Family Nurse Practitioner Exam

What is the recommended method for diagnosing gonorrheal pharyngitis or proctitis?

1. Serum chlamydia titer

2. Gen-Probe

3. Thayer-Martin culture

4. Culture and sensitivity of the purulent discharge

The correct answer is: Thayer-Martin culture

The recommended method for diagnosing gonorrheal pharyngitis or proctitis is through specialized culture techniques, specifically using a Thayer-Martin culture. This medium is designed to isolate Neisseria gonorrhoeae, the bacterium responsible for gonorrhea, by inhibiting the growth of other organisms. Thayer-Martin culture contains antibiotics that suppress the growth of competing flora in the pharynx or rectum, making it easier to identify the presence of the pathogen. In cases of suspected gonorrheal pharyngitis or proctitis, laboratory culture is crucial because it not only confirms the diagnosis but also allows for antibiotic susceptibility testing. This is especially important given the rising rates of antibiotic resistance among gonorrhea strains. Other methods, while useful in specific contexts, are not the first-line approach for confirming a diagnosis in these particular locations. For example, serum chlamydia titers do not provide direct information about gonorrhea and are more relevant for identifying chlamydia infections, which often co-occur but require different diagnostic approaches. Gen-Probe is a nucleic acid amplification test that may offer good sensitivity but is less commonly employed specifically for pharyngitis or proctitis when direct culture is available. Culture and sensitivity