Case Scenario 2

Table 1
Infection Description Presentation Causes/ Risk Treatment per Addtl info
Factors CDC
Candida Fungus- Vaginal Hormonal Topical If left
caused yeast swelling, changes, creams, untreated, it
infection. itching, pregnancy, including can spread to
redness, and uncontrolled miconazole other parts of
burning. diabetes, and and antifungal the body,
weak medications, causing the
immune including symptoms to
system. fluconazole be more
severe.
BV Caused by Strong fishy With a weak Antibiotics, It increases
bacteria odor and immune including STDs’ risk and
overgrowth. grayish-white system, clindamycin even risk for
thin vaginal many or HIV.
discharge. sexual metronidazole
partners, .
smoking, and
douching.
Chlamydia Caused by a Pain or burning Smoking, Antibiotics, It can cause
bacterial sensation when having including complications
infection urinating and unprotect doxycycline like pelvic
transmitted lower ed sex, weak and inflammatory
through abdomen immune Azithromycin. disease if left
sexual pain. system, untreated.
intercourse. multiple
sexual
partners, and
engaging in
sexual
intercourse
with a person
with STDs.
Gonorrhea Bacteria- Abdominal Multiple sex Cefixime or Delayed
caused STI. pain, partners, ceftriaxone treatment can
urinating pain, smoking, antibiotics result in pelvic
and discharge unprotected inflammatory
from the penis sex, having a complications.
or the vagina. partner with
the STI.
Trichomonas Yellow-green Weak Tinidazole or A woman’s
Parasite- vaginal immune Metronidazole risk of
caused STI. discharge, system, antibiotics. contracting
swelling of the unprotect STIs and HIV
 vulva, and ed sex, can be
burning or smoking, and increased by
itching. multiple delayed or no
sexual treatment of
partners. trichomonas.

Cervicitis Cervix Yellow-green Weak Azithromycin Pelvic

inflammation vaginal immune or inflammatory
caused by discharge, system, doxycycline disease or
infection vulva swelling, unprotect antibiotics. complication
itching, and ed sex, results if
burning. having a sex Cervicitis is
partner with left untreated.
an STD, and
smoking.
PID It is a Abnormal Weak Ceftriaxone or Delayed
reproductive vaginal immune doxycycline treatment can
organ discharge, system, antibiotics. result in
infection. tenderness, having a sex infertility.
fever, pain in partner with
the lower an STD,
abdomen, and smoking,
pain during having
sexual unprotected
intercourse. sex, and
having many
sexual
partners.
HIV HIV is a Swollen lymph Having a Efavirenz or Delayed or no
virus that nodes, fever, sexual emitricitabine treatment of
destroys night sweats, partner with antiretroviral HIV results in
immunity. rash, and HIV, having medications. AIDS.
tiredness. unprotect
ed sex, and
sharing sharp
objects with
an infected
person.
Syphilis Caused by It manifests Contact with Penicillin If left
spirochete through genital biological dose. untreated, it
treponema sores, rash, fluids, can result in
pallidum. joint pain, including long-term
fever, and semen, health issues,
fatigue. blood, and including
vaginal neurological
secretions damage, heart
 from an sickness, and
infected stroke.
person,
having
multiple sex
partners, and
having
unprotected
sex.
Hep B It is caused Stomach pain, Sharing Antiviral It can cause
by contact fever, black needles for medications. chronic liver
with bodily urine, drug use, disease,
fluids or exhaustion, having cirrhosis, and
blood of a and yellow unprotected liver cancer if
person with eyes or skin. ed sex, and not treated.
hepatitis B. having many
sexual
partners.
Hep C It is caused Stomach pain, Sharing Antiviral It can cause
by contact fever, black needles for medications. chronic liver
with bodily urine, drug use, disease,
fluids or exhaustion, having cirrhosis, and
blood of a and yellow unprotected liver cancer if
person with eyes or skin. ed sex, and not treated.
hepatitis C. having many
sexual
partners.
HSV HSV is Manifests It is spread Valacyclovir It can spread
associated through sores through and acyclovir even with no
with or small contact with antiviral symptoms and
infection painful blisters bodily fluids medicines and is very
caused by the on the skin, or skin of an practicing contagious.
virus. It is fever, enlarged infected good hygiene.
caused by lymph nodes, person,
contact with headache, and sharing
bodily fluids muscle aches. drinks, food,
or the skin of or objects
an infected with an
person. infected
person, and
having
sexual
contact with
an infected
person.
Table 2
 Question Answer
Name 10 Risk Factors for contracting STIs Multiple sexual partners, contact with bodily
and HIV fluids, unprotected sex, being young, history
of STIs, forced engagement into sexual
activity, smoking, injecting drugs,
recreational drugs, misuse of alcohol, and
sharing sharp objects.
Name five safer sex practices. Abstinence, limiting the number of sex
partners, disinfecting shared sex toys, using
contraception or protection including condom
use, and testing for health status before sexual
intercourse.
Can HIV be transmitted through sweat, saliva, No, unless the sweat, tears, or saliva are
and tears? (Include rationale) mixed with blood containing the virus.
Name two types of intercourse are at the Receptive anal sex and receptive vaginal sex.
highest risk for contracting HIV
Why are women more susceptible to HIV in a This is because women during penile
male-to-female relationship (versus a male penetration, women have greater mucus area
contracting it from a female)? exposed to HIV.

