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What cell types make up the cervix and where are they located Columnar epithelium endocervix Non-keratinizing squamous epithelium ectocervix Inflammation of the endocervix most commonly caused by sexually transmitted organisms It is characterized by a yellow-greenish mucopurulent discharge on visual inspection or on an endocervical swab specimen 1 C trachomatis: gram-negative, obligate intracellular bacterium

.

What is mucopurulent cervicitis (MPC)

people, and they like the challenge of playing against a human rather than an artificial opponent There is an enormous number of game-show style games available for free on the Internet; they re cheap to develop and quick to download Most of them make their money through advertising, because they don t offer a rich enough experience to charge for The other branch of proprietary online games is the persistent world that I talked about in the last chapter These require vast investments to build, and ongoing expenses to maintain, and they make their money through monthly subscriptions Persistent worlds need just about every skill the game industry uses: ordinary game programmers and also programmers skilled at working with networks and servers; artists, animators, and musicians; game designers, level designers, and writers And unlike retail games, where the developers usually move on to another project as soon as the previous one is done, persistent worlds need people on a continuing basis It s a little like the difference between a movie and a theme park: the cast and crew of a movie can go home once the filming is done, but a theme park needs employees every day that it s open and it needs to change and expand from time to time to keep people coming in Online games present a number of design and development challenges that don t exist in games that are only played on one machine The game must be scrupulously fair, and it should not be possible for players to manipulate the system to gain an unfair advantage It also needs to respond well to the sudden disappearance of one of the players, since people can log on and off at any time Online games require facilities for people to get together and talk about the game, brag boards that show who are the best players, customer service agents to help solve problems and moderate disputes, and a great many other features that non-networked video games don t have to bother with Now that game consoles are starting to have modems, online games will become important for them as well However, the primary reason for playing an online game is to communicate with other people, and at the moment that still means typing Since consoles don t routinely come with keyboards, this will limit their appeal As customers move to broadband Internet connections, we can expect to see voice communication between online players, but that is still a few years off In any case, online games for consoles are in their infancy at the moment, and promise to be an area of significant growth in the years to come.

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2 Neisseria gonorrhoeae: gramnegative diplococci What is ectocervicitis Inflammation of the ectocervical epithelium This squamous epithelium is an extension of the vaginal epithelium and can be infected by the same organisms that cause vaginal infections Trichomonas: strawberry cervix (small petechiae to large punctuate hemorrhages on the ectocervix) HSV: ulcerative and hemorrhagic lesions/vesicles during the primary infection HPV: genital warts, cervical dysplasia on Pap smear What age group is most frequently affected with cervicitis What are the typical symptoms of MPC 15 25 year olds Vaginal discharge, dysuria, urinary frequency, dyspareunia, postcoital bleeding A tender, friable cervix that may also be erythematous and/or edematous Patients infected with C trachomatis or N gonorrhoeae are frequently asymptomatic! What laboratory test supports a diagnosis of MPC How is the diagnosis of each of the following organisms made >30 polymorphonuclear (PMN) leukocytes on a Gram-stained specimen from the endocervix C trachomatis: cell culture (gold standard, but difficult), nucleic acid amplification tests (NAAT) from urine, DNA probe, enzyme immunosassay N gonorrhoea: Thayer-Martin agar culture (gold-standard), DNA probe, enzyme immunoassay T vaginalis: visualization of motile trichomonads on wet mount HSV: Tzanck smear test, serologic testing, viral culture HPV: clinical appearance, cytology

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