Cedrick
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A 16 year old girl is febrile and incoherent but able to indicate that she has severe lower abdominal pain
pelvic examination shows afoul smelling cervicovaginal discharge and a septic abortion is suspected
which of the following procedures is most appropiate for identifying the microbial agents causing her infection ?
a.-inoculation of anaerobic transport media at the bedside
b.-inoculation of the specimen into tissue culture
c.-quantification of the bacteria in the discharge by using a calibrated inoculating loop
d.-streaking a swab specimen onto Thayer-Martin media at the bedside
e.-use of Lowenstein-Jensen and Sabouraud for media for acid-fast bacteria and fungi,respectively
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| nadiabarati
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d??
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| Cedrick
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yes I was thinking b or d
but since tehere is supected septic abortion ?
B?
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| robin082006
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A
Most septic abortion causes by anearobic bacteria so I go with A (Bacteroides)
Edited by robin082006 on 06/19/06 - 11:10 PM
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| Cedrick
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That was my first choice!!!
then I thought too much
Thanks
A
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| bactitech
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Our laboratory does NOT accept specimens for anaerobes on vaginal/cervical specimens UNLESS they are collected intrauterine from an OR situation. Our laboratory would reject this specimen, as there are normal anaerobes in the vagina. No micro lab in their right mind would allow docs or nurses to inoculate their media at the bedside. They would require you to use proper anaerobic transport media, which can differ by institution. Be sure to check with your own micro lab for proper procedures AND acceptable specimens for these types of cultures.
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| klimt
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maybe practically A is not the best ans, but theoretically it seems so.....
still, if it's not A, then what's the next best and?
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| bactitech
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I'm sure they want A. However, it is impractical in real life. Memorize what you want for your tests, realizing that real life is not like Kaplan in many ways....
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| jsknetsdude
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Two major factors contribute to development of septic abortion.
Retained products of conception due to incomplete spontaneous or therapeutic abortion
Introduction of infection into the uterus - Pathogens causing septic abortion usually are mixed and derived from normal vaginal flora and sexually transmitted bacteria. These organisms include the following:
Escherichia coli and other aerobic, enteric, gram-negative rods
Group B beta-hemolytic streptococci
Staphylococcal organisms
Bacteroides species
Neisseria gonorrhoeae
Chlamydia trachomatis
Clostridium perfringens
Mycoplasma hominis
Haemophilus influenzae
http://www.emedicine.com/EMERG/topic10.htm
B: Seems odd but .. you cant point to specific organism you have to do culture and then select
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