXPLAIN ANSWER
|
| truedeam59
Forum Elite
Topics: 29
Posts: 145
|
yOU DID NOT READ CARREFULLY. iT IS N GONORHOEA BUT NOT YOUR CHOICE
|
| truedeam59
Forum Elite
Topics: 29
Posts: 145
|
HERE IS THE CORRECT ANSWER ROBIN
The correct answer is B. The symptoms suggest infection with Neisseria gonorrhoeae; however, with Gram's stain results alone, it is not possible to distinguish the gonococcus from normal flora organisms such as Acinetobacter, unless gram-negative diplococci are found within polymorphonuclear leukocytes. The fastest
and most reliable assay specific for diagnosis of gonorrhea is the use of commercial DNA probes, with results available in 2-4 hours.
Culture on Thayer-Martin medium (choice A) is indeed the choice for culture of N. gonorrhoeae, but would yield slower results, and therefore be a secondary choice
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
Thanks
___________________
The Key to Succeed is Patience.
|
| mitty
Forum Guru
Topics: 52
Posts: 376
|
A is wrong b/c it says blood culture.It is the sample from the discharge we culrure in thayer-martin media not the blood.
___________________
He will make it happen.
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
I searched through Kaplan note but didd't see about the answer B, I learned new information, thanks
___________________
The Key to Succeed is Patience.
|
| USMLEGladiator
Forum Elite
Topics: 76
Posts: 325
|
truedeam what is source of q.
___________________
scores are just up to how high we aim and of course the amount of effort and time we put into it
|
| truedeam59
Forum Elite
Topics: 29
Posts: 145
|
Sorry guys. I was out for a while.
I found it in Kaplan questions. But I don't know which year. I just got it from a friend. They have a lot of question in this
|
| bactitech
Forum Elite
Topics: 25
Posts: 481
|
Please realize that although a DNA probe can turn around in 2-4 hours, you are very unlikely to get results that quickly. This test is extremely expensive and must be done in batches. We are a very large laboratory and only run these tests on day shift. Anything that comes in the evening doesn't get done until next day. If it comes in past 2 p.m. or so on Friday, it won't be done until Monday. Our lab does a LOT of these. A smaller lab might only run them every other day or so, as I believe there are a lot of controls that need to be run with each batch. Any positive must have a confirmatory done also, which requires putting that specimen in a second run. You'll therefore have to rely on your diagnostic skills somewhat before getting any kind of laboratory confirmation for GC or Chlamydia.
GC takes two days just to show up on a culture plate. Then, if there's not enough growth for testing, it must be subcultured which takes another day. Most times probe testing is quicker, even with the weekend problem. Probe testing is also much more sensitive than culturing. Chlamydia are hard to grow in culture so DNA amplification testing has been a real help in diagnosing cases of this STD.
___________________
Clinical Microbiology since 1974
|
|
| |
| | | | | | | | | | | |
