Case 3: Genitalia
A 21-year-old college student reports to your clinic with external bumps on her genital area. The bumps are painless and feel rough. The patient is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. The patient reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She had one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
To prepare:
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Write a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
Use resources not older than 5 years.
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. Chapter 18, “Female Genitalia” (pp. 535–599)
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.Chapter 11, “The Female Genitalia and Reproductive System” (pp. 541–562)
Assessing the Genitalia
Different people experience different symptoms of different diseases. This study delineates on various aspect concerning a case involving a 21-year-old girl reported with external bumps on her genital area. Two years ago, she completed the treatment of Chlamydia.
In this case, history of the girl is important to helping understand what the girl is suffering from. History necessary in this case, is whether the girl has had sexual intercourse, whether she had suffered from any sexually transmitted disease before, whether she has heard multiple partners before, the last time she went for testing and if had sex, whether she used any kind of protection during sexual intercourse (LeBlond, Brown & DeGowin, 2009). This will help to relate the experiences and symptoms to the likely disease the patient is suffering.
Physical examination and diagnostic tests are appropriate to gather more information about the condition of the patient. Physical test will include pelvic examination, while diagnostic tests will include lab analysis of cervix and urine, carrying out of blood and saliva sample test to find out healthcare the girl has STDs (Seidel, Ball, Dains, Flynn, Solomon, & Stewart, 2011). These tests will help to make a diagnostic through examining the symptoms. For instance, in case the patient has HIV Virus, the test will indicate two lines on the testing kit indicating that she has HIV virus. This then will guide in the provision of appropriate medical interventions.
Five possible conditions that may be considered in a differential diagnosis for the patient include genital herpes, syphilis, gonorrhea, genital warts, and HIV/AIDs.
References
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical. Chapter 11, “The Female Genitalia and Reproductive System” (pp. 541–562)
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. Chapter 18, “Female Genitalia” (pp. 535–599)