00:01
Okay, this question says, you have a 22 year old woman that presents with slight fever, a burning of urination, complaint of frequent urination and vaginal discharge, and a small lesion on the labia.
00:13
She reported that she was moderately sexually active and had three sexual partners in the past six months.
00:20
Her last sexual contact was about seven days earlier, and she had developed mild symptoms about five days earlier, beginning with a discharge from the vagina.
00:30
She began having pain on urination about three days earlier.
00:34
A urine analysis revealed a ph of 8 .2, some white cells, and a few red blood cells, and there was protein in the urine.
00:43
And it says a smear of the vaginal secretion showed a number of gram negative cocci.
00:49
So it says, what is your diagnosis here? so it is very likely that this patient has a sexual transmitted infection.
00:58
Okay, so they are asking us for the diagnosis here.
01:02
So the diagnosis here can be vaginitis, okay, because of the discharge, the previous information about a sexual contact seven days earlier, and that the symptoms started manifesting two days after that last sexual contact, and also pain on urination.
01:26
The urinalysis information are also matched with the diagnosis of vaginitis, and also with urethritis.
01:37
Okay, so this is the diagnosis for this patient.
01:40
And then it says, what was the most likely organism? well, in this case, vaginal discharge can be caused by many organisms, for example, chlamydia, and also gonococcus, okay, neisseria gonovae.
01:57
But in this case, chlamydia is not a gram negative cocci, okay, while neisseria gonovae is a gram negative diplococci.
02:11
So in this case, the most appropriate organism that is causing this patient's symptoms is this bacteria here, neisseria gonovae, okay.
02:20
And it says, describe the transmission.
02:23
Well, neisseria gonovae is mainly transmitted through sexual contact, including vaginal, anal, or oral sex with an infected partner.
02:31
It can also be passed from an infected mother to her newborn during delivery.
02:36
And rarely, neisseria gonovae can be transmitted through contact with infected bodily fluids or surfaces, such as sharing needles with an infected person or touching contaminated objects, okay.
02:47
And then it says, describe what clinical features are critical to your diagnosis.
02:51
Well, in this case, practically the critical features that lead to the diagnosis of urethritis with vaginitis in this patient caused by neisseria gonovae are complaints of frequent urination and burning on urination that practically indicate irritation and inflammation in the urethra, also the presence of white blood cells and protein in the urine that indicates an inflammatory response in the urinary tract.
03:16
The urethra is part of the urinary tract, remember...