GYN

Based on the case study scenario provided, complete a comprehensive well-woman exam and critically analyze to focus attention on the diagnostic tests then, Post your differential diagnosis. Include the additional questions you would ask the patient. Be sure to include an explanation of the tests you might recommend, ruling out any other issues or concerns and include your rationale. Be specific and provide examples. Use your Learning Resources and/or evidence from the literature to support your explanations.

ANSWER

GYN

Introduction

The case study focuses on a 24-year-old Caucasian female, Susan Lang, who presented to the clinic for regular care. Susan works full-time as administrative assistance and relates very well with what she does. She has no records of medical, surgical, or allergic history. She has been smoking and takes hard liquor daily. She complains of having postcoital bleeding for the last six weeks and has had a sore throat for the last three weeks. She also complains of fever which was taken care of. Susan’s physical examination shows a slight frothy yellow discharge by the cervix and a clitoral piercing. She has had thirteen partners for the last twelve months and reports no history of sexually transmitted infections. This paper will focus on Susan’s condition and critically analyze the primary diagnosis and the treatment options.

Primary Diagnosis

The primary diagnosis for Susan’s condition is TrichomoniasisTrichomoniasis, a well-known sexually transmitted infection by a parasite. In most females, the infection can lead to painful urination, general itching, redness, burning, and foul-smelling vaginal discharge. Anyone sexually active can get affected. However, it highly affects women as compared to men. Women get an infection on their lower genital tract in their vagina, vulva, urethra, and cervix.

Trichomoniasis spreads during sex when infected individuals pass it to another either from the vagina to the penis or from the penis to the vagina (de Brum Vieira, Tasca, and Evan Secor, 2017). Other minor symptoms may include pruritus, erythema, inflammation, and dysuria. The clinical assessment shows that Susan presents some of the major symptoms of TrichomoniasisTrichomoniasis. She has a slight frothy yellow discharge on the cervix. She has a sore throat, which may occur due to oral sex. She also has had sex with thirteen different partners who have not been tested for sexually transmitted infections.

Additional Questions

• How much do you earn for a living?
• Are you able to sustain your needs through the kind of work you engage in?
• Do you believe that one can get infected with STIs?
• Do you ever feel frightened or fearful of your sexual partners?
• Do you ever feel forced to engage in sex?
• In the past three months, have any of these partners been diagnosed with an STI?
• How many sex partners have you had in the last three months?
• Have you experienced any soreness, burning, or itching on the lower genital tract?
• How do you protect yourself from sexually transmitted infections?
• Have you ever received any education on the spread and effects of sexually transmitted infections?

Diagnostic Tests

The most effective diagnostic test is Nucleic acid amplification test and microscopy test. Nucleic acid detection relies on a nucleic acid sequence to identify and detect particular species such as T vaginalis (Kissinger, 2015). Microscopy test entails a detection through microscopic examination through a wet mount preparation of the vaginal secretions. The microscopic observation will detect the protozoa from the vaginal secretions. A positive result will indicate the presence of Trichomonas vaginalis infection.

Treatment Options

Trichomoniasis raises the risk of spreading other sexually transmitted infections. Trichomoniasis can be treated through antibiotic medication like tinidazole and metronidazole, which effectively clears up the infection in most individuals (Lewis, 2014). The treatment eliminates the parasites, but one can get infected again within three months of treatment. Trichomoniasis can be avoided by preventing vaginal sex through condoms, sticking to one partner, and talking openly with sex partners about sexual histories and the risks of infection.

References

de Brum Vieira, P., Tasca, T., & Evan Secor, W. (2017). Challenges and persistent questions in the treatment of TrichomoniasisTrichomoniasis. Current topics in medicinal chemistry, 17(11), 1249-1265.

Kissinger, P. (2015). Epidemiology and treatment of TrichomoniasisTrichomoniasis. Current infectious disease reports, 17(6), 31.

Kissinger, P. (2015). Trichomonas vaginalis a review of epidemiologic, clinical, and treatment issues. BMC infectious diseases, 15(1), 1-8.

Lewis, D. (2014). Trichomoniasis. Medicine, 42(7), 369-371.