[Solved] week 2 DB response

Assignment Prompt & Instructions

see attachment

– a year ago

**files (1)**

– ## Week2DBresponse–.pdf

**## Week2DBresponse–.pdf**

Infe
ctio
n

Description Presentation
Causes/Risk

Factors
Treatment per

CDC Additional Info

Can
dida

Fungal
infection
(yeast)

Vulvar
itching, thick
white
discharge

Antibiotics use,
diabetes,
pregnancy, tight
clothes

Fluconazole
150 mg PO
single dose

Not sexually
transmitted

BV
Bacterial
vaginosis

Thin gray
discharge,
fishy odor

Douching,
multiple partners,
new sex partner

Metronidazole
500 mg PO
BID x 7 days

Not an STI, but
related to sexual
activity

Chl
amy
dia

Bacterial STI

Often
asymptomatic,
discharge,
dysuria

Unprotected sex,
<25 yrs, multiple
partners

Doxycycline
100 mg BID x
7 days

Screen all
sexually active
females <25

Gon
orrh
ea

Bacterial STI
Purulent
discharge,
pelvic pain

Same as
chlamydia

Ceftriaxone
500 mg IM +
doxycycline

Often co-infected
with chlamydia

Tric
hom
onas

Protozoan
STI

Frothy
yellow-green
discharge,
odor

Unprotected sex,
multiple partners

Metronidazole
2g PO single
dose

Treat both
partners

Cer
vicit
is

Inflammation
of cervix
often due to
STI

Bleeding,
discharge,
pelvic pain

Chlamydia,
gonorrhea

Treat based on
causative
organism

Can lead to PID

PID

Infection of
upper
reproductive
tract

Pelvic pain,
fever, cervical
motion pain

Untreated STIs
Ceftriaxone +
doxycycline +
metronidazole

Risk for
infertility

HIV

Virus
affecting
immune
system

Fever, fatigue,
weight loss

Needle sharing,
sex, mother-to-
child

Antiretroviral
therapy (ART)

Lifelong
management

Syp
hilis

Bacterial STI
(Treponema
pallidum)

Chancre, rash,
systemic
symptoms

Sexual contact
with infected
person

Penicillin G
benzathine IM

Multiple stages;
test with RPR/
VDRL

Table 2: STI Knowledge Questions

SOAP Note – Tina, 27-year-old Female

Subjective:

Chief Complaint (CC):
“My vagina is burning, and I have painful blisters.”

HPI (OLDCARTS):

Hep
B

Liver
infection due
to HBV

Fatigue,
jaundice,
nausea

Sexual contact,
needle use

Supportive,
antivirals for
chronic cases

Vaccine available

Hep
C

Liver
infection due
to HCV

Often
asymptomatic,
may cause
fatigue

Blood-to-blood
contact, needle
sharing

Direct-acting
antivirals
(DAAs)

No vaccine;
chronic if
untreated

HS
V

Herpes
simplex virus
(type 1 or 2)

Painful
vesicles/
ulcers, fever

Sexual contact
Acyclovir,
Valacyclovir

Recurrent; no
cure, only
symptom
management

Question Answer

Name 10 Risk Factors for
contracting STIs and HIV

Unprotected sex, multiple partners, new partner, age <25,
MSM, history of STIs, drug use, sex work, inconsistent
condom use, partner with STI

Name 5 safer sex practices
Use condoms, limit partners, regular testing, mutual
monogamy, avoid sex under influence

Can HIV be transmitted
through sweat, saliva, and
tears?

No. HIV is not transmitted through sweat, saliva, or tears due
to insufficient viral load

Name 2 types of intercourse at
highest risk for contracting
HIV

Anal sex (receptive), vaginal sex (receptive)

Why are women more
susceptible to HIV in male-to-
female transmission?

Larger mucosal surface area exposed, higher viral load in
semen, potential microtears during sex

• The patient presented with a C/C of vaginal burning and painful blisters that began 3 days
ago. The area of concern is in her left labia minora. The patient describes that blisters as
painful and having a burning sensation with visible fluid-filled vesicles. Friction, urination,
and tight clothing worsen the pain. The patient describes relief with cool compresses, and
loose clothing. The discomfort is constant with intermittent sharp pain. She rates the pain a
6/10.

Medical History:

• no previous medical history

• no known allergies to drugs, food, or environmental factors

• no recent illnesses or hospitalizations

• vaccinations are up to date

Surgical History:

• No prior surgical history

Social History:

• #2 sexual partners in the last 6–12 months

• Use of protection (condoms)

• Tobacco, alcohol, recreational drug use, x2 a month socially

• sexual practices (oral, vaginal, anal)

Medications:

• Currently not on any medication

Allergies:

• NKDA (No Known Drug Allergies)

Objective:

Vital Signs:

• Temp: 98.6°F

• HR: 76 bpm

• BP: 112/70

• RR: 16/min

• SpO₂: 98% RA

Physical Exam:

• Genital Exam: Multiple small grouped vesicles on an erythematous base noted on the left
labia minora, tender to palpation. No foul-smelling discharge. No cervical motion tenderness.
No inguinal lymphadenopathy.

