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  #1  
Old 04-23-2010
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ObGyn Gynecologic Infection Diagnosis?

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
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Old 04-23-2010
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Default Answer is A

This seems to be gonococcal infection and they should be cultured on Thayer Martin.
DNA probe is for HPV
Capsular serology is for GBS which is Gram positive not negative
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Old 04-24-2010
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yes i agree. the answer is definitely A (gonorrhea)
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Old 04-25-2010
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i tot of A as the ans when i read the question but unfortunately B is the correct ans.
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Old 04-26-2010
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I think it s B because they say which procedures would most likely lead to the correct diagnosis. The answer A is probably wrong cause they talk about blood culture which is for neisseria meningitidis. Even the endocervical smears are more difficult to interpret due to the presence of other Gram-negative coccobacilli. Therefore, the sensitivity for endocervical smear is 50% to 70% .So ,DNA probe assays is the best way to confirm the diagnosis
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Old 04-26-2010
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Quote:
Originally Posted by getting99 View Post
This seems to be gonococcal infection and they should be cultured on Thayer Martin.
DNA probe is for HPV
Capsular serology is for GBS which is Gram positive not negative
DNA probe assay s not only for HPV.Tey can even use it it for detection of chlamydia trachomatis
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Old 04-27-2010
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Quote:
Originally Posted by sam01 View Post
I think it s B because they say which procedures would most likely lead to the correct diagnosis. The answer A is probably wrong cause they talk about blood culture which is for neisseria meningitidis. Even the endocervical smears are more difficult to interpret due to the presence of other Gram-negative coccobacilli. Therefore, the sensitivity for endocervical smear is 50% to 70% .So ,DNA probe assays is the best way to confirm the diagnosis
oh ic.. thanks.
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