Genital Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Genital and links to relevant pages within the course.
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| Clinical Significance No blood is found in the urine of healthy individuals although samples from menstruating females, frequently, but not always, test positive for blood. Hematuria is associated with renal or genital urinary disorders in which the bleeding is the result of irritation to the involved organs or trauma. Examples include renal calculi, pyelonephritis, glomerulonephritis, tumors, trauma or exposure to toxic chemicals or drugs and/or strenuous exercise. Hemoglobinuria may be due to the lysis of red cells within the urinary tract. If it is caused by intravascular hemolysis, the hemoglobin is then filtered through the glomeruli. In the normal individual, the hemoglobin molecule attaches to haptoglobin and in this way bypasses the kidney filtration system. When the hemoglobin/haptoglobin system is overwhelmed, as in cases of hemolytic anemia, severe burns, transfusion reaction, infection or strenuous exercise, hemoglobin passes into the urine. | View Page |
| A 25 year-old female presented in the emergency room with an acute urethral discharge of 2 days duration. A smear for gram stain was obtained (see accompanying image). Many polymorphonuclear leukocytes and intracellular and extracellular gram negative diplococci were observed.
Based on the clinical history and the gram stain observation, a diagnosis of gonorrhea can be made. | View Page |
| How is HBV Spread? Hepatitis B most often spreads when certain body fluids from an infected individual come in direct contact with another person.Contact may occur through:
a break or sore in the skin
a contaminated sharp
contact with mucous membranes that line the insides of the mouth, nose, eyes, and the genital organs.
HBV is not spread through casual contact, such as handshake, or through sweat. | View Page |
| Significance of Specific Findings: Epithelial cells in large numbers within sputum smears means that the specimen is predominantly oral saliva, rather than true sputum from the lung. Epithelial cells in urine smears indicate that the sample has been contaminated by organisms found on the vulva or distal urethra. Bacteria found near or on epithelial cells are usually normal contaminating bacterial flora.White blood cells indicate inflammation and possible infection. The direct smear examination should focus within and around these cells.Red blood cells in a direct smear are not usually significant.Yeast may be present as normal flora in upper respiratory tract or genital tract. They may be significant if they predominate, or if budding yeast forms are seen.Hyphae are more likely to indicate the presence of fungal infection, but this determination requires correlation with clinical findings.Bacteria found in spinal fluid, blood, tissue and specimens from other sterile sites are always significant.Body fluids which are normally sterile must be examined carefully. If only one organism per oil immersion field is identified, then there are about 105 organisms per mL present in the sample! Bacteria observed in specimens from the throat, genital tract and other areas containing normal flora suggest infection only if their composition and type varies significantly from the norm. | View Page |
| Reporting Genital Smears Direct smears read specifically for the presence of gonococci should include a direct reference to gram negative intracellular diplococci.
| View Page |
| Reporting Direct Smear Results Direct smear results are generally reported in the same way that they are read, except that bacterial cell arrangement (ex: clusters, chains, pairs) may be misleading and is generally not reported except in the case of intracellular diplocci in genital smears. | View Page |
| Special Considerations for Genital Smears Gram negative cocci which occur in pairs with their adjacent sides flattened, giving them a coffee bean appearance, are typical of the genus Neisseria. Neisseria gonorrhea is commonly found within white blood cells; these organisms must be carefully sought within genital tract specimens, and their presence or absence should be specifically noted in the report.The presence of intracellular gram negative bacilli in a purulent male urethral smear is presumptive evidence of gonococci, but this assumption cannot be made in a female. Beware of other organisms which resemble gonococci but are found extracellularly, such as Acinetobacter lwoffi, which must be distinguished biochemically. | View Page |