• Other Systems: Normal

Point of Care Testing (POCT):

• HSV PCR swab from lesion: High sensitivity and specificity for HSV-1 and HSV-2 (CDC,
2021)

• HIV rapid test: Recommended for new STI evaluation

• Urine NAAT for gonorrhea and chlamydia: Evaluate for co-infections

• Syphilis RPR and Hepatitis B/C screening: Per CDC recommendations for STI screening

Assessment/Diagnosis:

Presumptive Diagnosis:

• Genital Herpes Simplex Virus (HSV) Infection – ICD-10: A60.9

Rationale:

• Classic presentation of painful, fluid-filled vesicles on erythematous base, localized on labia
minora, recent unprotected sex, no previous known episodes.

Differential Diagnoses:

1. Contact Dermatitis: Less likely—symptoms typically bilateral and not vesicular.

2. Chancroid: Rare in the U.S.; painful ulcers with ragged borders, not grouped vesicles.

3. Syphilis (Primary): Typically a painless chancre; not vesicular.

Plan:

Pharmacologic Treatment (Assuming HSV PCR Positive):

• Acyclovir 400 mg tablet PO TID for 10 days

Patient Education:

• Medication Use: Take all medication as prescribed, even if symptoms improve early.

• Side Effects: May include nausea, headache, dizziness.

• Transmission: Avoid sexual activity until lesions are fully healed. HSV can be transmitted
even when asymptomatic.

• Safe Sex: Use condoms consistently to reduce recurrence transmission risk.

• Partner Notification: Partners should be informed and may need testing.

• Chronic Management: Discuss suppressive therapy if recurrences occur frequently (>6/
year).

Non-Pharmacologic Management:

• Keep area clean and dry.

• Use sitz baths and loose clothing.

• Apply cool compresses to soothe discomfort.

Follow-Up:

• Return to clinic in 1–2 weeks or sooner if symptoms worsen.

• Retesting or management for other STI test results as they return.

Complications of Non-Treatment:

• Increased risk of HIV transmission

• Severe and prolonged outbreaks, especially in immunocompromised patients

• Psychological distress

• Neonatal HSV transmission risk in future pregnancies

– Table 2: STI Knowledge Questions
– SOAP Note – Tina, 27-year-old Female
– Subjective:
– Objective:
– Assessment/Diagnosis:
– Plan:
– Pharmacologic Treatment (Assuming HSV PCR Positive):
– Patient Education:
– Non-Pharmacologic Management:
– Follow-Up:
– Complications of Non-Treatment:

**## Week2DBresponse–.pdf**

Infe
ctio
n

Description Presentation
Causes/Risk

Factors
Treatment per

CDC Additional Info

Can
dida

Fungal
infection
(yeast)

Vulvar
itching, thick
white
discharge

Antibiotics use,
diabetes,
pregnancy, tight
clothes

Fluconazole
150 mg PO
single dose

Not sexually
transmitted

BV
Bacterial
vaginosis

Thin gray
discharge,
fishy odor

Douching,
multiple partners,
new sex partner

Metronidazole
500 mg PO
BID x 7 days

Not an STI, but
related to sexual
activity

Chl
amy
dia

Bacterial STI

Often
asymptomatic,
discharge,
dysuria

Unprotected sex,
<25 yrs, multiple
partners

Doxycycline
100 mg BID x
7 days

Screen all
sexually active
females <25

Gon
orrh
ea

Bacterial STI
Purulent
discharge,
pelvic pain

Same as
chlamydia

Ceftriaxone
500 mg IM +
doxycycline

Often co-infected
with chlamydia

Tric
hom
onas

Protozoan
STI

Frothy
yellow-green
discharge,
odor

Unprotected sex,
multiple partners

Metronidazole
2g PO single
dose

Treat both
partners

Cer
vicit
is

Inflammation
of cervix
often due to
STI

Bleeding,
discharge,
pelvic pain

Chlamydia,
gonorrhea

Treat based on
causative
organism

Can lead to PID

PID

Infection of
upper
reproductive
tract

Pelvic pain,
fever, cervical
motion pain

Untreated STIs
Ceftriaxone +
doxycycline +
metronidazole

Risk for
infertility

HIV

Virus
affecting
immune
system

Fever, fatigue,
weight loss

Needle sharing,
sex, mother-to-
child

Antiretroviral
therapy (ART)

Lifelong
management

Syp
hilis

Bacterial STI
(Treponema
pallidum)

Chancre, rash,
systemic
symptoms

Sexual contact
with infected
person

Penicillin G
benzathine IM

Multiple stages;
test with RPR/
VDRL

Table 2: STI Knowledge Questions

SOAP Note – Tina, 27-year-old Female

Subjective:

Chief Complaint (CC):
“My vagina is burning, and I have painful blisters.”

