Cases Studies 3 & 4 – Primary Care HW

A 47-year-old male patient (A) presents to your office c/o painful and bleeding defecation that started a

couple of days ago. Pt also states that he noticed some intermittent pruritus on his back. Pt comes

accompanied by his male husband of 45 years old (B), who states that he had noticed a painless “blister”

on his genital area, but he is not quite sure when it appeared.

Patient A: with no past or family relevant history and NKA

Patient B: PMH of seasonal allergic rhinitis and NKS. No other family or relevant history.

On complete physical examination:

On Patient A: a visible anal fissure in the inferior region of the sphincter was noted. It is also noticed

disseminated papules in the trunk and macules on palms and soles.

Patient B: A visible ulceration in the genital area noted and patient denies pain on palpation. No

adenopathy noted or reported by patient (B).

Since patients are a marital couple, you proceed with serological testing for each patient (A &B) because

you suspect a sexually transmitted disease. Both patients deny having or being treating in the past for

STD’s

Lab Results:

Patient A: Leukocytosis – Treponema (Positive) – Non-Treponema (Positive) – HIV (Negative) – Hepatitis

(Negative)

Patient B: Treponema (Positive) – Non-treponema (Negative) – HIV (negative) – Hepatitis (Negative)

——————— Do not include the above section in your paper. ONLY THE QUESTIONS BELOW——-

Please answer the following questions in APA format and include in-text references.

1) What serological lab works would you order to obtain the above results? (Be specific with the lab

names)

2) What is the diagnosis for Patient A?

3) What is the diagnosis for Patient B?

4) What would it be the differential diagnosis for patient A and patient B?

5) How are you going to treat Patient A? (Be specific and include the time of treatment)

6) How are you going to treat Patient B? (Be specific and include the time of treatment)

7) What would be the possible cause of this infection if both patients did not have any sexual encounter

outside their relationship in the last year?

ORDER CUSTOM, PLAGIARISM-FREE PAPER

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.