12.4: Scenerios for this Lab

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Students will be assigned either Case Study 1A, 1B, or 1C to do today. All students will do Case Study 2 as part of the results next time.

Case Study #1A

A 26-year-old female presents to her doctor complaining of 2 days of increased urinary frequency, dysuria, and sensation of incomplete voiding. Her abdominal exam indicates mild suprapubic tenderness. Her blood pressure is normal and she does not have fever, chills, costovertebral angle (CVA) tenderness, or vaginal discharge. She reports that she became sexually active with her new boyfriend one month ago. She and her boyfriend have sexual intercourse 3-4 times a week. She is using a combination of a diaphragm and spermicide for contraception. She is otherwise healthy. A microscopic examination of her centrifuged urine shows 9 white blood cells and 15 bacteria per high-power microscopic field. A urine dipstick shows a positive leukocyte esterase test and a positive nitrite test.

Assume that your unknown is from the urine of this patient.

Case Study #1B

A 90-year-old woman resides at an area nursing home. She shows signs of mild dementia, and because of severe arthritis and requiring a walker for ambulation, sits in a chair most of the day. She has not used any form of estrogen in at least 30 years. She also has a history of 4-5 confirmed urinary tract infections per year. This morning, her caregiver is unable to coax the patient out of her bed. She seems confused and disoriented. Vital signs reveal tachycardia in the 120â€™s, respirations at 24/min, and a blood pressure of 78/49. She is immediately taken to an ER for evaluation. A CT of the abdomen and a chest x-ray appear normal. She has a WBC count of 2300/μL. She continues to exhibits marked confusion compared to her baseline and is exhibiting anxiety. Urine and blood samples are taken and sent for culture and sensitivity
Assume your unknown is from both a urine sample and a blood sample.

Case Study #1C

A 79-year-old man living in a nursing home has COPD, a lifetime history of heavy smoking, and hypertension. His caregivers note that he is exhibiting rigor, has a temperature of 103°F, and lacks his normal alertness. Vital signs include a blood pressure is 165/90, a pulse of 128 beats per minute, a respiratory rate of 32 breaths per minute, and a pulse oximetry on room air of 80%. He is transferred to an acute care facility where a chest X-ray reveals a right lower lobe infiltrate and his white blood cell count is 18,000/μL with a marked left shift. He has thick, foul-smelling yellow-green sputum.

Assume youR unknown is from the sputum sample.

Caution

CAUTION: TREAT EACH UNKNOWN AS A PATHOGEN!. Inform your instructor of any spills or accidents. WASH AND SANITIZE YOUR HANDS WELL before leaving the lab.

Contributors and Attributions

Dr. Gary Kaiser (COMMUNITY COLLEGE OF BALTIMORE COUNTY, CATONSVILLE CAMPUS)