Gyn Lab Med Flashcards
lab tests used for diagnosis of chlamydial infection of the female reproductive tract
- Nucleic acid amplification tests (NAATs) PCR DNA probe
- culture/gram stain
- ELISA
NAATs for chlamydial infection
- urine or bodily fluid
- MC used, very accurate
culture/gram stain for chlamydial infection
- Culture swab from site of infection
- Tx empirically, can take 24-48 hrs for results
ELISA for chlamydial infection
- looks for antigens to pathogen
- less accurate than culture but second most specific
different serotypes of chlamydia trachomatis
- 18 total serotypes
- A, B, C cause trachoma**
- D-K cause STDs localized to mucosal surfaces
- L1, L2, L3 cause STDs that lead to lymphogranuloma venereum
lab tests used for diagnosis of gonorrheal infection of the female reproductive tract
- NAATs, PCR DNA probe:
- urine or bodily fluid
- MC used, very accurate
- Culture/gram stain:
- Culture swab from site of infection
- Tx empirically, can take 24-48 hrs for results *ELISA
- looks for antigens to pathogen
- less accurate than culture but second most specific
preferred lab testing method to confirm a clinical diagnosis of trichomonas
Wet mount prep: visualize T. vaginalis on slide
Describe the laboratory work up of a patient presenting with vaginal discharge
- pregnancy test
- culture
- wet prep
- +/- whiff test
recommended lab test for diagnosis of primary, secondary, latent, and neurosyphilis
- biopsy: Trepenoma Pallidum in lesion exudate or tissue using dark-field microscopy
- Rapid Plasma Reagin (RPR)
- VDRL (venereal disease research lab)
- treponemal
- FTA-ABS
RPR for syphilis
o Faster than VDRL
o Detects antibody directed against a cardiolipin-lecithin-cholesterol antigen
o Not specific for T. pallidum
o Reported as positive screen or negative screen
o Equally sensitive as VDRL for serum testing
o Positive within 7 days of exposure
o Decrease titers with time and/or treatment
VDRL for syphilis
o Slower than RPR
o The VDRL-CSF is the standard serologic test for CSF
• When reactive in the absence of contamination of the CSF with blood, it is considered diagnostic of neurosyphilis
o Detects same antibody as RPR
o 4X rise = active infection
Treponemal lab for syphilis
Measures antibody directed against T. pallidum antigens
FTA-ABS or MHA-TP for syphilis
o VERY specific – used to confirm a positive RPR or VDRL
o Negative test of CSF excludes neurosyphilis
lab tests used to work up a genital ulcer or ulcers
• Viral culture (definitive) • HSV DNA by PCR • RSR • VDRL • IgG and IgM -IgG = old infection, already have antibodies made -IgM = new infection is present
laboratory work up for suspected pelvic inflammatory disease
- Urinalysis: Exclude cystitis and pyelonephritis
- Cultures: Gonorrhea and chlamydia cultures
- Pregnancy test: All female patients of childbearing age with lower abdominal pain require a pregnancy test
- Wet Prep: Look for numerous WBC’s; PID is rare without a coexisting purulent endocervical infection
serotypes of human papillomavirus that are associated with condyloma acuminata
6 and 11
serotypes of human papillomavirus that are associated with cervical CA
- 16 and 18
- others that are high risk: 31, 33, 45, 52, 58
current recommended screening guidelines for cervical dysplasia utilizing Pap smears
- Age to begin screening: age 21 years. Women under 21 should not be screened regardless of the age of sexual initiation or other risk factors.
- Women 21-29: Screening alone every 3 yrs is recommended. For women 21-29 years of age w/ 2 or more consecutive negative cytology results, there is insufficient evidence to support a longer screening interval (>3 years). HPV testing should not be used to screen women in this age group
- Women 30-65: Should be screened with cytology and HPV testing every 5 years or cytology alone every 3 years
Indications for the use of CA-125
o Monitor cancer treatment
o Screen for ovarian cancer if you’re at high risk
o Check for cancer recurrence
using CA-125 as a screening
o A CA 125 test is not accurate enough to use for ovarian cancer screening in general because many noncancerous conditions can increase the CA 125 level.
-there are many conditions that can increase CA 125