Tina is a 27-year-old female who presents to the clinic complaining of a painful burning
sensation in her left labial area for three days. She reports recently having unprotected vaginal
intercourse with a new male partner. Upon examination, you note fluid-filled vesicles on the left
labia minora that are painful to touch.
Write a brief SOAP note regarding this patient. Make sure to include your answers to these
questions in your SOAP note.
1. Subjective:
a. What other relevant questions should you ask regarding the HPI?
 Does the patient have symptoms of discharge, itching, or burning?
 How frequently has she engaged in sexual activity with her partner?
 Does Tina have any STI history?
b. What other medical history questions should you ask?
 What is the current list of medications used by Tina?
 Does the patient have any underlying medical condition that could affect treatment and
diagnosis?
 Does she have any food or medication allergies?
c. What other social history questions should you ask?
 What is the living situation or occupation of the patient?
 Does Tina have a mental health history or a history of substance use?
 Does she have STI risk factors?
2. Objective:
a. Explain what POCT you will order and perform, and discuss your rationale for ordering
and performing each test.
The tests to order include:
 Blood test: To check for infection.
  Urine test: To identify any existing infection.
 Genital swab: To detect DNA presence from pathogens.
 Vaginal swab: To identify the parasitic, bacterial, and fungal organisms’ presence.
 The rationale for performing and ordering these tests is to determine the patient's
symptoms. The genital swab and urine tests assist in identifying the exact parasite,
bacteria, or fungus causing the infection, while blood tests will identify any underlying
infection.
3. Assessment/ Diagnosis:
a. What are your presumptive and differential diagnoses, and why?
 Presumptive diagnosis: Genital herpes. This is because of the fluid-filled vesicles’
presence on the left labia minora, which is a symptom of genital herpes.
 Differential diagnosis: Yeast infection, chlamydia, syphilis, gonorrhea, and
trichomoniasis. This is because they are STIs.
b. Is there any other diagnosis or differential diagnosis you would like to add?
 Other differential diagnoses: pubic lice, bacterial vaginosis, and scabies.
4. Plan:
a. What will you prescribe for this patient? Why? (Assume one of your lab test results is
positive), Explain what medications and treatments you would recommend
 The prescription medication for this patient would be antiviral medications, including
valacyclovir or acyclovir. These would reduce the risk of the virus spreading and lessen
the duration of symptoms.
b. Explain treatment guidelines and side effects, including any possible side effects of the
medication and treatment(s), partner notification, and follow-up care plan.
 Treatment guidelines- Even if the symptoms disappear or improve, take medications as
prescribed. Practice safe sex and use condoms to protect against the spread of STIs,
maintain good hygiene, and undergo checkups regularly.
 Treatment side effects- Itching or skin irritation caused by topical medications.
 Partner notification- The patient should inform the sex partner of her diagnosis and ask
them to get tested for their health condition.
 Follow-up plan- Make appointments to identify new or worsening symptoms, monitor the
patient's symptoms, and evaluate the effectiveness of medications prescribed.
c. What patient education is important to include for this patient? (Consider when the
patient can resume sexual activity.)
 The patient should be educated about genital herpes prevention and transmission, when it
is safe to resume sexual activity, and when to expect the symptoms to disappear.
d. Explain complications that can occur if the patient does not comply with the treatment
regimen.
Please refer to evidence-based guidelines to support your decision-making.
 Non-compliance to treatment may result in resistance of the virus to medication or
worsening of Tina's symptoms. The patient may also spread the virus to uninfected
individuals. Complications such as high HIV transmission risk, inflammatory disease,
and infertility may result from untreated infections.