Friday, April 29, 2011

ALEXMED pon ade sini pon ade..


T.Pallidum

i) Name serological test: CAT (cardiolipin) & TAT (treponemal) . BOTH USE FOR diagnosis and monitoring treatment and follow up.
Importance of CAT :
·          +ve 10-14 days after appearance of chancre
·         -ve in early primary syphilis
·         +ve screening test so..should be confirmed with TAT…and repeating the CAT
·         Quantitative (gradual increase with progress of disease)
·         Can be used to follow therapy
·         False +ve result
False +ve: malaria
            : measles
            : Infectious mononucleosis
            : leprosy
            : collagen vascular disease ( SLE )
            : drug addiction

TAT      -FTA Abs : most sensitive,1st become +ve in early..remain +ve for many years..
                        Disadvantages : cannot be used to judge efficacy of treatment
            -TP-PA :  performed in microdilution plate.

ii) Test use to diagnose 1ry stage
§  Dark ground microscopy - for motility
§  Flourescein  labeled anti treponemal serum - for antigen
§  NA probes and PCR – for DNA
§  CAT –ve but TAT +ve
iii) Differences HARD and SOFT chancre.
HARD
SOFT
Produce by T.Pallidum
Produce by H.Ducreyi
Never be culture on culture media.
Grow on choc agar.

iv)Specime collection for EVERY STAGES.>
1ry STAGE
-Exudate from chancre (squeezed gently using gloves) BLEEDING should be avoided (RBC mask the spirochetes)
2ry STAGE
-Exudate from skin lesions, mucous patches or condyloma lata
LATENT SYPHILIS
-Serum sample
LATE SYPHILIS
-Serum sample
-CSF sample (active neurosyphilis)

N.GONORRHOEA
i) Selective media used : THAYER MARTIN > consists of VCN
v  Vancomycin - Gram +ve bact
v  Colistin - Gram -ve bacilli
v  Nystatin - Fungi
ii) Specimen collection ( acute/chronic in males and females )
ACUTE
CHRONIC (org. very few in no. / totally absent)
Urethral discharge from men
Morning urethral drop
Prostatic secretion
Urethral discharge from female
Cervical secretion
Swab from cervix uteri

iii) Culture done in acute stages
ü  Confirm the diagnosis
ü  Isolate the organism to determine its sensitivity to different antibiotics
ü  Medico-legal proceeding
Repeated gonococcal infection common
ü  Protective immunity to reinfection does not appear
ü  Antigenic variation

MYCOPLASMA
i) General character:
Ø  Smallest – so can pass through bact filters
Ø  Lack of rigid wall, bounded by triple layered membrane
Ø  Complete resistant to penicillin, so inhibited by tetracycline or erythromycin
Ø  Reproduce in cell free media – grow on agar rich sterols
Ø  Inhibited by specific Ab
Ø  Do not revert to, or originate from bact parental forms
Ø  Affinity to mammalian cell membrane by special terminal adhesion proteins
ii) What are genital mycoplasma (urogenital mycoplasma) : Mycoplasma Hominis
                                                                                                : Ureaplasma urealyticum
Iii) Disease caused by genital mycoplasma
Mycoplasma Hominis
Ureaplasma urealyticum
In females: 3P
-          Pyelonephritis
-          Post abortal or Post partum fever
-          Pelvic inflammatory disease
-          Salphingitis
In male not causing any..
In males : non gonococcal urethritis (10%)
In females : lung disease in premature, low birth weight infants

iv) Differentiate urogenital mycoplasma from others :
GROWTH INHIBITORS with specific antisera            BUT     differentiate ureaplasma urealyticum to M.Hominis by UREASE TEST (+ve in ureaplasma –ve in Hominis)
v) Specimen collection in urogenital mycoplasma affection
o   ONLY UPPER GENITOURINARY specimens are value – because both species frequently colonize the lower genitourinary of both sexes.
o   Urethral swabs or urine after prostatic massage in males.
o   Fetal membrane swabs and semen – part of investigation infertility
ALL SPECIMENS….put in STUART’s TRANSPORT MEDIUM & sent to lab.

CHLAMYDIAE
i) General properties :
§  Coccoid shape
§  Obligatory intracellular – deficiency in energy producing metabolic pathways
§  Types of NA DNA & RNA
§  Resemble cell wall Gram –ve bact, but no peptidoglycan layer
§  Complicated life cycle of reproduction by fission
§  Sensitive to sulphonamides
§  Contain ribosome and metabolic enzymes
§  Lack mechanism for metabolic energy production
ii) Classification & disease caused
Sites of infection
Disease
Organism ( serovars )
Eyes
Trachoma
Adult & neonatal conjunctivitis
C.T (A,B,Ba,C)
C.T (D-K)
Genital tracts
Male
Female
LGV
C.T (D-K)
C.T (D-K)
C.T ( L1-L3)
Respiratory
Pneumonitis of infants
Pharyngitis, pneumonia
Psittacosis
Pneumonia
C.T (D-K)
C.Pneumonia
C.Psittaci (avian)
C.Psittaci (ovine)

iii) Modes of transmission
Trachoma : eye to eye, droplet, hands, contaminated cloth and flies
Adult inclusion conjunctivitis: anto-inoculation of genital secretion or oral- genital contact (sexually active)
Neonatal conjunctivitis (ophthalmia nenonatorum) : passage through infected maternal birth canal.
C.psittaci from bird to human : Inhalation of dried birds faeces or feathers
TWAR strain C.pneumoniae  : human contact

P/s : what we've study in practical class shoulh be read...hopefully this time would get us easily get 15/15... 

3 comments:

  1. terima kasih banyak2 abang ibal yang kiut miut comel lagi merah..

    ReplyDelete
  2. iqbal:

    sama sama.. merah noo.. comei lagi tu.. alah.. sukanye.. hehe.. ni nak belanja makan. baek bagitahu nama.. haha..

    ReplyDelete
  3. sayang abg ibal..harap2 takde org jealous

    ReplyDelete