Please answer each case study individually with answering all the questions with
ID: 261379 • Letter: P
Question
Please answer each case study individually with answering all the questions with at least 20 senstences total for EACH CASE STUDY!!!
This 16-year-old female presented to the emergency room of an urban medical center with complaints of crampy abdominal pain for days and vaginal bleeding. She denied symptoms of urinary tract infection and abnormal vaginal discharge and had not noted any chills or fever. She had no nausea or vomiting. The pain increased in the 24 hours prior to presentation, and at the time of examination she also noted pain in the right upper quadrant. She was sexually active with one male partner in the preceding 3 months, and claimed to use CASE condoms as a method of birth control. She is the mother of one child. On examination, her temperature was 38.3 °C, and there was exquisite ten- derness in the right upper quadrant as well as the left lower quadrant. No rebound tenderness or guarding was noted. On pelvic exam, cervical motion tenderness was present, as well as right and left adnexal tenderness. No masses were palpated . Clinically, this patient was believed to have pelvic inflammatory dis- ease (PID) and was admitted to the hospital for antibiotic treatment. What bacteria have been associated with PID 2. An endocervical swab was obtained from the patient and used to inoc- ulate McCoy cells. After 48 hours of incubation, the McCoy cells were stained with an immunofluorescent reagent that demonstrated the presence of inclusions (Fig. 1). This finding established the presence of what infectious agent? Briefly describe the life cycle of this organ ism in McCoy cells 3. In addition to PID, in which this organism may well have a significant role, in what other clinical situations might this organism be expected to be recovered? 4. Tissue culture is one of several methods used to detect this organism in clinical specimens. What other methodologies currently exist? How do they compare with tissue culture with respect to sensitivity? . How effective are beta-lactam antibiotics in treating infections caused by this organism? What is the rationale for using a beta-lactam in addition to doxycycline in this patient's therapy? What else should be done epidemi- ologically in cases of PID? 6. What type of screening strat- egy has been used successfully to prevent PID? What popu- lations have a high prevalence of chlamydial infection What are the potential conse- quences of PID Figure 1Explanation / Answer
Case 3:
1.
Neisseria Gonorrhoeae and Chlamydia Trachomatis are two organisms associate with PID.
2.
Chlamydia trichomatis has small G shaped intracellular bacteria with noninfectious reticulate form and infectious elementary body. It is most sexually transmitting disease in world.
An endocervical swab was obtained from the patient & used to inoculate McCoy cells, after 48 hours of incubation, the McCoy cells were stained with an imunnofluorescent reagent that demonstrated the presence of inclusions. All Chlamydia are anaerobically performing their metabolism using fermentation of various body fluids including vaginal fluids and they perform biphasic life cycle with both infectious replication & non-replicative phases in McCoy cells.
Chlamydia bacteria are ovoid in shape and they are non-motile. They do not produce spores but possess infectious elementary bodies to release into the host cells.
4.
Two method to detect : Nucleic Acid Amplification Tests and a Liquid Pap Smear Medium.Nucleic Acid Amplification Tests have higher sensitivity, more specific and ease in specimen transport.
5.
Beta-lactam antibiotics in treating infections caused by this organism:
Beta -lactum antibiotics such as penicillins, sulfonamides contain beta-lactum ring in their structures, examples include penicillin, cephalosporins, carbapenems and monobactum antibiotics. They act in inhibiting the cell wall synthesis, therefore they considered as bactericidal. These antibiotics are generally effective against Gram positive bacteria and some are also effective against gram negative bacteria. Examples include staphylococcus species, streptococcus species. Doxycycline is going to inhibit protein synthesis of "this microbial species" because beta-lactum are essential to act "against drug resistance properties of microbes". The other epidemiological studies are needed to perform endocervical swab test to determine any presence of Neisseria gonorrhoeae that cause PID
These penicillins are active against the gram- positive bacteria and they act by inhibiting the cell wall synthesis. Transition state analog of penicillin & enzyme: Chemical reaction of penicillin (beta-lactum ring) in reaction with N-C bond of D-ala-D-ala analog i.e. glycoproteinpeptidase finally result in formation of "transition state analog". The mechanism is mainly mediated by suicide inhibition of the enzyme irreversibly by reacting with enzyme.
note: upload rest of the questions again.