HPI (OLDCARTS):

Hep
B

Liver
infection due
to HBV

Fatigue,
jaundice,
nausea

Sexual contact,
needle use

Supportive,
antivirals for
chronic cases

Vaccine available

Hep
C

Liver
infection due
to HCV

Often
asymptomatic,
may cause
fatigue

Blood-to-blood
contact, needle
sharing

Direct-acting
antivirals
(DAAs)

No vaccine;
chronic if
untreated

HS
V

Herpes
simplex virus
(type 1 or 2)

Painful
vesicles/
ulcers, fever

Sexual contact
Acyclovir,
Valacyclovir

Recurrent; no
cure, only
symptom
management

Question Answer

Name 10 Risk Factors for
contracting STIs and HIV

Unprotected sex, multiple partners, new partner, age <25,
MSM, history of STIs, drug use, sex work, inconsistent
condom use, partner with STI

Name 5 safer sex practices
Use condoms, limit partners, regular testing, mutual
monogamy, avoid sex under influence

Can HIV be transmitted
through sweat, saliva, and
tears?

No. HIV is not transmitted through sweat, saliva, or tears due
to insufficient viral load

Name 2 types of intercourse at
highest risk for contracting
HIV

Anal sex (receptive), vaginal sex (receptive)

Why are women more
susceptible to HIV in male-to-
female transmission?

Larger mucosal surface area exposed, higher viral load in
semen, potential microtears during sex

• The patient presented with a C/C of vaginal burning and painful blisters that began 3 days
ago. The area of concern is in her left labia minora. The patient describes that blisters as
painful and having a burning sensation with visible fluid-filled vesicles. Friction, urination,
and tight clothing worsen the pain. The patient describes relief with cool compresses, and
loose clothing. The discomfort is constant with intermittent sharp pain. She rates the pain a
6/10.

Medical History:

• no previous medical history

• no known allergies to drugs, food, or environmental factors

• no recent illnesses or hospitalizations

• vaccinations are up to date

Surgical History:

• No prior surgical history

Social History:

• #2 sexual partners in the last 6–12 months

• Use of protection (condoms)

• Tobacco, alcohol, recreational drug use, x2 a month socially

• sexual practices (oral, vaginal, anal)

Medications:

• Currently not on any medication

Allergies:

• NKDA (No Known Drug Allergies)

Objective:

Vital Signs:

• Temp: 98.6°F

• HR: 76 bpm

• BP: 112/70

• RR: 16/min

• SpO₂: 98% RA

Physical Exam:

• Genital Exam: Multiple small grouped vesicles on an erythematous base noted on the left
labia minora, tender to palpation. No foul-smelling discharge. No cervical motion tenderness.
No inguinal lymphadenopathy.

• Other Systems: Normal

Point of Care Testing (POCT):

• HSV PCR swab from lesion: High sensitivity and specificity for HSV-1 and HSV-2 (CDC,
2021)

• HIV rapid test: Recommended for new STI evaluation

• Urine NAAT for gonorrhea and chlamydia: Evaluate for co-infections

• Syphilis RPR and Hepatitis B/C screening: Per CDC recommendations for STI screening

Assessment/Diagnosis:

Presumptive Diagnosis:

• Genital Herpes Simplex Virus (HSV) Infection – ICD-10: A60.9

Rationale:

• Classic presentation of painful, fluid-filled vesicles on erythematous base, localized on labia
minora, recent unprotected sex, no previous known episodes.

Differential Diagnoses:

1. Contact Dermatitis: Less likely—symptoms typically bilateral and not vesicular.

2. Chancroid: Rare in the U.S.; painful ulcers with ragged borders, not grouped vesicles.

3. Syphilis (Primary): Typically a painless chancre; not vesicular.

Plan:

Pharmacologic Treatment (Assuming HSV PCR Positive):

• Acyclovir 400 mg tablet PO TID for 10 days

Patient Education:

• Medication Use: Take all medication as prescribed, even if symptoms improve early.

• Side Effects: May include nausea, headache, dizziness.

• Transmission: Avoid sexual activity until lesions are fully healed. HSV can be transmitted
even when asymptomatic.

• Safe Sex: Use condoms consistently to reduce recurrence transmission risk.

• Partner Notification: Partners should be informed and may need testing.

• Chronic Management: Discuss suppressive therapy if recurrences occur frequently (>6/
year).

Non-Pharmacologic Management:

• Keep area clean and dry.

• Use sitz baths and loose clothing.

• Apply cool compresses to soothe discomfort.

Follow-Up:

• Return to clinic in 1–2 weeks or sooner if symptoms worsen.

• Retesting or management for other STI test results as they return.

Complications of Non-Treatment:

• Increased risk of HIV transmission

• Severe and prolonged outbreaks, especially in immunocompromised patients

• Psychological distress

• Neonatal HSV transmission risk in future pregnancies

– Table 2: STI Knowledge Questions
– SOAP Note – Tina, 27-year-old Female
– Subjective:
– Objective:
– Assessment/Diagnosis:
– Plan:
– Pharmacologic Treatment (Assuming HSV PCR Positive):
– Patient Education:
– Non-Pharmacologic Management:
– Follow-Up:
– Complications of Non-Treatment: