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  #1  
Old 04-13-2010
Yallah's Avatar
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Question Which virulent factor here?

A 23 year old female came to the physician because of three days history of fever, nausea, and vomiting. Plus 4 days history of urgency and dysuria. PE showed suprapubic and flank tenderness. Urine exam showed 30WBC/hpf. Which of the following best describe the virulence factor of the most likely causal organism?

A- P pilli
B- M protein
C- Protein F
D- Lipoteichoic acid
E- Pyrogenic exotoxin
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  #2  
Old 04-14-2010
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Default is it D

is it D-lipotechoic acid of gram - cell wall? this is E.coli ryte?
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Old 04-14-2010
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Default I don't think so

Quote:
Originally Posted by Seetal View Post
is it D-lipotechoic acid of gram - cell wall? this is E.coli ryte?
Teichoic acid is seen in Gram positive not Gram negative organisms
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Old 04-15-2010
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Default oops

Quote:
Originally Posted by JaJeeK View Post
Teichoic acid is seen in Gram positive not Gram negative organisms
oh damn... u're absolutely right. what was i thinking. so then P pili?
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Old 04-15-2010
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Default It's a staph

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Originally Posted by Seetal View Post
oh damn... u're absolutely right. what was i thinking. so then P pili?
I think the answer is M protein.
this girl is young and staph saprophyticus is likely here
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Old 04-15-2010
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Default

I think it's Neisseria, causes Urthritus, and PID which would explain the flank pain and dysuria. It's a gram-ve so can't be B/D/E that leaves A or C, and to be honest I can't remember if there is even a protein F so i pick A
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Old 04-15-2010
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Default It's A for sure

Yes, that's an easy question.
The girl is having E.coli pyelonephritis and the virulence factor is definitely P pili there's no doubt about this.
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Old 04-15-2010
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Default

i think the patient has pyelonephritis-associated pili. she has ascending infection to the renal pelvis due to E COLI infection ,ie vesicoureteral reflux of urine .the suprapubic pain is due to cystitis and the flank pain,fever wbc cast etc...is due to pyelonephritis.so the virulence factor for e coli adherence to the uroepithelium is the p-pili.
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  #9  
Old 04-16-2010
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Question

hmm.. no definite answer posted on this one. so then for sure we settling on P pili of E.coli?
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