Case #1 A 74 year old female complains of watery, yellowish vaginal discharge fo
ID: 10080 • Letter: C
Question
Case #1A 74 year old female complains of watery, yellowish vaginal discharge for the past 3 weeks. She is otherwise in good health and without any major cardiovascular disease. Vaginal exam is remarkable for a thin and pale vagina. Vaginal wet-mount microscopy shows elevated white blood cells but no bacteria. Potassium hydroxide (KOH) prep is negative.
1. What is the most likely cause for her condition?
2. What is the most appropritate treatment at this time?
Case #2
A 24 year old male presents to your clinic. He stated: "I am having a hard time, you know, getting my penis hard." He denies any past medical, surgical, or significant family history. Physical exam is unremarkable as are his laboratory values. Ancillary tests are noncontributory.
1. What is the medical term used to describe this condition?
2. The most common cause for this condition in a 24 year old male without a history of spinal cord trauma or neurological disease is_.
3. List five commonly presctibed medications that may predispose the patient to this condition.
4. List and explain the contents of semen.
Explanation / Answer
Case #1 1. Most likely cause is a fungal infection from Candida Albicans, more commonly known as a yeast infection. Since a bacterial infection has been ruled out by the KoH prep and wet-mount microscopy, a yeast infection would account for the yellowish discharge. However, there would be other symptoms associated with a yeast infection, such as severe vaginal itching and possibly a fishy odor. 2. Topical treatment of non prescription antifungal drugs like Clotrimazole (Lotrimin), or an oral dose of fluconazole (Diflucan). Case #2 1. Erectile Disfunction (ED) or male impotence. 2. Anxiety is the most common cause in younger males. 3. Antidepressants: Prozac, Zoloft; Antihistamines: Tagamet, Zantac; Hypertension meds: Esidrix, Diuril. 4. Contents of semen: approximately 90% seminal fluids; secreted by seminal vescicles, prostate gland and a small amount from the bulbourethral glands. Purpose of seminal fluid: protect sperm in the slightly acidic environment of the female reproductive tract while offering nutrition to sperm in the form of fructose. The mucus and protein grant a cohesive texture to contain the sperm and aid in mobility. And of course, the sperm, or spermatozoa is the motile haploid male gamete that fertilizes the ovum to form a zygote.
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