penny is a \"wild child \" 20 year college student enjoying the freedom of being
ID: 68378 • Letter: P
Question
penny is a "wild child " 20 year college student enjoying the freedom of being away from home and in school with all the boys, when one evening after dinner she became very ill. she went to the urgent care complaining of nausea, vomiting, and intense abdominal pain that came on suddenly. As the P.A. took down her history, Penny shared that she was sexually active and had had at least 10 diffrent sexual partners that year. she was taking a an oral contraceptive, but was not using condoms.She also admits to being treated for STDs in the past including genital herpes, cervicitis, vulvovaginitis caused by chlamydia and syphilis. she currently was running a fever of 101.1 and her pulse was 78 beats per minute. respiration was up to 15 breaths per minute and her BP was high at 150/86. The provider decided to do a pelvic exam and discovered that penny was in a great deal of pain with abdominal guarding and rebound tenderness. Her cervix and uterus were enlarged and with abdominal guarding and rebound tenderness. Her cervix and vagina also were covered in a purulent white discharge. Samples of blood,urine, fecal, and vaginal discharge were taken for testing. A PAP smear was preformed and an ultrasound of the pelvic cavity was completed. The results showed that penny was not pregnant, did not have HIV , did not have appendicitis, but was positive for gonorrhea and chlamydia cultures. Given the above information about penny and the information you know about the female reproductive system answer the following questions : why would the provider want to be sure that penny did not have appendicitis? what specific signs and symptoms does penny have that indicates she has a pelvic inflammatory diease ? if you were her provider what would you say about her consequences of her sexual behavior and long term infertility in females? What was the point of the PAP smear and the HIV test?
Explanation / Answer
Q1. The provider wanted to be sure because nausea, vomiting, fever and abdominal pain are classic symptoms of acute appendicitis and they wanted to rule out this possibility.
Q2. The specific signs include abdominal guarding and rebound tenderness. The presence of a purulent white discharge in the cervix and vagina are prominent signs and symptoms which indicate pelvic inflammatory disease.
Q3. Having too many sexual partners and having sex without condoms could have serious implications with respect to sexual halth. Such diseases could induce chronic pelvic pain, infertility and even ectopic pregnancy.
Q4. A PAP smear checks the cells of the uterine lining. It is basically done to detect cervical cancer. HIV test was done by looking for any viral component in the saliva, serum or urine.
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